I battled this issue last year in the spring , and had huge success with some dry needling done by a chiropractor. In one visit, my leg went from feeling constantly tight while running and with normal daily activities to feeling a complete release within a few minutes of having the needles in my calf. I know that my experience will vary with others, but that virtually solved my tight calf problem just like that.

I was dealing with the same issue about a month ago and didn't wanna spend the money for another visit to the chiro, so i started doing a bunch of research on compartmental syndrome in the calf ( i'm a recent graduate of an exercise physiology master's program) and was mostly wanting to educate myself of the physiology of what was going on in my leg, and came across this Youtube channel/video that shows fascia release technique for the deep compartment of the calf which is what i was battling. Although the release was not as immediate as the dry needling, it was veryyyyy noticeable and it has cleared up my issue without having to visit the chiropractor. Here is the video , and I hope it helps you get healthy!

https://www.youtube.com/watch?v=MQTRAdJvIQ4

Is this bilateral? Have you altered your run form or switched into a lower heel/toe drop?

Was looking at your blog- going off of your previous run times/ability, this isn't probably isn't a fitness issue...so I'd start picking apart changes that you've made and start eliminating.

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http://www.reathcon.com

+1 on the last post. I had this for years in my shin area. Went through a lot of PT and switched to a low drop shoe and it has been pretty much gone for three years now. I had developed an imbalance that was putting to much stress on certain muscles

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Andy Mullen
Team Zoot

I had this last year as well. Actually, i should say i had exercise induced nerve compartment syndrome. I was supposed to have surgery, but I didn't want that, so the solution I came up with was that I switched to an elliptical, which took the impact out of running. With in 2 months, most of the symptoms had gone away... I realize it wasn't perfect training, elliptical vs running, but it worked and solved the problem for me.

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Where's you pain at? Chronic exertional compartment syndrome (CESC) typically (>90% of the time) is related to anterior and lateral compartments which cause lateral shin pain. Tight calf pain can be a sign of superficial or deep posterior compartment syndrome, although this is incredibly rare. Unfortunately no treatment, aside from fasciotomy has been shown to be very beneficial. Fasciotomy is a pretty big procedure, but can be very successful and assuming it works you will be back to running fairly quickly. While it is certainly possible that you have CECS if your pain is in you calves the odds are it is something else. That being said, it is worth getting tested (exertional compartment pressure testing) if your symptoms are limiting your running to that degree.

x2

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I thought I had this. Severe tightening of calf and shin muscles when running. I got tested for compartment syndrome (needle into each with pressure monitor at end of needle for baseline pressure. Then run around the hospital grounds then tested again with needles and pressure monitor). My results came back fine.

Switched to minimalist shoes (very, very slowly) and did lots of feet strengthening, grafton technique massage of feet and legs, thera-band exercises and gradually strength and balance returned. Still working on feet, ankle, tibial strength but loads better than before and buiding up distance and speed.

Also, changed to a 'clean' diet and try to minimise foods which cause inflammation.

Hope this helps!

Update:
DEEP tissue massage helps tremendously and I do feel thetightness less wearing low drop shoes. Ivisited an acupuncturist which DID NOT seem to help any. I’m scheduled to see a doctor tomorrow to geta referral for dry needling. If I didn’tneed to have dry needling prescribed by a doctor, I would have already had itdone. Thanks again everyone, you’ve beenimmensely valuable.

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I'm trying to figure out if I have exertional compartment syndrome and whether I should see my primary care MD or an ortho or a physiatrist...

The difference with me is that it doesn't feel like bilateral calf tightness so much as generalized lateral pain. Every step is painful and achy and my lower legs feel like they're going to snap and collapse. Never felt anything similar in my life, and I've had every running injury over the past 25 years of running. Started a couple weeks ago. No changes in shoes, running surface, training volume, etc. Actually, running less this summer than last summer (30MPW vs. 50MPW).

I've taken a couple days off, then 4 days off, and now going to try a week or two, but rest doesn't seem to help. Would you suspect compartment syndrome, and which type of doc would be best to see for dx & tx?

True compartment syndrome implies loss of blood flow and sensation to the compartment that is actually swelling. This is exquisitely rare, especially posteriorly. If massage therapy helps, it would seems built up fatigue, stress and low level injury (that was likely ignored) is to blame. If your calf and/or parts of your foot are going numb you have an issue. Otherwise, compartment syndrome is unlikely. Try regular stretching post run and observing your fatigue and stress levels.

It's possible it is vascular related. Exertional compartment syndrome won't always have parasthesias (numbness, tingly, etc). There are vascular pressure diagnostic tests that are used but finding the right doc can be tough.

Other differential diagnosing would be ruling out a neurogenic component.

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CB
Physical Therapist/Endurance Coach
http://www.cadencept.net

sorry, can't help, but just wanted to say sorry to hear that man!

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@adamwfurlong

I had anterior/lateral release in 2007 (bilateral fasciotomy). Diagnosed by a doctor board-certified/CAQ in sports med, then because I "failed," I was referred to an orthopedic surgeon (HMO health care). At the time, the Stryker test was unfamiliar enough that they turned the appt into a clinic for the PTs, residents, and fellows. Experience with both CECS and differential diagnoses is probably the most important factor; otherwise they'll tell you to quit reading Dr. Google/Dr. Slowtwitch.

Good luck!

I dealt with chronic exertional compartment syndrome for 10+ years. Bilateral faschiotomies (fascia release) didn't work, but bilateral faschiectomies (fascia removal) did.

From all those with CECS I've talked to, the biggest determinant is tightness and pain during running that quickly subsides once you stop.

You might want to look into popliteal artery entrapment.