Better Braces

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How To Acquire Better Braces

(Based On Personal Experience)

This advice is intended for someone seeking long term bracing solutions. Long term bracing is usually for joints with chronic instability unlikely to be corrected with physical therapy or surgical repair.

For bracing a new joint start here, or skip to step 3 for already braced joints.

  1. Focus on a single body part 
    • Example) upper limb, lower limb, or torso
    • I know it’s hard to choose when every joint seems like a problem… but you have to prioritize or you will overwhelm yourself and the healthcare providers.
  1. Determine which joint to brace
    • For patients with widespread instability figuring out which joint to brace can be very confusing
    • When looking for a new brace, have a medical professional examine all the neighboring joints to the one that hurts/ dislocates the most.
    • Test out bracing neighboring joints to see how the limb and body are affected as a whole.
    • Example) After a year of my thumb resting in a subluxed position, I finally went to the OT to get a new thumb brace. When my hand was examined they was found that my wrist instability was worse than my thumb. When I was given a properly fitting wrist brace, I was able to use my thumb again. Adding stability to my wrist ended up fixing the problem with my thumb.

Start here for already braced joints.

  1. Work with an orthotist who regularly does custom bracing and modifies off the shelf options
  1. Figure out which motion to restrict, support, and allow 
    • Your doctor, physical therapist, and/ or orthotist will have a large say in how this goes, but they should be willing to listen to your input and collaborate with you. If your health care provider isn’t working with you, then it might be time to seek care elsewhere.
    • If you have a choice, it’s better to support motion than to restrict it.
    • It can be helpful to write a list for the orthotist describing your dream brace. Think about how you would optimally like restriction, support and mobility. You can even make a video to show them exactly how you want to be able to move and how you want to resorted. A video is helpful so your team can consult with colleagues and revisit the situation without you having to be there.
  1. Review your options comprehensively and try and choose a brace that has potential to be modified and adjusted. 
    • Consider insurance factors, if you can only get one brace per a certain number of years sometimes it’s worth it to try a more comprehensive and expensive option.
    • Consider finical factors, but do determine your ideal decision regardless of cost. Before totally dismissing an optimal but costly brace make sure you consult with all family, local charities, and team of doctors to try and find a way to pay for the better brace you really need need. I’ve  been lucky so far and usually end up risking the cost up front and getting reimbursed at a later date through my insurance. The downside to this process is the excessive amount of time, energy, and paperwork it takes to get these things covered and when your unwell and not functioning is usually when you need the brace the most. The cyclical nature of these EDS problems are a major barrier to our wellness.
  1. Adjust to the new brace slowly! 
    • Receiving a good brace can make you feel invisible. Be careful not to overdue it. Remember it takes time to properly adjust. As exciting as it is to be able to function again, you don’t want to end causing yourself another set back.
  1. Expect to return to the orthotist at least several times over the next six months.As your body adjusts to the new stability, your alignment and muscle use can change significantly.
    • When making adjustments, consider the ability to reverse experimental adjustments. When your testing something out it’s always better to make sure it’s removable/ irreversible or at least something that won’t damage the entire brace if you end up needing to change it again.
    • If the brace is uncomfortable, causing additional pain or problems you should return for adjustments.
    • Be specific about what’s working and what’s causing problems.
    • You can wright a list of activities that the brace is interfering with. It’s hard to find a brace that works well for everything, so think about what you need the brace most for and focus on making the brace functional for that activity.
    • Example) My ankle braces drive me crazy when I’m sitting or lounging, but they work well when I’m walking.  After an entire year of barely being able to walk without a boot cast, I still consider them one of my favorite braces.
    • Don’t worry about being a burden to the bracing company with all your adjustments… that’s their job and if your polite and patient with their efforts  they should be happy to help.
  1. Be persistent about attaining comfort and function 
    • If the brace is uncomfortable or causing additional pain or problems return for adjustments
    • Don’t worry about being a burden to the bracing company with all your adjustments… that’s their job and if your polite and patient with their efforts  they should be happy to help.

! Bracing Precautions !

  • Bracing one joint transfers force onto the neighboring joints.
  • Make sure the brace isn’t damaging neighboring joints.
  • Do extra physical therapy and strengthening for braces joints to help decrease the risk for muscle atrophy
Version 2
My favorite brace: a custom CTO allowing me to safely avoid a major spinal fusion.

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