Military brace

The military brace is a distinct body posture historically associated with military training and discipline. Beyond its role in the military, it has clinical significance, especially in the diagnosis of specific syndromal conditions.

Definition and Description

The military brace, occasionally referred to as scapular posterior depression or the costoclavicular maneuver, represents a modified version of the stance typically adopted when "standing at attention". This posture can be broken down into the following components:

• Initial Position: Begin by standing relaxed, with the head oriented forward.
• Shoulder Movement: The shoulders are both depressed (pushed downward) and retracted (pulled backward). This action resembles the posture when standing at attention.
• Humerus Position: The arm bone, or humerus, is extended and abducted at an angle of 30 degrees.
• Head and Neck Posture: The neck and head are hyperextended. This means pushing one's head backward, forcing the chin down.
• A colloquial means to understand and practice the military brace is by lying supine (on one's back) on the floor, endeavoring to touch the back of the neck to the floor, thereby pushing the chin down. Following this, one attempts to replicate this exact neck position while either standing or seated.

At institutions like The Citadel, the military brace has added specifics:

• Arm Positioning: Arms must be firmly placed against the sides of the body, ensuring no space exists between the arms and the torso.
• Shoulder Thrust: Shoulders are robustly pushed back, attempting to get the scapulae (shoulder blades) as close to touching each other as feasibly possible in the center of the back.

Clinical Significance

While the military brace is ingrained in the traditions of military schools, its significance extends to the realm of medicine. Specifically:

• Diagnosis of Costoclavicular Syndrome: This syndrome is a vascular compression disorder where the subclavian vessels get compressed between the clavicle and the first rib. Adopting the military brace can exacerbate symptoms, assisting in its diagnosis.
• Thoracic Outlet Syndrome (TOS) Evaluation: TOS involves compression of the neurovascular structures as they exit the thoracic outlet. The military brace posture can induce or accentuate symptoms associated with TOS, thereby aiding in its clinical diagnosis.

Historical and Contemporary Use

Predominantly utilized in military schools, the military brace embodies discipline, structure, and alignment. Cadets are often instructed to adopt this posture during parades, ceremonies, and other formal events as a testament to their training and discipline. The precision and rigor required to maintain the military brace epitomize the structured environment of military institutions.

Conclusion

The military brace, while rooted in military tradition, has implications that span both the ceremonial and clinical spectrums. Its multifaceted nature underscores the need for a comprehensive understanding, especially among medical professionals who might encounter related clinical scenarios.