Get a second opinion.

I am a physician, but not an orthopedist or sports med doc so this is not my area of expertise, but it does seem that you may have a chronic exertional compartment syndrome. Whereas this is more common in the lower leg, it can occur in the quads/thigh compartment. I think that you need a second opinion since the first plan of therapy has not worked.

Well, I had acute compartment syndrome in my left thigh after a freak crash where the handle bars on my bike twisted into my quad. I thought it was just a "normal" thigh contusion. However, after limping around a few days after the crash and seeing the swelling increase I became somewhat worried. Later that night I awoke from sleeping with the most excruciating pain I have ever felt. Realizing that my leg was "dying" I drove myself to the hosiptal and underwent emergency surgery. I have a ten inch scar and some nice "pie crusting" on my leg but no other issues or problems.

Compartment syndrome can be acute or chronic, chronic treatment is usually conservative, while acute symptoms signal a medical emergency--as was my case. You might get some good advice here but my guess is that RICE--minus the compression which is obviously not needed, and time off your feet will help(success rates are low though going just the conservative route). If that fails your likely in for a fasciotomy, i.e. "going under the knife" so that the pressure can be released. Good luck, this is not something to mess around with, and I would get a couple of different doctors to look at you. Montior your leg viligantly.

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"I really wish you would post more often. You always have some good stuff to say. I copied it below just in case someone missed it." BarryP to Chainpin on 10/21/06

Any direct trauma to the region? example: hitting a rock at the sight of the chief complaint while falling from your bike. When did you first notice the pain and what do you think caused it?

I should probably stop here and you should go get another opinion from someone that can give you a thorough physical exam. Good luck. ERIK

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"Spectacular achievements are always preceded by spectacular preparation."

Thanks for all the advice. I have seen 2 sports doctors, the first one just said muscle damage caused by overuse which will get better with rest and ice. I definitely don't have acute CS as I'm not having severe pain, it's more of an aching feeling and swollen. Your experience sounds pretty bad and I've read about surgery which sounds like a last resort if rest doesn't help me. I will try to see another doctor too, thanks all.

I now know the trigger was a 3 hr bike ride in hills in the big chain ring. I felt really heavy quads for a week after that and then the aching and swollen feeling started. The problem was I tried to train and race through it for 4 weeks. I never felt sharp pain so didn't think it was something the doctor could help with and figured I just needed rest. So Doctor says compartment syndrome due to overuse.

Yeah, what happened to me sucked, really scary. I did go into the hospital the day after it happened and the Doc sent me home with crutches and some advil. It wasn't until a few days later that the shit hit the fan, and it happened very quickly, as in, the pain was constant and not too bad to within a few hours I was going under. That's why I said monitor it closely. I don't know if chronic CS can turn into Acute CS, but if it can, you want to make sure it doesn't happen to you.

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"I really wish you would post more often. You always have some good stuff to say. I copied it below just in case someone missed it." BarryP to Chainpin on 10/21/06

Geez, the is scary stuff. What is "compartment syndrome"?

Good luck with it, btw.

The way my doc explained it to me was: Think of your muscles like sausages. They are encased by fascia (think: sausage casing.) When you work out, the muscles swell from the increased bloodflow. Normally, this isn't a problem... there is room to handle the muscle expansion. But if the swelling is severe enough, or you just got unlucky genetically, there isn't enough room for the muscles when they swell. The muscles do the equivalent of sausage trying to split its casing when it cooks. The fascia around the muscle acts like a tourniquet, and blood flow is restricted or stops.

I had a horrible case of it in my shins, and ended up having surgery. The surgery worked perfectly for me, but my case was very clear.

Everything I read about CS was related to the lower leg, usually the anterior (shin) or posterior (calf), so I'm afraid I can't help the OP.

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-Mark Rebuck, http://www.markrebuck.com/

Circle.
Are you still in this forum? I would really like to contact you.
If you see this, please answer.

Are you looking for him for questions about compartment syndrome. I just had surgery for it a few years ago. If you have any questions I might be able to answer them.

Hei.

So nice of you to answer. The reason why i was so keen to get in contact with the person who wrote the question about compartment syndrom in the quads is that his story is the first thing i have read thats is similar to what i have.
Summer 2018 i was preparing for half marathon, running more than before, my muscles was tired over some weeks, but still working, but somehow i went over a threshold and my quads and calf was really heavy and tired. Could not race, first i thought i was overtrained, and just take som weeks of and it will be back to normal. But now, over a half a year later, my legs are still dysfunctional, cant walk (just very short distance) have pain almost all the time. Tired when sitting. I have been in contact with several experts, no one can give an good answer. So i quite desperate finding someone who hade something similar, but so far i have not.

/jacob

My experience is a little similar but doesn’t quite sound the same.
Mine was in my lower leg. At first it would only come on while running. It would start to feel tight. Then it would almost feel like it was getting swollen(sp?). But from the outside it would look the same. Then it would go to a numbness/ pins and needles. It felt like if I could just stretch it out, it would go away, but it never actually worked.
It started once I started running after about 10 minutes. Then got worse. After 5 min. Then almost immediately after I started running.

Finally it got to the point where it would even happen while I was walking the dog.

Doctors started me with physical therapy of massage, stretching , Graston, and acupuncture with stim.
Zero results.


Finally went to a surgeon who immediately referred to it as exercise induced compartment syndrome. One of the previous posts explains the facia very well. But he said my muscles were trying to swell once I started running, but the facia was too tight and wouldnt allow it.

I don’t exactly remember but i believe Mine was the outer two compartments of my lower left leg. He made about a 4” cut on the outside of my calf. And was able to get to everything from there.
2-3 days on crutches. Then I was allowed to start walking.
Biking, once the stitches were out I think around 10 days.
2-3 weeks and I was able to start lightly running.
After a month it was like nothing ever happened and I was 100%

He told me to be ready for a very weird feeling when I started running. And it was odd. I could feel my leg like it was about to swell and feel bad again, then it would have a tearing sensation where he cut. Then it would feel fine.
That happened for about the first month during the first 5 or so minutes of each run. Then that was gone.

They have tests they can do to measure the pressure in your legs. My doctor didn’t do them because my description was textbook and he didn’t think it could be anything else.

I have found that some docs don’t really accept exercise induced compartment syndrome. I went to 3 or 4 before I found one. Everyone else said therapy or stretching should take care of it.

I hope this helps.