For every new bracing patient, I review the importance of brace wear compliance at the measuring appointment, then again at the fitting, and really every time I can say it, I remind them how important it is to wear their brace.  I talk about the BrAIST study, that shows the direct correlation between brace compliance and preventing progression. I talk about this opportune window of time we have to influence their curves. I talk about how, while it seems like forever, they will not be wearing their brace forever. Some patients take it to heart, while others do not. 

None of my patients enjoy wearing a brace. It is not fun. But trust me, with time it gets easier. With consistence it becomes a part of your everyday life. You’ll start to feel weird if you don’t have your brace on.  It doesn’t happen overnight, but it does happen.

Unfortunately, no matter how much I try to explain the importance of compliance, these are still teens we are talking about here. There is so much happening in their world socially, that sometimes having to wear a brace seems like a death sentence. They’ll absolutely refuse to wear their brace to school. Even though our 3D CAD-CAM style braces are minimally apparent under clothes, I understand that many feel like the whole world can see it. I can say from experience, after wearing a brace for the 2-week break-in period to experience what my patient’s do, that I felt like everyone knew. I had it on at work and felt like everyone could tell and often found myself having to explain  why I was wearing a brace. The truth is, even my co-workers had to ask if I was wearing my brace. You really can’t notice it unless, as I tell my patients, someone hugs you or punches you in the stomach! My point is, no one pays as much attention to you as you think they do. And honestly, if they see it, who cares? Every kid has their own battles and is self-conscious of some aspect of their life. But if we could all just not worry about what others think, this life would be so much easier. 

Below are examples of three patients I saw this week. The first has stopped wearing his brace all-together and is no longer doing his Schroth PT. He will not wear his brace to school and then when he sporadically puts it on, it is not comfortable. Well it won’t be comfortable until you are consistent with wearing it. It’s like weaning it in every random time you decide to wear it. You have to build up tolerance.  By his choosing not to do his exercises and not to wear his brace, his curves have progressed 6 degrees and 5 degrees from his initial evaluation. Curve progression, after going through all it takes to learn Schroth PT and be fitted with a brace, is the last thing we want to see. The plan for him is to start this therapy again and begin wearing his brace.

The second patient is doing his Scroth PT but refuses to wear his brace to school, giving him only 14 hours brace time daily. His curves have remained stable, but imagine what could happen if he would only wear his brace more hours in the day! It isn’t bad to maintain curves. Sometimes that is all that can be achieved with bracing. But his curves having maintained with minimal wear, leads to the belief that potential curve correction could be attained if he would just wear it more.

The third patient is very compliant, doing his Schroth exercises regularly and wearing his brace for 22 hours/day. His thoracic curve has decreased 5.4 degrees and lumbar down to 12 degrees, 50% of what it was at initial evaluation!  His philosophy about wearing his brace is great: “I don’t like wearing my brace. But I just suck it up and wear it. I know it won’t be forever.” 

Again, no one likes to wear a brace. But the best way to tackle it is to face it head on, embrace it, and remind yourself that it won’t be forever.

-KC Wheeler, CPO