Biomechanical model study of pelvic belt influence on muscle and ligament forces

Many patients with low back and/or pelvic girdle pain feel relief after application of a pelvic belt. External compression might unload painful ligaments and joints, but the exact mechanical effect on pelvic structures, especially in (active) upright position, is still unknown. In the present study, a static three-dimensional (3-D) pelvic model was used to simulate compression at the level of anterior superior iliac spine and the greater trochanter. The model optimised forces in 100 muscles, 8 ligaments and 8 joints in upright trunk, pelvis and upper legs using a criterion of minimising maximum muscle stress. Initially, abdominal muscles, sacrotuberal ligaments and vertical sacroiliac joints (SIJ) shear forces mainly balanced a trunk weight of 500N in upright position. Application of 50N medial compression force at the anterior superior iliac spine (equivalent to 25N belt tension force) deactivated some dorsal hip muscles and reduced the maximum muscle stress by 37%. Increasing the compression up to 100N reduced the vertical SIJ shear force by 10% and increased SIJ compression force with 52%. Shifting the medial compression force of 100N in steps of 10N to the greater trochanter did not change the muscle activation pattern but further increased SIJ compression force by 40% compared to coxal compression. Moreover, the passive ligament forces were distributed over the sacrotuberal, the sacrospinal and the posterior ligaments. The findings support the cause-related designing of new pelvic belts to unload painful pelvic ligaments or muscles in upright posture.