Sometimes we see online that parents talk about a horizontal red mark that can appear on the rib cage from a scoliosis brace.  The question is whether to be concerned or not.

There are basically two types of red marks from a scoliosis brace :

1.) The ones that go away within a couple minutes (&)

2.) The ones that do not go away quickly and become bruises

Things you should consider if your child is having this issue :

A.) Is the brace too tight?

Typically these braces are supposed to be worn snug, or else it is basically pointless to use them.  The reason why we say it like this is that they need to influence the spine and a loose brace does not do the trick.  The word we use at our clinic is “snug”.  Tight, can be too much.  The question though is what is too tight?  Or, too snug?

What we can tell you from our 20 plus years of experience is that your child will tell you very quickly if there is a bad problem, especially related to the tightness.  Perhaps they will wait until they leave the office but as the parent, you will find out very quickly.  This is usually not a problem and the orthotist should be able to pick up on all this before your child has time to verbally state the issue to you, to be honest.

Too tight means that the brace is causing red marks that do not go away, in a short period of time.  You do want to see temporary red marks on the body from a scoliosis brace actually, but only to a point.

You got the brace to correct the spine.  Pressure on certain body points is good, but not so much that a true sore develops.

Pads Inside Of A Scoliosis Brace

There are  usually 3-4 pads in a scoliosis brace.  One on each side, just above the top of the hip bones.  These are important because they let you know where to position the brace.  They also are used to anchor the brace so it does not migrate.

The other two pads are usually on the left lateral spine and right thoracic area (but this can vary sometimes).  These pads apply pressures to correct the curvature.  If these pads are too intense the skin will tell you by either becoming a sore or staying red for a really long time.B.) Is the brace being put on the correct way?

This is a chronic issue, actually.  People tend to blame the brace and the brace might be at fault sometimes.  But, the other side of the equation also matters.  It is how you apply yourself to the brace.  This is paramount.

While it is best to confirm all of this with your orthotist, it is good practice, in our opinion to snug up the brace while laying down.

First, position the brace so that the hip grooves are appropriately placed above the hip the top of the hip bones and then tighten the brace laying down.

One hand should close the brace itself and the other hand should simultaneously pulls on the strap.  This is a very commonly over looked step.

Most people want to pull on the straps and be done but this is not enough.

The circumferences around the lower spine are at their smallest and you will get the best purchase on the body if you apply it and snug it up laying down.

If you do this a different way and apply it when your child sits, their body will flex and their abdomen will push out temporarily.  So, the question is, are we pushing on the right areas of the spine at this point?

Also, when your child then goes to stand their abdomen circumferences will shrink and the brace will be loose and move around.   Please check out our other videos and blog posts on the site as we go into great detail on all of this.

Let’s be honest.  Your child would rather not wear the brace if they had the choice, so if they are going to wear it, a review of how to apply it is extremely important.

And no offense, if this was a test, many parents would not pass on application only after having heard the information one time.  This is not personal.  It is what it is.  We as people need to hear things a few times before we get it.  So, check back in for a follow up if needed.  – Again, we feel very strongly about tightening the brace when your child lays down but check with your orthotist first.

Remember, if the brace is lose when your child is up and about, then the brace can move and the brace causes this red mark because of all the rotation of the brace and the up and down motion that is happening.  This causes friction and friction can equal red marks.  So yes, the problem might be the brace, but it is also because of an application issue.

C.) Is your child wearing a t-shirt between themselves and the brace?

T-shirts are soft and wick away moisture.   Too much moisture is not helping the creation of red marks.

Please remember that the brace also has padding and padding is insulation.  Insulation means increased body temperature which could equal more sweat.

You can see that without a shirt (or even a back up shirt) the patient can get hot sometimes and this might overheat them or cause sweating issues that then irritate the skin due to the pressures of the orthosis.

There is no magic t-shirt.

Just look for something that is soft, that is not too thick and that has a little bit of a sleeve.  The sleeve part is good because many of these braces have an extension that goes up into the axilla (arm pit) and a little short sleeve might provide a little extra interface for comfort.

Doing all of these things will hopefully get you an in brace xray that looks like this one here we have included.

In brace xrays are helpful but only if the patient puts the brace on correctly and only when the brace is made correctly.

The combination of the two will hopefully get you a result like you see with our patient here (name removed for hippa reasons).

Good luck and check out our other posts on scoliosis.  You might like them. ?

• Remember that this is health information and it is best to check in with your orthotist about the stuff we mentioned here.