Bracing can be a controversial topic, especially in health care and rehab settings. People may ask, “Won’t wearing a brace make my muscles weaker?” And the answer is… maybe! It depends on the type of brace, why you are wearing it, and how long you are wearing it for.
TYPES OF Low Back, Abdominal, And Pelvic BRACES
First of all, there are many different types of braces that go on some part of your torso. Here are some examples:
Classic Back Brace: These you can pick up at a drug store and velcro around your lower ribcage to just above the hip. Some of them have some struts in them for extra support, or extra straps that go over your shoulders. They can be super helpful for short-term usage, ie if you have an acute back pain flare up where it feels like all of your back muscles are spasming. However, if you wear them all the time for a longer period of time, your core muscles will start to weaken, which is not ideal. It is best to wear it until pain is manageable and then gradually taper down your usage, so your muscles can re-adapt to holding you up. If you are prone to sudden, intense back spasms, see a PT to address what may be the underlying cause of your back pain!
Sacroiliac (SI) Joint Brace/Pelvic Brace: These are narrower belts that go around your pelvis, between your hip bone and your leg bone. They can be great to give some support for folks who tend to be more on the hyperflexible side, and whose pain goes down into their glutes/pelvis rather than just in their spine. They can be helpful for folks who are pregnant as well, since this is a time when the SI joint tends to move more. Because they are designed to reinforce the ligaments of the pelvis instead of the muscles, they can be worn for long periods of time without weakening the muscles. SI belts are best worn for prolonged standing or walking, but they are often less comfortable for sitting down, because they can cut in at the front of the hips in a seated position. The Serola belt is our favorite in this category. Again, PT can be very helpful in addressing pain in this area as well!
Abdominal Binder: Binders are often given to folks in the hospital after an abdominal surgery, to help give some support to the abs and reduce pain with changing positions, etc. Abdominal binders vary in size, but tend to be softer and stretchier than some of the other braces, and don’t usually have struts or other stronger supports. These can be helpful for folks after giving birth, in order to help support the core muscles in coming back together after being stretched out throughout pregnancy. Sometimes they are also used for abdominal hernia support. They are designed for short-term use, and ideally should not be worn for long periods of time, just until pain has gone down and the person can start to comfortably use their own abdominal muscles again. Again, gradually tapering off of using these is recommended.
Waist Trainer: These have been popularized with the goal of making the waist smaller relative to the rest of the torso. While these may not be dangerous for the average user, they can alter a person’s breathing pattern by not allowing deep breaths into the belly, which may cause some shortness of breath and/or tension in the neck and shoulders, as more of these muscles may be recruited to assist with breathing because the diaphragm is inhibited. They also may cause some negative impacts for folks experiencing pelvic organ prolapse, due to the overall increase in pressure in the abdominal cavity, but this has not been studied specifically.
Pregnancy/Maternity Brace: There are many versions of these, and they are usually some combo of the Classic Back Brace and sometimes an SI brace as well, only designed to fit a pregnant person. Sometimes insurance will provide these for folks at a lower cost. Some cultures use long fabric wraps for this purpose. One that we often recommend is the FitSplint, which gives some SI and back support, and has multiple highly adjustable straps so a person can wear it throughout the phases of pregnancy and through to postpartum as well.
Postpartum Recovery Shorts: These provide some of the abdominal support of a pregnancy brace for postpartum, but also have a compression short component, designed to help give support to the lower belly and perineum after C-section or vaginal birth. Once again, these are designed for short-term use while the body is healing.
Pelvic Support Belt: Pelvic support belts give some support around the vulva and perineum after childbirth or with changes in menopause. They can be helpful for folks experiencing some pelvic organ prolapse or heaviness/bulging around the pelvis. However, they do not provide any low back or abdominal support. Pelvic health physical therapy can be very helpful to help with these symptoms as well, so please reach out if you are looking for support.
Weight Training Belt: These are stiff belts around 6 inches wide to be worn around the abdomen to increase intraabdominal pressure for heavy lifting (ie 80% of one rep max or higher). They are not recommended for use at lower-level lifts, as they can reduce muscle recruitment. They do not prevent much movement of the spine, contrary to popular belief, so it is important to also have good lifting technique when using these belts. They are also not recommended for use by individuals with high blood pressure, as increasing intraabdominal pressure in this way creates a blood pressure spike during lifting as well if accompanied but a Valsalva maneuver (ie closing your throat and puffing out your belly to accomplish a lift).
Thoracic Lumbar Sacral Orthosis: TLSOs are some of the most supportive braces available, designed for use after spinal surgeries. They should not be worn unless prescribed by a medical provider. There are even CTLSOs that also include a neck brace component.
If you aren’t sure if you could benefit from a brace or not, talk to a medical provider about your options! You can also go to a brace store, such as Brace Yourself Sports Medicine on E Burnside, to try on different types of braces and see what size/style fits you best!