Are you getting the best support from your belt during your core training program? If not, read on – perhaps The Com-Pressor, a unique sacroiliac belt which allows you to specifically apply compression and support where YOU need it most, will help.
Low back and pelvic girdle pain often occur when there is dysfunction of the deep stability, or 'core', muscles. In this situation, retraining of the core muscles is needed before core strengthening can occur. The Com-Pressor is a unique sacroiliac belt which supports the pelvis specifically where compression is needed the most during the retraining period. Designed by Canadian physiotherapist, Diane Lee, its application is based on scientific evidence which suggests that pelvic instability can occur when there is insufficient compression of the joints of the pelvic girdle (reduced force closure); namely, the sacroiliac joints and the pubic symphysis (Snijders et al 1993). As mentioned above, the cause of the reduced force closure, or insufficient compression, is often impairment in motor control (timing of activation) of the deep stability muscles. These muscles include (but are not limited to) the transversus abdominis, the deep fibres of the lumbosacral multifidus and the pelvic floor (core muscles). The Com-Pressor SI belt is used as an adjunct during core muscle retraining and acts both to provide mechanical support to replace the compression or force closure lost and proprioceptive input to remind the brain which muscle needs facilitation. How does it do this?
Figure 1. The body belt
The Com-Pressor supports the pelvis through the tension of four very strong elastic straps. The straps are attached to an underlying body belt (Fig. 1) which is best applied around the pelvis just below the anterior, superior iliac spines (ASISs) (Damen et al 2002) if the need is to compress the SIJs and just above the greater trochanters of the femurs if the need is to compress the pubic symphysis (Vleeming et al 1992). The body belt is applied with the individual in standing. The location of the strap(s) is variable and depends on the individual’s needs which are determined by the active straight leg raise test (ASLR) (Mens et al 1999).
The ASLR test has only been validated for peripartum women with pelvic girdle pain (Mens et al 2001) however; in clinical practice it is used for men and women, athletic and non-athletic, peripartum and nulliparous (Lee 2004, Lee & Lee 2004). The supine individual is asked to lift their extended leg no more than five inches off of the table and to note the effort required to do so. With pelvic instability, one leg is often harder to lift than the other. Subsequently, compression is applied to the pelvis in a variety of combinations and the impact of the specific compression on the effort to lift the heavier leg is noted both by the individual and the therapist. Compression applied anterior and bilaterally at the level of the ASISs is thought to simulate the support provided by the left and right transversus abdominis, compression applied posterior and bilaterally at the level of the posterior, superior, iliac spines (PSISs) is thought to simulate the support provided by the deep fibres of the left and right lumbosacral multifidus while compression applied through the pubic symphysis bilaterally is thought to simulate the support provided by the pelvic floor.
Figure 2. The ASLR test
Compression can also be applied to the left ASIS and the right PSIS to simulate the left transversus abdominis and the right deep multifidus or the right ASIS and the left PSIS to simulate the right transversus abodminis and the left deep multifidus (Fig. 2). You are looking for the specific location of compression that makes the effort to lift the leg easier. This finding directs the next step in the use of the Com-Pressor SI belt which is the application of the elastic straps. The strap is applied in the midaxillary line first, tension is then applied to the strap and the opposite end is then attached to the body belt either in the anterior midline or the posterior midline according to the findings from the ASLR test (Fig. 3). Two straps applied to the anterior pelvis will support the transversus abdominis bilaterally, two straps applied to the posterior pelvis will support the deep lumbosacral fibres of multifidus, one strap on the left anterior aspect of the pelvis and another on the right posterior aspect will support the left transversus abdominis and the right multifidus. When there is instability of the pubic symphysis, the body belt should be worn low across the pelvis just above the greater trochanters and one anterior strap applied across the midline from the right midaxillary line to the left to support the joint as well as the pelvic floor.
Figure 3. Applying the compression straps
The Com-Pressor SI belt is appropriate not only for post-partum women but also for athletes with osteitis pubis or groin strains, lower abdominal strains or hernia or any individual who has impaired lumbopelvic 'core' muscle function as a consequence of maladaptive habits with or without trauma. Its versatility combined with its durability makes this belt useful in multiple clinical situations. Used in combination with a prescriptive exercise program for 'core' muscle training and then strengthening, the Com-Pressor is a valuable product that facilitates treatment for all individuals with impaired lumbopelvic function.
Click here to watch a short video on the use of the Compressor
This video clip comes from the DVD – An Integrated Approach to the Assessment and Treatment of the Lumbopelvic-hip Region by Diane Lee & Linda-Joy Lee and the full DVD is available – see Products.
Click here to order your belt today
Where else to get the COM-PRESSOR SI belt
You can purchase this product online by clicking on the above link or you can purchase it from the following distributor:
- Australia (Queensland) - Alpha First Aid & Alphasport www.alphasport.com.au
References
Damen L, Spoor C W, Snijders C J, Stam H J 2002 Does a pelvic belt influence sacroiliac joint laxity? Clinical Biomechanics 17(7):495
Lee D G 2004 The Pelvic Girdle, 3rd edn. Elsevier Science. Edinburgh Available online at www.dianelee.ca
Lee D G, Lee L J 2004 An Integrated Approach to the Assessment and Treatment of the Lumbopelvic-hip Region – DVD. Available online at. www.dianelee.ca or www.optp.com
Mens J M A, Vleeming A, Snijders C J, Stam H J, Ginai A Z 1999 The active straight leg raising test and mobility of the pelvic joints. European Spine 8:468
Mens J M A, Vleeming A, Snijders C J, Koes B J, Stam H J 2001 Reliability and validity of the active straight leg raise test in posterior pelvic pain since pregnancy. Spine 26(10):1167
Snijders C J, Vleeming A, Stoeckart R 1993 Transfer of lumbosacral load to iliac bones and legs. 1: Biomechanics of self-bracing of the sacroiliac joints and its significance for treatment and exercise. Clinical Biomechanics 8:285
Vleeming A, Buyruk H, Stoechart R, Karamursel S, Snijders C 1992 An integrated therapy for peripartum pelvic instability: a study of the biomechanical effects of pelvic belts. American Journal of Obstetrics and Gynecology 166(4):1243
