My brother in law thinks that he has compartmental syndrome of the calf muscle. Are there any suggestions for treatment other than surgury? Thanks.
Compartment sydrome in the calf would be new to me. I’ve experienced very bad anterior compartment syndrome and got rid ofit by changing my running machenics, most importantly footsroke. For the sake of brevity let’s just say I’m more of a pose runer these days.
Posterior deep compartment syndrome does occur, I just don’t think it’s usually in the calf. Either way, perhaps he should try to alter his biomechanics such that when he runs he doesn’t stress the offending muscles so much.
If it’s down to surgery what does he have to lose?
ere’s an excerpt from an article on exercise induced leg pain.
Exercise induced compartment syndrome is when increased intracompartmental pressure during exercise impedes blood flow and function of the tissues within that compartment. The compartments in the lower leg, which are more prone to this syndrome, are the anterior (front) and the deep posterior (middle back) compartments. Virtually any injury associated with bleeding or swelling in the compartment can lead to a compartment syndrome. Chronic pain in the lower leg usually arises and the pain is described as a deep cramping sensation and feeling of fullness in the mid-third of the leg. Rest usually relieves it but it will reoccur 20 minutes into exercise again. With chronic anterior compartment syndrome, dorsiflexion is weak and excessive swelling can put pressure on the nerves causing numbness and tingling in the foot and toes. Conservative treatment involves ice, anti-inflammatory medication and activity modification and a doctor visit if the symptoms do not go away. The most important thing for runners to do is to listen to what their bodies are telling them. If you’re starting to feel pain, don’t continue running on it. Be smart; ask a trained professional what to do because it will only get worse if it is left unattended. SAFE RUNNING!!!
Compartmental syndrome is a potentially very bad thing… It can be mild but on the worse end of the spetrum the compartmental syndrome will cause muscle tissue to die inside of the compartment, which will inturn increase the pressure within the compartment leading to more muscle death etc. etc. etc.
Having said that your first plan of action is going to be to get a proper diagnosis, a physician (most likely an orthopedist) can do some tests to get a better idea.
Although it is possible that this can be treated conservatively (icing, NSAIDs etc.) becuase of the serious potential consequences, it is not a very good idea not to have it looked at.
Surgery is only one of the options, they may only have him see a physical therapist, podiatrist etc. etc. etc. only someone that examines you would be able to make that kind of call.
This is definately a situation where a little bit of caution is going to go a long way
He THINKS he has compartment syndrome? He better find out exactly what it is from an orthopedic specialist that works with athletes before he undergoes treatment. Plantaris tendon ruptures often present with symptoms similar to compartment syndrome in other muscle bundles. Don’t get the Plantaris tendon confused with the Plantar facia located on the bottom of your foot…they are two entirely different groups of connective tissue.
I’ve torn both of my Plantaris tendons, and it took, or I should say, is taking more than a year to get my speed back.
Again I would reiterate that it is not enough to think that you have compartment syndrome. As Ktalon mentioned something like a plantaris tendon rupture (like compartment syndrome has a sudden onset associated with exercise) can casue unilateral (one leg) lower extremity pain… the differential (possible other things it could be) include a laundry list of conditions
Cellulitis, Baker cyst, trauma, compartment syndrome, localized allergic phenomena, malignant or benign tumors, inflammatory conditions, erythema nodosum, and abscesses all can cause unilateral leg symptoms. (Emergency Medicine Clinics of North America
Volume 19 • Number 4 • November 2001)
go to the doctor!!! preferably not the ER they wont be able to spend the appropriate amount of time in diagnosing the condition, but the ER is better than not going at all
good luck
Going back about 14 years now, I was diagnosed with compartment syndrome in both legs and had surgery…a great success…I was playihng football within a month of surgery. Approximately 4 years ago I had a ‘recurrence’…At the suggestion of my chiropractor, I got some massage on both legs and the problem was fixed. I am not sure what I had the second time around (one theory was scar tissue from the original operation - you could feel it get crunched when being massaged), but massage sure fixed it…made me promise I would recommend massge to anybody who though they had compartment syndrome before they opted for the surgery alternative…
One other caution related to massage for some kinds of leg pain…you still have to really pay attention to what kind of pain it is…don’t depend upon the massage therapist to be as careful as you are about the possible source of the pain. I don’t think this is the place to try and tell about the different types of leg pain and what they may mean…see someone about it if you have any doubts.
For example, if someone has a blood clot in the leg, it can be very painful, or not painful at all. Massage can break the clot loose, then it becomes an embolus and depending upon how big it is and where it lodges in your lung, it can be a minor event, or, deadly.
guy on my XC team in college had Ant. compartment Syndrome. Diagnosed in August, surgery, 4-6 weeks off and good as new. He actually ran a few of the October races.
It was mentioned above but you should get it checked out. If severe enough tissue death and/or nerve damage is possible. On the other hand it probably beats a sharp stick in the eye.
I had a compartment release procedure done 3 years ago. It is an disturbingly medieval, yet very effective means of correction.
The first point, as many have pointed out here, is that proper and expedient diagnosis is demanded. It is my understanding that the only way to determine, accurately, if it is compartment syndrome is a test where the pressure within the muscle compartment is measured at rest and after exercise.
I spent two halting years of frustration before I saw an sport-specific orthopod that administered the test mentioned above. I had physical therapists working with my gait, orthodics, massage, etc. Nothing really helped.
That being, stated, had I seen a very running-aware PT (like Mark Plaatjes here in Boulder) early on, I may have been able to avoid the surgery with some adjustment and deep tissue massage therapy. But once your have compartment syndrome, surgical release of the fascia is really the only way to go.
See someone that knows/understands the athletic specifics of your sport, and suck it up and have the gruesome test mentioned above.
I too had Ant. compartment syndrome and wouldn’t wish it on anyone. I debated with the surgical and non-surgical options and decided to due a bit of both. I presented the symptoms about 10 miles into a 20 mile run – ordinary day no big changes in mileage – it just happened. Thinking it was shin splints I iced rested and popped some Advil. With a big race season ahead I wouldn’t allow my self to think that anything could get in my way so a few days later out the door I went. I couldn’t run 100 yards with out nasty pain. To make things trickier I was booked to fly to Nice in to weeks for Long course worlds. So I figured I’d pool run until then and just pound the mileage on the bike. Finished Nice had an OK race but could hardly walk after.
Thinking that hey this may be serious (I’m SMRT) I made my way into a see a Sports Med doctor who diagnosed ant. compartment syndrome in about 30 seconds and ask me WHEN I wanted to book surgery. Problem was I wanted to compete at IMC in 10 weeks and then IMH. That surgery would really get in the way. He gave me an alternative to work with a physio to get me through that period and but really hammered home the long term risk I was taking and that ultimately this was a surgical condition for a competitive athlete. I could avoid the surgery but realistically I would have to give up running. I did finish off my season with a trip to race at Hawaii and sure enough that was followed with a bilateral compartment release and months of rehab. But I still can run and you don’t realize how important that is until it is almost taken away from you.
My story should serve as lesson as what not to do. I really put myself at way to much risk to meet a short term goal. My post surgical rehab was months not the weeks that the other poster had noted. Mostly due to the fact that I had to relearn my running mechanics from the months of accommodating this injury. On the bright side I’ve completed 4 IM’s since then – and I also met my wife during the rehab process.
So… I should not be giving advise other than to seek the proper kind professional advise and after getting multiple opinions – trust your medical professional and deal with the reality of the situation.
Good luck!