Back Braces: Should You Be Wearing One? (For Sufferers of Scoliosis and Back Pain)

The body is a surprisingly vibrant lens through which to view culture. Since culture is comprised of humans — including their bodies — it’s impacted by them, and vice versa.

In language, for example, we can see the body reflected in idioms like “a pain in the neck,” “the weight of the world on your shoulders” or calling someone a “tight ass.”

Often when clients ask me if they should be doing a particular exercise, or wearing a supportive device (yes, like a back brace), or stretching in a certain way, my answer isn’t just about the thing, but the worldview that would lead a person to such a solution in the first place.

So, when we’re talking about back braces and whether you should be wearing them, I feel the need to first talk about models for looking at the body.

Because the way I see it? Is not how everyone does.

Now, before we go any further, I’m going to pop in here with my standard disclaimer. Let me state unequivocally that anything I write here is just my opinionIt is not medical advice. And it may not be applicable in all situations (more on exceptions further down).

Do your research. Understand your situation. And of course, consult a medical doctor before you start your own “burn your back brace” movement.

On that note, you should also find a doctor that you like and trust and who will listen to your concerns. A person who will explain her thinking to you, not just prescribe something because “that’s the way it’s always been done.”

Not all doctors — surprisingly — stop to think about why they’re doing what they’re doing. But the ones who do are your best ally.

Okay, back to back braces.

If you’ve ever been told you have scoliosis, you probably also heard that you should wear a back brace so the spinal curvature doesn’t get worse.

If your child has been diagnosed with scoliosis, you probably heard the same thing, along with a lot of scary stories about how deformed a spine can become when not properly contained in its perfect straight line.

And if you’ve ever injured your back, you probably got similar advice: back brace all the way, baby!

So, should you be wearing these supportive devices to shore up your wayward spine?

Well….maybe.

Like I said earlier, we have to take a look at why a brace would be recommended in the first place, and that has a lot to do with how you see — or an entire culture sees — the body.

Remember how I said that language is reflective of the body? I’m sure you’ve heard your backbone referred to as your spinal “column.” And you’ve probably also heard about your rib “cage.”

Hmm. Column and cage. A column is generally an inflexible supportive structure. Except perhaps with regard to modern earthquake retrofitting, they generally don’t bend or sway.

And a cage is, well, restrictive.

Both connote rigidity.

So, if you’re thinking about a spine inflicted with scoliosis as a defective column (an S-curved column is going to make for a pretty shaky structure), then a brace makes a lot of sense.

But what if the spine isn’t a column, but more of a spring, or a slinky? What if — gasp! — it even generates locomotion?!

Okay, you probably have no idea why that statement is so revolutionary, or even what it means, really. So, let me back up a bit here.

The standard western biomechanical model of the body is that limbs move you forward. You want to walk, you pick up your leg and set it down, and then repeat on the other side. Behold! Locomotion.

In the interest of indulging my linguistic nerdiness here, can I interject that there’s an idiom for this, too? Put one foot in front of the other!

Okay, okay, moving on….

It turns out that this isn’t really how we walk. Or, rather, it’s not how we should walk. I’ve got plenty of clients who do walk this way. They all have back, neck and/or hip trouble, not to mention a lot of wear and tear in their knees.

Seriously, I think if I could just get people’s spines rotating properly, 90% of people’s structural-related pain would vanish <== not a scientific statistic.

Anyhow, we now know that the spine is actually responsible for initiating a twisting movement that rotates the pelvis (you know these bones as your hips) and swings the leg. The legs are actually responding to the twist initiated in the core.

Say what?!

Yes, that’s right, walking starts in your core (and so do your arm movements, but that’s another post for another day).

This concept was referred to as “the spinal engine” by Serge Gracovetsky, Ph.D. in his 1988 book of the same name.

Okay, so we have a biomechanical model where your spine is not just a supportive column for compressive force (i.e. gravity), but rather the generative force for forward movement.

And you want to put a brace around it.

This is where that body-culture lens gets kind of interesting. Western culture, and the American version of it in particular, has a love affair with rigidity. You can see it reflected in something I like to call The Cult of Extremity in All Things.

The answer to everything in our culture seem to be rigidity.

Back hurting? Tighten that core! Harden those glutes! Get yourself a set of abs of steel!

Posture slouched forward? Yank those shoulders back! Here’s a strap and some tape to hold them in place!

Feeling a little flabby? Twice daily workouts! Go hard! If you’re still breathing, you’re not working hard enough!

Seriously. To listen vicariously through my clients to the advice they’ve been given, you’d think core strength was a panacea.

No space is created for fluidity. For softness, or undulation, for spiraling movements, or even for basic ease.

Ida Rolf, founder of Rolfing, used to comment that people would come to her and say, “You just don’t know how strong I am.”

Her reply: “You have the kind of strength that comes from effort. The strength I’m talking about comes from ease.”

Strength with ease? Yes, please.

Quick aside: I’m not knocking strength training. Big fan, actually. Go lift heavy things. Pick them up, put them down, do it again.

But don’t get locked into tension.

Just like it’s not useful for a ballerina’s feet to be turned out as she walks down the grocery store aisle picking out her pack of birthday cake flavor Oreos (what, you think ballerinas don’t eat Oreos?), it’s also not useful for your abs to be on lockdown 24/7.

Or any other muscle, for that matter.

Okay, back to your regularly scheduled programming.

Back braces. Basically, they operate under the assumption that your spine, and by close relation your ribs, are supportive structures that don’t need to move or adapt to your changing posture.

If your spine and ribs don’t need to move, how are your lungs going to inflate, I ask you? Because everywhere you have ribs? You also have lungs.

And when you breath, those ribs shift in response. Since your ribs attach to your spine, it moves, too. Or should. Ideally.

So, if you have scoliosis, should you wear a back brace? Again, I refer you to the disclaimer at the start of this post. But here are some of my thoughts for your consideration:

A spine that bends and sways and twists generally absorbs shock better, like the proverbial green twig.

That means that when your foot hits the ground, which I hope it does several thousand times a day, the impact can travel through your leg, up your spine and out the top of your head rather than jamming into a rigid, cement-like bony structure ultimately causing tension in the muscles, and potentially degradation to the discs and joints.

Is the only healthy spine a straight spine?

I’ve had many, many clients with scoliosis who were able to live quite comfortably and functionally with “abnormal” curvature in their spines. In fact, once the spine and ribs can move and twist (usually with some focused tissue release), they often notice a great reduction in discomfort when the actual curvature hasn’t changed at all. So, is the only way to feel good to get your spine straight?

Are the bones the source of the curvature, really?

Western body models tend to see the skeletal structure as a sort of wire frame from which all the soft bits of you hang, like a suit of clothes. I see it the opposite way. Your bones “float” in a soup of soft tissue, the tension of which determines the angles and alignment of joints. The bones may be exhibiting a symptom of a greater pattern. Liz Koch, author of Core Awareness, postulates that scoliosis may even develop in response to a lung that didn’t fully open, thereby causing the bony structure to form around a smaller lobe on one side. Is that what’s happening? I don’t know. Is it possible? Absolutely.

These same ideas hold true for back pain as well. I’ve had people limp in practically unable to walk, and all I do is release a bit of tissue so the spine can rotate and you’d think I was running a revival tent with folks getting out of wheel chairs and walking for the first time in decades.

(This doesn’t happen every time, mind you. I wish. Turns out, bodies are complicated.)

Of course, there are a few points of caution, and, dare I say, exception. I’m not a fan of the always/never dichotomy, and find that almost every tool has an application in some form or another.

If you have an acute spinal injury, you might need a brace to allow your body to heal. (Again, obviously, and especially in this case, work with your doctor.)

If you have debilitating back pain and cannot function (i.e. sit, stand, walk, bend, pick your six month old up off the floor), you might need a brace to help you get through your days and do the things you need to do while you work towards restoring structural integrity.

How long will this take? There is no way to know. But I strongly encourage people not to relegate themselves to life in supportive devices, but rather aim at independent function. You may never get all the way, but you’ll likely get a lot closer.

And structural integrity gives you something really, really important: freedom.

An independence that allows you to go anywhere and do anything, whenever you want.

I often joke with my clients that it’s the little things in life, like being able to turn your head and look over your shoulder, but truly. It’s amazing how when the restrictions dissolve out of your body, all that tension that comes from effort and force drifts away, and you experience ease, there’s a bliss there that’s hard to describe.

I hope, whether you have scoliosis or not, or whether you suffer from back pain or not, that I’ve given you a new way to think about your spinal spring.

Because really, it’s not some stiff, unyielding hunk of cement in your back. Your spine is your true living, breathing, moving core.

Set it free.

Further Resources:

Video: Non Invasive Assessment of Spinal Function with Serge Gracovetsky, Ph.D.

Article: Spinal Engine vs the Pedestrian Theory of Locomotion

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