Life with a SWASH Brace | What Parents Should Know

You can watch the video with this content!

If it's your first time on my blog, hi!

My name is Minie, I'm a special needs mum based in Sydney and my daughter wears a SWASH brace.

I couldn't find much information on this brace on the internet, all the pros and cons, all the tips, the juicy advice for us parents.

And so I'm going to create the article on everything you want or you need to know about the SWASH brace!

What is a SWASH brace?

First of all let's define what a SWASH brace is.

SWASH is an acronym that stands for Sitting, Walking And Standing Hip orthotic.

The year was 1984 and it all started because of the parent of a special needs child (of course! 😏)

It was the father of a young girl with cerebral palsy who developed subluxation due to hip adduction, which is a very common problem with cerebral palsy.

So basically this hip brace was created to promote hip abduction, which would help with hip alignment, preventing scissoring gait, giving an improved posture, and many other benefits.

Basically this brace forces the hip to stabilize in all three planes of movement: sitting, standing and walking.

What I like is that it's still a functional brace so it does allow movement: it promotes a neutral position while walking and standing, but rotates into abduction while sitting.

It has three parts: the pelvic band (or as I call it, the belt), thigh cuffs and uprights.

What does the SWASH brace mean for our family?

Our daughter does not have cerebral palsy, she has Kabuki syndrome; but she still has hip dysplasia and the risk of subluxation.

Her hypotonia (low muscle tone) doesn't help supporting the head of the femur staying in the socket and maturing the socket in a stabilized position. So, if we don't do anything, she might face a a couple of hip surgeries: one fairly soon, when she turns around 3-4 years of age, and another one later on when she's 6 or 7.

The SWASH brace was given to us in the hope that it could buy us some time and possibly avoid the first hip surgery only to have one when she's around 6 or 7.

And of course I said count me in!

I also like the idea that this SWASH brace seems to improve the posture, and since she was born with a hemi-vertebra, I really welcome the idea of an early intervention on her posture which might help with future chances of scoliosis.

I'm also aware of the fact that the aluminium parts of the SWASH brace make it heavier than other braces, and you know our daughter has hypotonia which makes me think that - maybe - walking and moving so much for so many hours per day in this heavy brace will improve her muscle tone even more than just walking without it.

What I love the most about the swash brace is that it's a functional brace, so it still allows her to crawl, walk, stand, go around, explore the world while trying to help her hips.

Pros and cons of the SWASH brace.

I have already outlined all the pros of this brace: it stabilizes the hips, improves the posture, it promotes abduction, and I'm really hoping that indirectly it will increase our daughter's muscle tone in her lower body and around the spine.

The cons are definitely outweighed by the benefits, but I think the families should know them, in order to make the appropriate adjustments to their daily routine.

1. Disadvantage n.1: the SWASH brace is definitely heavier than other braces.

Those that I know are Rhino brace or Pavlik harness and definitely the SWASH brace is much heavier than those.

So if your child has to stay in this brace for as long as possible throughout the day, and you know that you're going to rock your child or hold them or cuddle with them wearing the brace for prolonged times thorughout the day, my suggestion is to buy a hip seat, because otherwise chances are you're going to hurt your back.

2. Disadvantage n. 2: you might get lots of bruises on your forearms, especially at the beginning.

I always joke about it saying I got these bruises doing pole dancing! (which is not true!).

But I would seriousy recommend investing in a hip seat because that will help release some of the weight on the seat and not your arms.

3. Disadvantage n. 3: the aluminium of the uprights could actually scratch surfaces around the house.

If your child is going to move around and if they're close to a surface and keep moving, inadvertently they could scratch it. So my advice is to cover the uprights either with fabric or foam or - I'm loving it right now! - tennis grip tape.

4. Disadvantage n. 4: the Velcro of the thigh cuffs might actually pull your tops.

Oh, that's so annoying!

So definitely try to cover it: I created a couple of sort of gloves for those Velcros so that they're removable; I can wash them and I can go back in the future and adjust the Velcro as my daughter grows.

I wouldn't recommend sewing the Velcro because you're gonna have to adjust the brace in time.

5. Disadvantage n. 5: the white caps at the end of the uprights could actually fall off.

So please ask your provider to give you a couple of spare caps.

My suggestion is not to glue them, because if you have to move around the thigh cuffs they have to come off the uprights, so it's better not to glue those parts together indefinitely but maybe find other ways.

Again, try tennis grip tape: it works like a charm!

Strategies to cope with a hip brace. (not just a SWASH brace!)

Hip braces are not funny.

Not for the child that has to wear them for possibly months or even years nor for their families.

And yet, the benefits of having a hip brace that could prevent a hip surgery are undeniable, so what should you do?

My goal is always to find strategies that are: fun, practical, productive,

Here are the strategies I recommend to stay motivated and keep going with the hip brace.

A. Smooth implementation of the new brace.

I created the acronym CHEST.

The idea behind the acronym chest is that the more my husband and the support team around us know how to use this brace the more this brace will be off my chest!

C: correct placing.

In the case of the swash brace you make sure that the pelvic band is actually sitting on the hips so it's not up on the waist; the uprights have written L or R on them to recognize which one is the right or left (But you can actually see it if you look at the brace on the side whether the uprights are promoting a sitting position or not); and the cuffs the thigh cuffs always have to be above the knee.

H: hours (meaning time you put it on).

Time it, because if you generically think "oh my child has worn the brace most of the day" it feels to you much less satisfying than "today we scored 11 hours; yesterday we could only do 6 hours; maybe tomorrow we can do 13!".

E: Entertainment and enjoyment.

Entertainment means: try to entertain your child and redirect their attention.

Especially in the very first few days of wearing a new brace they will be frustrated because it's annoying; so try to redirect their attention by inviting them to do new games, play along with them, entertain them as much as you can.

Enjoyment: if at any point your child gets so unsettled that wearing the brace could actually be traumatic for them, just remove it.

Talk about it with your orthopaedic specialist, but I think that no professional will tell you "yes, please, create traumas for your child".

Do it gradually.

The first day you may try a couple of hours; the second day you will try to get your child to stay in the brace a few more hours, and so on.

S: Support.

Whether your child was walking already before or not, at the beginning they will still need to find their balance in that brace, so try to give them extra support.

If your child is only sitting independently and not walking yet, with that brace they might need a little bit of extra support while sitting.

If your child - like mine - just started walking and then they were put in a brace, they will have to get used to it. Just give them a walker for the very first days until they get back on their feet (literally!🤣).

T: time you take it off.

Always track how long has your child been in the brace for, which is actually my second strategy.

B. Track your effort.

It always helps me (personally) to measure my efforts, to measure my goals, to have something very specific, a number.

And I have a couple of ideas in this strategy.

The first one is what we're doing with the SWASH brace right now, which is a spreadsheet that I created to track every single day how many hours our daughter is staying in the brace, which accumulate with time.

I have the actual chart to see how much we are building up: a massive amount of hours to show to our doctor at the next orthopedic visit.

So far we've done more than 600 hours, and that feels great! It gives me a lot of hope and a lot of motivation to try and hit 700, and maybe at the visit we'll have more than 1,000 hours spent in the brace!

You can download the spreadsheet for FREE here:

A second strategy that I had with the previous brace (the Rhino brace) was tracking down the number of hours and on small lottery tickets, and every day I would put the lottery ticket of the day in this glass jar; so day by day, week by week, I would see the jar getting more and more full of these lottery tickets, that maybe would buy my daughter some freedom from braces and surgeries.

C. Make it fun.

Whatever works for you and for your child: make it fun.

Because at the beginning my daughter was quite skeptical with this new SWASH brace, I put a belly dance scarf on her and I told her "Go, walk around the house" and the colour of it and the sound, and the jingles she was making around the house while walking were so funny that it convinced her that the SWASH brace is not so bad afterall.

D. Do not celebrate the time off the brace.

This strategy might feel counterintuitive, but I promise: it's not!

Do not allow your child to feel the time you remove the brace as a reward: it's not. Wearing the brace has to be their new normal, it's a new habit they just have to get used to it.

It's hard but it's not impossible.

E. Personalise the brace.

Now: first ask your orthotic or orthopedic specialist if you can do it or if they will want the brace back.

My previous experience with other braces was that they didn't want those braces back as they were a single person use; but you never know.

You can always personalize the brace with things you can remove: any laces, ribbons, stickers; add colours, add fabrics, add jingles, add bells.

Anything compatible with your child's preferences and needs.

Actually it has made the whole bracing experience a lot more bearable for me, to pimp my daughter's brace! 🤣

F. Remember why we brace them.

In times of despair try to remind yourself the why: why is your child wearing a brace?

The benefits could really outweigh the temporary sacrifice the temporary overwhelm.

See it this way: yes wearing a brace might take weeks, or months, possibly years; but it's still better than a hip surgery.

Consider that the hip surgery is not just the surgery itself and its risks, but it's also the recovery; all the pain, all those weeks spent in a cast. And after the cast there might still be recovery time in another brace.

So you might as well just try now to give your child the best chances of avoiding a surgery, but most of all to avoid possible subluxation, dislocation, or chronic pain in adulthood.

Let me know if you have experience with the SWASH brace, because I haven't found any other families here in Sydney who have experienced this kind of brace.

Most of all, please: let me know in your comments if, thanks to the SWASH brace, your child could avoid surgery.

That would really help me, my family, and lots and lots of other families.

Thank you!