COMPARTMENT SYNDROME

Compartment syndrome is a condition in which the pressure within a limb increases and compresses nerves, blood vessels, and muscles. The ischemia to these tissues can result in pain, feelings of limb tightness, swelling, and paresthesias such numbness and tingling. This condition most commonly occurs in the lower leg, but can also happen in the upper leg/arm, foot, hand, buttock, or abdomen. When talking about compartment syndrome there are two main types, acute compartment syndrome (ACS) and chronic exertional compartment syndrome (CECS).

ACS is caused by active bleeding or edema in a specific compartment, usually as a result of fractures, blunt force trauma, and reperfusion injuries after acute arterial obstructions. This form of compartment syndrome is often a medical emergency, and requires surgical intervention (i.e. a fasciotomy) to be resolved.

CECS is usually caused by repetitive and strenuous exercise, and often with a sudden increase in training load or volume. Because of this, CECS is often found in long distance runners, soccer players, and military personnel. The symptoms of CECS typically occur at a specific time/distance during exercise (i.e. after running 3 miles), and resolve with rest. This type of compartment syndrome is typically treated with conservative measures first, such as physical therapy, soft tissue massage, orthotics, and relative rest from the aggravating activity. In some instances, surgical treatment is necessary if the above-mentioned strategies do not help to alleviate the symptoms. If surgery is required, multiple studies have shown very good results, with most subjects returning to full participation in their activities.

Due to the most common site of CECS being the lower leg, the typical symptoms are lower leg pain as well as foot/leg numbness and tingling. This often leads to a delay in the diagnosis of compartment syndrome, as these symptoms mimic those of many other conditions. Other possible conditions that compartment syndrome could be confused with are shin splints, fibular/tibial stress fractures, lower back issues (such as disc derangements, stenosis, spondylolisthesis), and radicular conditions such as sciatica.

Compartment syndrome can be differentiated from these other conditions by the possible changes in peripheral pulses and limb stiffness seen with compartment syndrome, and through direct testing via US studies or intracompartmental pressure studies.

If you are experiencing any of these symptoms, see your current healthcare provider or call our office at 203-693-3754 to schedule an appointment with one of our expert Physical Therapists to determine the cause of your pain and to get you back to doing what you want to without pain!

REFERENCES:

https://www.physio-pedia.com/Compartment_Syndrome_of_the_Lower_Leg

Blackman, PG. A review of chronic exertional compartment syndrome in the lower leg. Medicine & Science in Sports & Exercise: March 200 – Volume 32 – Issue – pS4-S10