Living With Polio
Brace Maintenance and Care Guidelines
Tamara Treanore, CO, ABC
Daniel M. Ryan, MD
Brace maintenance and care will improve the function, extend the life and improve the comfort of the brace. The following guidelines are provided for your use. Please feel free to ask any questions.
I. Plastic braces:
Check for discoloration in the plastic on a regular basis. Discoloration indicates that the plastic in those areas is excessively stressed, creating the possibility of breaking and/or plastic failure with the associated incident of falling or injury. Bring this to the attention of your orthotist!!
Cracks-look for cracks in the metal joints-especially around rivets and by any joints. Again, bring this to the attention of your orthotist.
Clean plastic with a damp wash cloth using the same soap that you use on a daily basis. Wipe out well. If no padding is present, the brace can be washed under water. If pads are present, this is not recommended as the water can become trapped between the materials and cause separation.
Wipe pads off in the same manner but do not scrub the pad as it will roughen the surface and cause either friction or further soiling. Alcohol pads can also be used to wipe down the brace/pads.
The brace should be wiped out on a regular basis to reduce the incidence of dermatitis and odor. Using a sock or interface between your skin and the brace is standard- this will reduce the need for cleansing and protect your skin. Socks should be cotton/polyester blend with low-profile semis and no heavy banding, sewn in designs or anti-slip pads. If your leg size precludes you from using standard socks then a section of thermal underwear can be used to cover the calf area.
Check your shoes on a regular basis- remove the brace, the insole and shake out my sand, gravel, animal hair, etc. All these can abrade the bottom of the plastic brace and can be the site of plastic fracturing. Shoes should be leather, full cut, removable insole, Velcro or lace closure. There should not be any significant heel and the width of the sole should be appropriate for the size of your foot and the type of stability you need. Avoid manmade uppers, avoid heavy seams across the forefoot and make sure the shoe holds your foot into the brace securely. The shoe is a functioning part of your brace- it secures the brace to your foot and aligns your foot/ankle to the ground. Replace when the upper becomes stretched and sloppy- you are reducing the function of the brace and in effect, your safety.
DO NOT USE THE FOLLOWING. Febreeze, super glue, solvents, torches, tin snips, dremels, hack saws or band saws. Stay out of the tool shed! If you have a problem with your brace or with the function of your brace – TALK TO YOUR OTHTOTIST OR YOUR DOCTOR! I promise to stay out of your professional field if you promise to stay out of mine.
II. Metal and Leather braces:
Check for cracks in the metal joints on a regular basis especially around the rivers, the knee joints and the ankle joints. Check that any moving parts or aligned hinges are moving freely without any halting, binding or squeaking. If concerns are noted, speak to your orthotist.
Joints need to be cleaned and lubricated on a regular basis. Remove any fiber or debris out of the hinges with a cloth, a toothpick or with a can of compressed air. Use a dry silicone lubricant on the hinges and wipe off any excess. It is best to lubricate the hinges at night, thus permitting any excess to drain out, hopefully avoiding soiling your clothes. Wipe off the hinges again prior to wearing the brace.
If crunching or grinding is heard at any joint, you need to see your orthotist. Parts break, wear out, get out of alignment and get rusty. Most springs or ball bearings can be easily replaced, realignment is a tougher job. A metal hinge requires smooth function in order to move with your leg and to lock/unlock when needed.
Do not add anything to your hinges unless your orthotist approves. Materials added to protect clothing can impede the secure locking of the hinge and increase the possibility of falling.
Straps hold the brace onto the leg and provide biomechanical alignment between the brace and your body- each strap has a unique function and needs to be secured in order to achieve the outcome the brace was prescribed for.
Always check the rivet/screw that attaches the strap to the brace for signs of failure.
Remove hair, fiber or debris with fork tines, a toothpick or a comb. The exposed surface of each part of the strap is what determines the contact and security of the strap closure- keep them clean so that the straps close securely.
If the Velcro becomes worn, it needs to be replaced. Replacing a strap requires measuring, sewing the new strap, removing the old rivet, attaching the new strap and cleaning up the rivet site. The addition of pads can increase the amount of work required. There is a cost associated with this- a prescription can be provided to cover the cost but there is no guarantee of payment by your insurance company. However, just like the tires on your car, the soles on your shoes or the clothes you are wearing- things wear out and need to be replaced. Maintenance has an associated cost.
Covering the rivet site inside of the brace with a piece of moleskin or bandage will reduce any skin irritating from the metal. Raised edges must be addressed by…your orthotist. Again, please do not hammer, grind, drill or modify your brace in any way. Repairing “repairs” can be costly and sometimes impossible.
Straps can be washed and squeezed dry- use a soft scrub brush if needed and
follow the brace wear/care guidelines for additional help.
Hold onto old brace for emergencies!!
Replacement of braces is covered by insurances based on each company’s own protocols. In general, it is once every 3-5 years unless there is a change in function, change in weight, brace breaking or change in physical status. This must be documented by your physician and a certificate of medical necessity provided with the prescription. Again, there is no guarantee of payment by your insurer. We will try our best to verify your coverage, your deductible and your co-payment and will work with you to procure coverage if possible.