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The COM-PRESSOR A Specific Pelvic Compression Belt Patent Pending Designed by Diane Lee Optimal function of the pelvic girdle requires stability of the sacroiliac joints (two joints at the back of the pelvis - SIJ) and pubic symphysis (joint at the front of the pelvic girdle - PS).  Normally, a small amount of movement is possible at the SIJ and PS. When load is transferred through the pelvis, this motion must be controlled and compression of the SIJs and PS is required to achieve this. Compression of the pelvis is produced by contraction of the pelvic muscles. These muscles are collectively called the core and include the transversus abdominis (deepest abdominal) and the multifidus (deep back) muscles. Core stabilization exercises are often required when the pelvis is unstable. The COM-PRESSOR is a pelvic belt which applies a variable amount of compression to specific locations of the pelvis. The COM-PRESSOR allows customization such that the pelvis can be compressed where it is needed the most. The belt helps to support the pelvis while proper muscle function is being re-established through core stabilization training. Research has shown (Richardson et al 2001) that the core muscles (transversus abdominis and multifidus) increase compression of the SIJs. It is felt (Lee 2001) that transversus abdominis helps to compress the front of the pelvis while multifidus helps to compress the back of the pelvis.   Optimally, the transversus abdominis and multifidus should contract together so that a corset of compression around the entire pelvic girdle is produced. Indications for use This belt is indicated for individuals who have impaired function of the muscles of the core. The reasons for the impaired function can be multiple and include (but are not limited to): 1. recent or past pregnancy 2. recent or past abdominal or back surgery 3. recent or past low back or pelvic sprain (including injury to any of the structures of the low back or pelvis i.e. lumbar disc, facet joints, muscle sprain, ligament sprain) due to trauma (falls, lifting injuries) 4. improper training strategies which have lead to imbalanced muscle function 5. improper posture (standing and sitting habits) 6. reflex loss of muscle function secondary to visceral pain/inflammation/infection (bowel, bladder, uterine organic dysfunction) How to wear the belt First, you need to determine where your pelvis is lacking in compression. The Active Straight Leg Raise Test (Mens et al 1999) will help you figure this out. The Active Straight Leg Raise Test - ASLR 
1. Lie on your back with your legs straight.2. Keeping your right knee straight, lift your leg up towards the ceiling (no more than 12 inches off the table is necessary). Put your leg back down and note how much effort is required to lift this leg. Repeat the ASLR if necessary. Does lifting this leg increase your back or pelvic pain? 3. Repeat the ASLR with your left leg and compare the difference to the right leg. Is one leg heavier than the other? Is it more or less difficult to lift one or the other? 4. Put your hands on the outside of your hip bones with your fingers pointing towards your navel (or have someone else do this) and compress (squeeze) your hips together. Repeat the ASLR on the left and right leg and note any change in
b. the heaviness of the leg c. low back or pelvic pain while lifting the leg. 5. Put your hands on the outside of your hip bones with your fingers pointing towards your back (or have someone else do this) and compress (squeeze) your hips together. Repeat the ASLR on the left and right leg and note any change in
b. the heaviness of the leg c. low back or pelvic pain while lifting the leg. 6. Put one hand on the outside of your hip bone with your fingers pointing towards your navel and the other hand on the outside of your hip bone with your fingers pointing towards your back and compress (squeeze) your hips together. Repeat the ASLR on the left and right leg and note any change in
b. the heaviness of the leg c. low back or pelvic pain while lifting the leg. 8. Wrap the belt around your pelvis with the label "THE COM-PRESSOR" centered over your sacrum and secure the belt snugly in the front 9. Apply the compression straps to the belt according to where you need the compression the most.
b. If you felt best with #5 above (bilateral multifidus) secure one end of the compression strap to the side of the belt, stretch the strap to the back of your pelvis and apply to the belt in the back midline (see Figure 1). Secure one end of a second compression strap to the opposite side of the belt, stretch the strap to the back of your pelvis and apply to the belt in the back midline (see Figure 2). If you need more compression than this, apply a second (longer) compression strap overtop of the first one. c. If you felt best with #6 above secure one end of the compression strap to the side of the belt, stretch the strap to the front of your pelvis and apply to the belt in the front midline. Secure one end of a second compression strap to the opposite side of the belt, stretch the strap to the back of your pelvis and apply to the belt in the back midline. If you need more compression than this, apply a second (longer) compression strap overtop of the first one.
10. Repeat the ASLR with the belt in place and the compression straps secure. You should notice an obvious decrease in the effort required to lift your leg and the leg should feel lighter. When to wear the COM-PRESSOR Initially, you should wear the COM-PRESSOR whenever you are active (i.e. standing, sitting or during any activity of daily living). As you regain the strength of your core muscles you can wean off the belt by reducing the amount of compression (loosen the tension in the compression straps) and finally removing the belt altogether for short periods of time (begin with ½ hour). Ultimately, you should be able to eliminate the need for this belt. THE COM-PRESSOR is intended to be used as an adjunct for stabilization of the pelvic girdle. You should not depend on it entirely for support and should be trained how to re-establish the proper function of the core muscles. The belt will help you decide which muscles require training - a therapist properly trained in core stabilization exercises will teach you how to do this and how to gradually reduce the need for this belt. Where to get the COM-PRESSOR This unique belt is available through OPTP (Orthopaedic Physical Therapy Products) at : USA - through OPTP (Orthopaedic Physical Therapy Products) at 3800 Annapolis Lane #165 Minneapolis, MN 55447 Phone: (763) 553-0452 - Fax: (763) 553-9355 e-mail:customerservice@optp.com www.optp.com Canada – through Cardon Rehab Products 38 Buttermill Ave Concord, ON L4K 3X3 Canada 800-944-7868 References Richardson CA, Snijders CJ, Hides JA, Damen L, Martijn S P, Storm J 2001 The Relationship between the transversus abdominis muscles, sacroiliac joint mechanics and low back pain. In: Proceedings from 4th Interdisciplinary World Congress on Low Back & Pelvic Pain. Montreal p. 132 Lee D G 2001 An Integrated model of joint function and its clinical application. In: Proceedings from 4th Interdisciplinary World Congress on Low Back & Pelvic Pain. Montreal p. 137 (this article is available online at this website) 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. Eur Spine 8:468-473 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. Am J Obstet Gynecol vol 166 No 4 p 1243-1247 |
