POSTURE BRACES – DO THEY WORK ?
For those of you who know me the answer was never going to be a short easy yes or no ! Sooooo bear with me as I explain my views on these (relatively) popular posture braces.
A Google search shows many options of this style of shoulder or posture brace.
Their goal is to ‘pull your shoulders back’ to encourage you to stand taller and thereby reduce your ‘ rounded shoulder appearance ‘
These braces therefore rely on the shoulder blades being the cause of your rounded appearance – and secondly the humeral head = ball part of the shoulder, being pulled backwards ( or into a posterior glide in anatomical terms).
So why is this not a great idea you ask ? What if the shoulder blades are only forward as a consequence of your spine being pulled into a forward bend ( or flexion) ?
The brace doesn’t necessarily pull your spine into extension = straighter. It may, if you haven’t been stuck in your rounded habit for a long period of time, BUT if your thoracic spine is very stiff and your neck is used to being pushed forward , then just pulling your shoulder blades backwards could easily aggravate your neck or back pain by increasing the loading on soft tissue structures.
What if I own one of these braces and want to use it?
My tips would be to :
a) stretch your thoracic spine into multiple planes of movement before you wear the brace. Try stretches into extension, then into flexion making every bone in your spine move – eg cat cow exercises in hands and knees, then add some rotation exercises e.g. thread the needle in hands and knees or sitting trunk rotation
b) Then once you have stretched, practice finding your neutral upright posture before putting your shoulder brace on.
c) Then aim to lengthen through your spine to SOFTEN THE LOAD on the brace as it crosses the front of the shoulder. What if your thoracic or ribs is not your driver?
Part 2 of the reason I am not in love with these braces is – what if your ‘rounded shoulders’ is due to your ribs or spine being loaded from another region of your body? In Dr LJ Lee’s ConnectTherapy model – our goal is to search for your drivers – of your pain, or your postures, or your movement patterns through space. Sooooooooo if you stand with a rounded spine and forward head posture that is related to the way your foot or pelvis is positioned or the way these areas move through space during a task – THEN no amount of passive bracing will ultimately change the way your thoracic spine holds itself in space. If anything there is the risk you aggravate either your neck or thoracic spine or create another region of your body to be under increased load and potentially causing it to become a pain source.
If you follow the above exercises we suggested above PLUS perform corrective exercises for your driver, THEN maybe this brace could be used as a reminder brace for short term use. The goal would be to not ‘hang in the brace’ but lift yourself up and into the brace.
Part 3 of my reason is just that posture is not static. If you are bracing your shoulder blades back into this restricted retracted position – then what if you suddenly need to reach forward or stretch to catch something or extend the garden in the far corner of your vege patch. We should always be aiming to train our postures through space, and so re-teaching strategies of movements. Unfortunately, the sales pitch of ‘ pop this brace on and you will passively re-teach your body how to stand / sit straight’ is flawed.
Part 4 of this idea is our nervous system and the power of Intention .
Part 4 of this idea is that our nervous system controls how we exist in space and so without intentional exercises then we do not engage this vital aspect of postural / strength re-education.
So in summary :
Stretches / range of movement exercises WITH INTENTION to your goal is your start point.
Then work your driver with exercises prescribed for you by your physio
Then apply the brace and use it for short period WITH INTENTION and focus on your posture – rather than just put it on and forget it.