Should you wear a brace, support or corset?

If you are over a certain age you may remember quite commonly seeing people walking around in big foam neck braces. It was the accepted first form of treatment for whiplash injuries, such as from a car accident. These days you will see people walking around wearing huge moon boots following ankle sprains and even fractures. Its also common to see sports people wearing a knee or wrist support.

The thinking on weather or not  to use supports (and even what type of support) for injured body parts has changed a lot in recent years. Our understanding of the healing process influences decisions as does the published research.  We now know that actively using injured parts helps promote normal healing and reduce scaring. We also know that sometimes it is necessary to immobilise in order to help healing.

There is a lot of controversy over the use of braces following injury. There has also been a lot of research. Which is both helpful and confusing – every time one set of researchers prove one thing, another lot come along and debunk it!

What the evidence says.

The manual therapy and orthopedic professions have been doing U turns on this issue so fast that their heads are spinning. I started writing this post from the point of view that we should never wear a brace but had to change my mind when I read some of the more recent published data. What exactly are the factors to consider when trying to decide if a brace is a good idea?

  1. It does depend on how serious the injury is. You will need a professional examination to determine this. It is never a good idea to simply get onto the internet and order yourself a neck/back or even knee or ankle brace. The simple reason for this is that some injuries need to move to heal and others may benefit form some form of support.
  2. A brace is only ever a short term solution. By short term I mean no more than 10 days from the time of the injury occurring.  Research backs me up!
  3. The research also shows that actively using and stretching injured tissue promotes and speeds up healing. However this is a little controversial, mainly because the term stretching can mean a multitude of different things. It is best to seek professional advice as to what would suit you and your injury.

Why I don’t like braces, supports and collars.

  1. Your body is wonderful self healing machine. When you have an injury you have intricate systems such as immune and inflammatory systems that get to work immediately to fix you. You are an amazing self healer! Left to its own devises your body will fix most injuries without much help from you.
  2. You are also inherently lazy. Humans are lazy. This makes sense from an evolutionary point of view; when food was hard to come by you had better not waste energy using muscles that you don’t need to. this means that if you pop a support on an injured body part the muscles that normally support it will switch off and take a brake. Resulting in atrophy (wasting away) within a surprisingly short period of time.
  3. Unfortunately you have a brain. Your brain is in control of everything that happens in your body so you do need it in order to manage your inflammatory response to injury. However your brain also has a tendency to overthink things – it will weight up things like your beliefs and previous experience of injury. It will consider what the “experts” have said. It will then come to some interesting conclusions. I have written a lot about this in this blog post.
  4. Magic knickers/spanx are the work of the devil! Not only are they next impossible to get into but if worn for more than half an hour a day they will do the back and pelvic muscles no favours at all. See point number 2.

Of interest: Cervical collar efficacy

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