Radial and Median Nerve Protection Brace: The R&M Brace
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  • Who should use the brace?
    • Nerve Loading Tests
      • Neuropathic and Neurogenic pain
      • Why does it work?
        • Basic Anatomy of the Nerves of the Arm
          • Nerve Injury
            • Rationale for the benefits of the brace
            • Nerve Related Shoulder Pain
            • Nerve Related Elbow Pain
            • How to use the R&M Brace
            • Features of the R&M Brace
            • Graded Motor Imagery training
              • Link to NOI Graded Motor Imagery
              • FAQ
              • Contraindications and Precautions
              • Links
                • NOI home page
                  • Explain Pain book
                    • IASP
                      • Body in Mind: very interesting pain related blog and resources
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                      HOW TO USE THE R&M BRACE

                      The proximal patch is applied to the upper arm

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                      Peel the release paper from the shoulder patch and apply it to the skin overlying the lateral deltoid muscle. 
                      The adhesive is a water based low allergy pressure sensitive adhesive designed for long term application to the skin. 



                      The distal portion is attached just proximal to the wrist

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                      The distal wrist gauntlet is attached just proximal to the wrist and is fixed with a hook and loop system. Some people with neurogenic arm pain are sensitive to even light pressure around the wrist. If this is the case then the wrist gauntlet should be used with an adhesive patch to prevent the gauntlet from slipping and then loosely closed using the hook and loop. material. 

                      Adjust the length of the strap

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                      The length of the brace strap should be adjusted so that when reaching forward with the brace on the pain is not produced; or if the pain is initially constantly present the pain should not increase. 
                      If the changes in pain due to reaching are latent (ie onset or increase in pain hours after the movement is performed) then the brace should be adjusted to limit elbow extension by 45 degrees. 
                      The brace should initially be worn continually if possible; even when showering and sleeping. 

                      With improvement the strap can be lengthened

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                      As the pain improves the angle of restriction should be gradually reduced.
                      With further improvement the brace may be worn only during potentially provocative activities.
                      When worn the brace should be un-clipped at the buckle every hour or so and the elbow fully straightened while keeping the arm by the side of the body. 

                      The strap should be released every hour or so

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                      To avoid the elbow stiffening up the strap should be un-clipped every hour or so. This should be done with the arm by the side. The elbow should be bent and straightened a few times with the arm by the side and re-clipped.