Scoliosis Bracing

At Scottish Rite for Children, our multidisciplinary team of experts provide the best care to every child. For a patient with scoliosis, treatment options depend on the patient and the severity of the curve.

Bracing is the most common type of treatment for scoliosis at Scottish Rite. There are many factors our team evaluates to determine the use of a scoliosis brace such as the severity of the scoliosis and whether the child is still growing. Bracing is a treatment that can be used to help stop the curve from progressing. Every brace is custom made by our Orthotics department. 

To help you and your child through this process, we have experts from different specialties, available to help in all aspects of care. Below are the teams involved with a patient who is needing a scoliosis brace:
  • Orthotics
  • Psychology
  • Physical Therapy
  • Child Life

RESOURCES FOR OUR PATIENTS

ORTHOTICS

The Orthotics department at Scottish Rite for Children makes custom-made braces for our patients. With bracing being the most common type of treatment for scoliosis, this team works closely with our doctors to provide the best care to this patient population. 

Quick Links to Educational Videos
Daytime Bracing for Scoliosis
Behind-the-Scenes of the Orthotics Department

For any questions, please contact our Orthotics department at 214-559-7440.
Your scoliosis brace is made to hold your back as straight as possible while you are growing to keep the curve from increasing in size. To do this, it must be worn tightly for many hours every day.

Putting on the Brace
Wear a tight‐fitting undershirt. Open up the brace and slide it around your body. Move the brace up or down until the waist rolls fit in your waist between your ribs and the tops of your hip bones. Tighten the straps to the marks your orthotist drew on the straps. If the undershirt wrinkles or has seams, pull on the fabric to smooth them out. 

Wear Schedule
Getting used to wearing your brace will take some time. Your orthotist will instruct you about starting to wear your brace. The brace needs to be worn day and night as prescribed to be effective. You may take it off to shower, play sports or dance.

Taking Care of Your Skin
The brace pushes firmly on your body and will cause redness of your skin. Over time, the skin in the pressure areas may become darkened and tougher. These changes are temporary and may improve brace comfort. If you develop a sore or you have consistent pain from the brace, it needs adjustment.

Taking Care of the Brace
To help prevent skin irritation, the inside of the brace must be cleaned at least once a week. Use a cloth to wipe the brace clean using soap and water or rubbing alcohol.

Other Resources
Wearing Your Scoliosis Brace
Scoliosis Night Brace
Shirts for Braces
Each custom-made brace includes a dime-sized sensor that is placed inside which monitors temperature. 

Standard of Care
All patients receive a dime size sensor installed in their brace that monitors the number of hours per day the brace is worn using a temperature monitor. The sensor is downloaded at each visit to give you feedback on your progress toward meeting your wear schedule goals. It is helpful to see your progress and also allows our team to identify ways to help and encourage by identifying trends.

Brace RiteTM App
An app created by our experts, Brace RiteTM was created to give patients and families the ability to know real-time the progress/number of hours a child has worn their brace. Other details on the app:
  • Track brace wear over days, weeks and months.
  • The ability to check in on brace wear throughout the day.  
  • Allows each patient to see their own real time progress to help motivate and encourage brace wear.

PSYCHOLOGY

At Scottish Rite for Children, we have a team of pediatric psychologists that work with patients who have scoliosis on issues including:   
  • Screening for mental health concerns, such as anxiety or depression. 
  • Trouble with brace wear compliance. 
  • Adjusting to brace wear.  
We can also help problem solve issues between teens and parents or teens and peers. We are present during your appointment with your doctor to talk with you and offer support at that appointment. If there are concerns that need additional evaluation, please call 214-559-7666. 
Patient with psychologist in clinic
At first, wearing a brace can be uncomfortable. As you wear your brace more, you will get used to the feeling of the brace and it will become less and less uncomfortable. We would like to provide some skills for coping with the physical discomfort related to brace wear.

Distraction  
Focusing your attention on something else can help with physical discomfort. You can distract yourself with games, activities, talking with friends, going on a walk or any other activity that keeps your mind and body busy. 

Deep Breathing
Breathing exercises have been found to be effective in reducing physical discomfort, anxiety and muscle tension. These exercises help you calm your body and mind. Here are some techniques to try: 

Square Breathing
Print the square to do this exercise.
  • Start at the bottom right of the square (Labeled Start Here!). 
  • Breathe in for four counts, as you trace the first side of the square. 
  • Hold your breath for four counts as you trace the second side of the square. 
  • Breathe out for four counts as you trace the third side of the square. 
  • Hold your breath for four counts as you trace the final side of the square. 
You just completed one deep breath! Keep practicing for at least 10 deep breaths.

Mindfulness
Being mindful is paying attention to what is happening in the present moment. This includes what you are thinking, feeling, hearing and experiencing. Research has shown practicing mindfulness has improved focus and decreased levels of stress, anxiety and depression for children and teens (Zenner, Hermleben-Kurz, and Walach, 2014). Here are some meditation exercises:
  • Mindfullness for Kids 
  • The Head Space App is excellent for all ages. The app and Netflix series offers a great series of guided meditation programs for anxiety, pain, sleep and many other topics!
Continuing Normal Activities
People do well with a routine, so keeping up with normal expectations and activities is very important. Even though you are wearing a brace, you can continue to do activities you enjoy, participate in family activities, and chores.
Starting brace wear for scoliosis may become a source of conflict between kids and parents. Learning how to resolve this conflict is a very important part of the brace treatment for kids and parents. Here are some general tips for resolving conflict:
  1. Identify how you and your child are feeling. Helping your child identify how they are feeling is the first step in reducing the intensity of emotions. Younger children may benefit from a feelings chart or worksheet - print our feelings worksheet
  2. Stay calm. Model the type of emotion regulation you would like your child to use. This could include keeping your voice tone and volume low, not overreacting and being mindful of body language. 
  3. Use “I” statements to communicate feelings. For example, “I feel mad when you tell me to put my brace on” or “I felt frustrated when we saw your brace wear report card.” 
  4. Identify the true source of conflict and brainstorm solutions. Help your child identify the problems and work together to come up with solutions. 
    • Are there other stressors for your teen? 
    • What else is going on that needs to be talked about or discussed?  
  5. With the help of the orthotist and psychologist, set reasonable expectations for brace wear. If those expectations aren’t met, set consequences that parents can follow through on. Work together to solve problems related to brace wear.
If your teen or family needs additional help with brace wear, the Psychology team is available to consult during your clinic visit. 
Part of getting yourself ready for wearing a new brace includes preparing yourself mentally. Sometimes friends, siblings or classmates have a lot of questions, or are curious about this new change. Dealing with questions from friends and family can sometimes be annoying, but it doesn’t have to be stressful. Here are some tips to help deal with friends and classmates.
  1. Show them your brace and talk about it. Sometimes that’s all it takes! If you feel comfortable enough, let them try it on. We often think people will judge or poke fun, but the opposite is often true. When peers learn more about your situation, they often become more supportive and helpful.
  2. Sometimes you don’t feel like talking about it, and that’s okay too. Just know that being open and talking to your friends about the brace is much easier than trying to hide or keep it a secret. Think about the brace like a tool, similar to eyeglasses that help you see, braces that help you keep your teeth straight or a knee brace to help you heal from an injury. The more you think about the brace as a normal part of life, the easier it will be to deal with.
  3. Feeling self-conscious about your brace? That is absolutely normal! Many times, we think our peers are very aware of our new brace, but the reality is that many times it is not noticeable underneath our clothes (especially during the winter months when we’re all covered up). Try tip #1 again, because sometimes talking about it helps us feel less self-conscious.
  4. Is your brace not up to par with your fashion sense? Are you or your friends artistic? Maybe engage your peers in helping you put together some outfits that make you feel good about wearing the brace, or have some friends help you add color and pizazz to your brace so that it’s more your style. Have fun with it!
  5. After all that, is someone still being mean or bullying you about your brace? Be sure to tell someone about it. It will be helpful to resolve the situation if a trusted adult is informed (parent, teacher, counselor). You don’t have to go through this alone.
  6. Become the expert. You are the one dealing with this situation, which may be unique to others. Learn what you can about scoliosis and brace wearing and teach others about it. This is also a good way to make it easier on yourself to talk to others about your medical condition, the brace itself and answer any other questions they may have.

PHYSICAL THERAPY

For patients who must wear a scoliosis brace, physical therapy can be an important part of their treatment. Our therapists are committed to helping children with their overall movement and function. 

Scoliosis-Specific Exercises 
Scoliosis specific exercise (SSE) is a treatment provided by a trained physical therapist to teach proper form for the exercises and progress the movements over time. Below are the two methods offered by our therapists:
  • BSPTS (Barcelona Scoliosis Physical Therapy School) Schroth-based method 
  • SEAS (Scientific Exercise Approach to Scoliosis) method 
Follow your physician’s advice for brace wear and recommendations for surgery. Curve-specific exercises improve posture but do not to take the place of surgery or a brace.

What is expected from the patient?
In order to change your posture, you are expected to do your exercises at home for 15-30 minutes, five days a week. Changing your posture is hard work and you have to be dedicated to the exercises. Parents, therapists or physicians cannot change the way you hold yourself while sitting, standing, eating and so forth. No one can change your posture but you.

Who can benefit from this treatment?
Scoliosis-specific exercises are an option for patients and families interested in additional treatment for mild to moderate idiopathic scoliosis curves or kyphosis. Children should be old enough to have the concentration and coordination required. 

What should be expected?
You will learn exercises and positions to hold yourself straighter. A Scottish Rite for Children physical therapist, trained in scoliosis-specific exercises, will provide instructions in the physical therapy department. If you live near the hospital, you may see a physical therapist for a total of 8 -12 hours over the course of 6 months. Each session will last 45-90 minutes. If you live far away, you may be able to attend an intensive program. Consult with a physical therapist for your own treatment plan. 

Research
  • Physiotherapeutic scoliosis-specific exercises (PSSE) may reduce curve progression, but the research is limited. Click here to learn more.
  • We are researching the effectiveness of PSSE at Scottish Rite. Click here to learn more. 

WATCH VIDEO >> Physical Therapy for Scoliosis
Patient working with a physical therapist

CHILD LIFE

Our child life specialists team work with patients to promote coping skills and help reduce fear during a clinic visit, procedure or in an outpatient setting. For children with a scoliosis diagnosis who wear a brace, we understand the challenges that come with this treatment plan. Below are the various ways our Child Life department can help this patient population:
  • Provide developmentally appropriate (based on age) diagnosis and treatment information.
  • Create a motivation plan to encourage brace wear compliance.
  • Create a personalized schedule for a more realistic brace wear plan based on child’s school and activities.
  • Brainstorm ways to talk about brace with siblings, friends, or peers at school.
  • Build coping strategies for living with a scoliosis brace.
To contact one of the Child Life specialists:
Dallas Campus:
Child.Life@tsrh.org I 214-559-7795

Frisco Campus: 
ChildLife.Frisco@tsrh.org I 469-515-7187
Patient outside Dallas campus
Patient in Family Resource Center

Peer Support Program

The Peer Support Program connects families with another Scottish Rite for Children family who has a child with the same medical condition or who has had the same medical procedure. Many families find understanding and support through talking with another family who has had a similar experience.   

Families are carefully matched for Peer Support by our staff. Parents or caregivers can let their child’s nurse or clinic staff know if they are interested in the Peer Support Program.

How to be connected with a family or be involved with the Peer Support Program?
  • If a family would like to be supported, they can let their clinic staff know and the Family Resource Center Coordinator will contact the family.
  • If a family would like to provide support, or be a peer mentor family, they can let their clinic staff know or reach out to the Family Resource Center Coordinator.
  • Both families will then complete and sign an authorization form to move forward.
Learn more about the Peer Support Program (English I Spanish).

Family Resource Center
The Family Resource Center plays an important part in serving our patients and families. We have a licensed social worker and a medical librarian who are here to help any family. Learn more about our Family Resource Center.