referring now in more detail to the exemplary drawings for purposes of illustrating embodiments of the invention , wherein like reference numerals designate corresponding or like elements among the several views , the thoracic lumbar sacral posture garment of the present invention includes , generally , a garment 31 formed with a back panel 33 , front panels 35 , fastened by a zipper 38 , shoulder straps 37 , and an interior tensioning device , generally designated 39 . the tensioning device includes respective scapular gripping straps 41 anchored to the garment in the pectoral area 43 to pass over the patient &# 39 ; s shoulder and be attached to respective tension straps 45 which cross over one another in the back of the patient and pass through respective access slots 47 in the front panels to attach at their respective free extremities to fasteners , jointly designated 51 , on the lower portion of the respective front panels . it is important to alignment of the spine and relief of spine - related and even shoulder - related maladies that the top of the shoulders 59 ( fig1 ) of the patient be drawn rearwardly thereby straightening the scapulas and tending to straighten and unload the spine to thereby maintain the desired posture for facilitating recovery and to minimize further injury stemming from fractures , ligament inflammation , ligament tears and afflictions related to osteoporosis . in this regard , it is an objective of the present invention that the internal tensioning device 39 provide for a gripping action at the top surface of the patient &# 39 ; s shoulders 59 and apply rearward forces to the top of the shoulders , to preferably torque the scapulas as the shoulders are drawn rearwardly or posterially to maintain the desired posture itself . to this end , the garment in the preferred embodiment is constructed of stretchable , elastic breathable material capable of applying substantial compression to compression upon being stretched tight on the patient &# 39 ; s torso to thereby maintain a firm grip on the patient &# 39 ; s waist area to thus provide secure anchoring so that the rearward forces applied by the tensioning device 39 will apply the desired rearward forces to the tops of the patient &# 39 ; s shoulders . in this regard , the garment 31 serves as somewhat of a harness , having a high level of elasticity , but with a great degree of constraint to thereby , when the zipper fastener 38 is fastened , hold the garment relatively tight around the patient &# 39 ; s abdomen and waist to thereby form a solid anchor for the tensioning device 39 . a material which serves this function quite favorably is a seamless orthopedic compression material with 360 degree stitching with three dimensional compression available from qsd , lavel , qc , canada , hzs 2g2 . in construction , the garment includes the usual marginal reinforcing bands 61 and 67 to which the respective zipper sections are connected , and includes a waistband 63 ( fig1 ). wire eyes 46 are attached in vertically spaced apart relationship on one marginal edge along the zipper and wire hooks 48 attached to the confronting marginal edge for hooking into the respective eyes to hold the garment in closed relationship . the garment is formed in the lower waist portion with a pair of expandable , downwardly opening , v - shaped vents 67 with which allow for expansion of the waist area to accommodate different waistlines . the scapula gripping straps 41 of the tensioning device 39 are constructed of high - friction material such as neoprene , silicone , breathoprene , adhesive foam or any other material that has a high friction surface to securely and positively grip the top surfaces of the patient &# 39 ; s shoulder to provide for high - friction contact to thereby cooperate in the tension straps pulling forward on the tension straps to thereby draw the top area of the shoulders forwardly , thereby improving the patient &# 39 ; s posture . in the preferred embodiment , these straps 41 are inelastic at the level of forces applied of about 25 pounds so as to minimize stretching and relative movement on the surfaces of the shoulders to thus minimize the tendency to break contact , thereby maintaining the grip . in the preferred embodiment , the tension straps 45 are elastic so that upon application of 10 - 15 pounds force or more they will stretch to thereby allow for bending and turning of the patient &# 39 ; s torso while maintaining the desired tension drawing the back ends of the respective gripper strips 41 rearwardly and downwardly to maintain a firm application of force on the tops of the respective shoulders . referring to fig1 and 17 , it will be noted that the shoulder straps 37 formed with the garment are configured to rest on the tops of the shoulders and preferably incorporate restraining straps 71 ( fig5 ) which constrain the scapula gripping straps 41 ( fig5 ) in position to thus maintain those scapula straps in the most preferential position for applying torque to the tops of the shoulders to draw them rearwardly as tension is applied thereto . referring to fig1 and 4 , in the preferred embodiment the garment device includes a waist belt , generally designated 79 , which will fit over the lower waist area of the garment and includes on its opposite ends respective fasteners typically in the form of loops and pile 81 and hooks 83 for adjustably fastening the waist band over the lower portion of the garment device to cooperate in holding it downwardly on the torso of the patient . in practice , the garment is so constructed that its elasticity cooperates in gripping the wearer &# 39 ; s waist and torso area , as augmented by the belt 79 when the fasteners 81 and 83 are closed on one another in tight relationship to establish a secure anchor for the lower portion of the garment as the tension straps are tightened . the passage of the tension straps 45 from the interior to the exterior of the garment as dictated by the passage slots 47 is preferably spaced below the armpits , typically in the height of the midriff or thoracic area and is angled and oriented such that the straps themselves will be directed toward the respective fastener panels 51 on the front panels of the garment ( fig1 , 14 and 17 ). some embodiments of the garment are configured to incorporate a back support plate , generally designated 101 , ( fig2 ) or a back support plate stem 103 ( fig3 and 10 - 13 ). the back plate 101 may be constructed with a generally forwardly opening structure configured on its opposite sides with outwardly flared upper and lower wings 107 and 109 into which the upper and lower thoracic areas of the wearer &# 39 ; s body might nest . in the preferred embodiment , the plate 101 is formed centrally with a ventilation opening 111 and may be covered with a fabric 113 ( fig8 and 9 ). in one modification , the plate 111 may be formed with a downwardly opening u - shaped reinforcing ribs 115 ( fig7 ). the stem plate 103 is somewhat t - shaped in a vertical plane and incorporates a stem 121 spaced along its central area with ventilation apertures 123 and configured in its upper extremity with upwardly flared support wings 125 which also include upward and outwardly angled apertures 127 . the bodies of the support plate 101 and stem 103 incorporate hard plastic or may in some instances be constructed of thin aluminum , carbon steel or other relatively rigid materials to lend support to the wearer tending to immobilize the spine and body parts for cooperating with the scapular tension straps to provide support for the wearer and further cooperate in tending to provide somewhat of a pivot point for rotation of the upper portions of the scapulas when the tension straps are tightened and the upper portions of the shoulders drawn rearwardly . in operation , it will be appreciated that when the garment is to be donned by a wearer , the tab 50 of the zipper fastener 38 will be grasped to unzip the garment to be more or less laid open as shown in fig1 . the garment may then be raised to be placed over the wearer &# 39 ; s shoulder by inserting the arms through the respective openings 40 under the respective shoulder straps and the scapula gripping straps placed over the shoulders to dispose the respective gripping surfaces 42 in direct contact with the wearer &# 39 ; s skin to provide for frictional contact of such surface for high - friction engagement and to provide resistance against rearward sliding of the straps on the surface of the skin . the garment may then be drawn forwardly around wearer &# 39 ; s sides so the wearer may engage the hook and eyes 46 and 48 to hold the marginal edges of the garment in close proximity to one another as the wearer or technician grasps the zipper tab 50 to fit the zipper together and draw the garment further together around the patient &# 39 ; s thoracic 90 , lumbar 92 and sacral 94 of the wearer to thereby apply constraining forces and high friction to the lower portion of the torso , to thereby provide secure anchorage to the torso of the wearer ( fig1 ). the belt 79 may then be wrapped about the waist of the garment and drawn tight to secure the fasteners 81 and 83 ( fig1 ). the wearer or medical technician may then grasp the free ends of the tension straps 45 on the exterior of the garment and draw the tension straps firmly around the thoracic to draw the scapula gripping straps rearwardly to draw the tops of the shoulders rearwardly and , while maintaining the tension , attach the loop and pile fasteners 48 and 52 in tensioning relationship on the respective loop and pile fastener panels 51 to thereby cause the frictional engagement of the scapular straps 41 to maintain the upper portion of the shoulders 59 rearwardly as shown in fig1 , thereby pivoting the patient &# 39 ; s scapulas rearwardly and enhancing the posture of the patient , and , with fastening of the fasteners on the panels 51 , cause the shoulders to be so maintained in favorable posture position . then , the patient may go about his or her dynamic daily activities with the shoulders held rearwardly at the upper extremities , free to maneuver his or her chest area about in different directions with the arms free to undertake their daily tasks , all the while secure in the recognition that the top of the shoulders are held rearwardly and constantly reminded of the fact that the shoulder should be so maintained in rearward orientation to thereby provide support for the particular shoulder injury , spine injury or the like being treated so that the improved posture and support will facilitate healing of the particular tears or fractures being treated and restrict forward and downward movement of the shoulders which would otherwise further irritate or aggravate the particular injury . it will be appreciated that with this particular construction , the top of the shoulders are held rearwardly while leaving the arms free to move about in a normal fashion without restriction by straps and retainers extending underneath the armpits and the like . this support then tends to facilitate more rapid and full recovery from many types of shoulder injuries , spinal dysfunction and further affords support against stooping posture . by stabilizing the thoracic and lumbar spine , the vertebrae and other structure which may be suffering from injury will heal more rapidly . holding the tops of the shoulders rearwardly induces muscular activation in a favorable manner , tending to strengthen and shorten the back muscles while extending the pectoral muscles extend to thereby tend towards more favorable posture and support to overcome weak posterior musculature conditions . the support afforded will tend to accelerate rehabilitation of injuries to the rotor cuff labrum and provide support against shoulder instability , relieves discomfort from osteoporosis and will tend to retrain the patient &# 39 ; s movement away from postural dysfunction . for certain types of spinal dysfunction or ailments , it is desirable to incorporate the support and posture positioning of the inventive garment with additional more rigid back support , either along the line of the spine or , in some instances , extending laterally about the back area . for the more extensive support across the lateral back area , a back support panel 101 may be inserted inside the back area of the garment during the application of the garment to the wearer and prior to tightening the tension straps 45 . in this regard , in some embodiments , a pocket similar to the pocket 91 for the stem support 105 is provided for nesting of the back support panel 101 in position as the garment is placed on the wearer . then , as the tension straps are tightened to draw the scapula support straps 41 rearwardly , tension is also applied to the back support panel 101 to provide for stabilization of the spinal area , as well as applying support to the lower portion of the patient &# 39 ; s scapulas to thus to maintain the lower portion of the scapulas pressed forwardly and providing a fulcrum for the scapulas as the support straps 41 are drawn rearwardly to thus enhance the tendency of the upper portion of the scapulas to be drawn rearwardly and affording additional support tending to maintain the scapulas in their preferred positions to improve posture . likewise , the wings 107 on the opposite sides of the support panel tend to hold the thoracic area in a stabilized condition tending to enhance immobilization of the spine and related areas thus enhancing the overall healing effect of the combination . in other applications , the therapeutic prescription may call for more support in the spine area of the patient , and with less concern for stabilization of the lateral portions of the back , thereby dictating application of the stem brace 103 in a manner similar to that just described for the support panel 101 . in those instances , it is possible to merely insert the spine brace 103 within the panel before the tension straps 45 are tightened . in those embodiments where a pocket 91 ( fig1 ) is formed in the interior lower waist area of the garment , the bottom end of the stem may be inserted in that pocket to thus facilitate positioning during application of the garment itself to the patient . in either the case of the support panel 101 or stem brace 103 , it will be appreciated that use of those rigid supports in combination with the garment itself will facilitate immobilization of the various body parts and tend to maintain the shoulders drawn rearwardly and somewhat stabilized , thereby tending to enhance the rate of healing for the particular ailment being treated . with the foregoing , it will be appreciated that the garment of the present invention provides a particularly effective support for the patient and will enhance the effectiveness of the garment to maintain the top of the shoulders drawn rearwardly to thereby improve posture and potentially accelerate the healing effect stemming from such improved posture and tendency for immobilization . the invention may be embodied in other forms without departure from the spirit and essential characteristics thereof . the embodiments described therefore are to be considered in all respects as illustrative and not restrictive . although the present invention has been described in terms of certain preferred embodiments , other embodiments that are apparent to those of ordinary skill in the art are also within the scope of the invention . accordingly , the scope of the invention is intended to be defined only by reference to the appended claims .
high friction scapular retraction straps for application directly to the tops of the respective shoulders of a patient and connected with tension straps to draw the gripper straps and , consequently , the shoulders rearwardly , and including fasteners to fasten to a garment worn by the patient to hold the shoulders rearward .