1. Should I Brace My Child’s Scoliosis?
Rigid brace treatment for adolescent idiopathic scoliosis is the most common non
operative form of scoliosis treatment. There are two primary biomechanical
theories adopted by brace treatment advocates. The first is that bracing will
passively unload the over compressed vertebrae and cartilaginous growth plates
to induce less wedging deformity in the apical region of the scoliosis.The second
is that scoliosis brace treatment causes trunk muscle contraction which produces
the in brace correction. Most biomechanics experts would agree that spinal
braces do not produce muscle contractions that are corrective and that all
correction is produced by passive forces acting upon the surfaces of the ribcage
and pelvis.
If we assume that passive external forces cause the in brace correction then
what makes us think that when the passive force is released that the spine will
stay corrected? The answer is simple, it won’t. Muscles that support the spinal
column in gravity control the spines position. Children with adolescent idiopathic
scoliosis do not have abnormal anatomy, wedged deformity. The muscles
primarily type I spinal multifidus have been found to be of different lengths in
thoracic curvature most noticeably at the apical regions in the spine. The muscle
imbalance derives from the neurological control in the brainstem and spinal cord
responsible for creating spinal balance in gravity. Therefore applying a scoliosis
brace to force the spine straighter will have no impact on the muscle length
differences or the neurological command centers. In addition the added
gravitational support produced by the scoliosis brace will weaken the antigravity
system yielding less support produced independent of the brace. Most post brace
studies have identified progression after the brace has been weaned. Scoliosis
brace experts have adamantly recommended that all braced children should
perform spinal exercises routinely while weaning from a scoliosis brace to try and
prevent this collapse process once the brace comes off.
My concern with this process is that it doesn’t make any sense. Studies
performed in the research paper (OPTIMIZATION OF SKELETAL
CONFIGURATION:STUDIES OF SCOLIOSIS CORRECTION BIOMECHANICS
GEORGE T. WYNARSKY and ALBERT B. SCHULTZ*Department of Mechanical
Engineering and Applied Mechanics, University of Michigan, Ann Arbor) indicate
several facts regarding scoliosis brace treatment. Muscle forces were more
effective than brace forces in correcting all aspects of a thoracic scoliosis. Under
all circumstances examined, brace forces caused small left lumbar and left high
thoracic secondary curves, and produced only modest spine de-rotations. The
study goes on to state that in reality the brace treatment forces had very little if
any affect on the axial rotation, the most prevalent biomechanical finding linked
to progression and ribcage deformity in children with idiopathic scoliosis.
So to ask yourself the question, Should I brace my child’s scoliosis? I would
have to answer, NO! A better solution would be to enroll your child in a spinal

2. rehabilitation program the second you find out your child has a spinal curvature.
There are many options available but I feel the neuromuscular spinal
rehabilitation programs are superior to standard active rehabilitation exercises
primarily because most active programs, like Schroth, prescribe spinal brace
treatment in addition to performing exercises which unfortunately is a
contradiction in treatment philosophy because no matter how a scoliosis brace is
applied it is biomechanically flawed. CLEAR scoliosis treatment is gaining
traction because of its innovative core of doctors that utilize a very sophisticated
scoliosis rehabilitation approach.
About the Author:
Treating Scoliosis.com offers alternatives to scoliosis surgery when treating
scoliosis of the spine in adults and children. Visit
http://www.treatingscoliosis.com for more information on non-invasive scoliosis
treatment plans.