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Compartment syndrome is an acute medical problem following injury, surgery or in most cases repetitive and extensive muscle use, in which increased pressure (usually caused by inflammation) within a confined space (fascial compartment) in the body impairs blood supply. It can be a result of overuse and over-developing the muscle through training.  This condition is most commonly seen in the anterior compartment (shin) and posterior compartment (calves) of the leg.  It is commonly misdiagnosed by laymen as “shin splints”. Compartment syndrome can be very painful, and if left untreated, can lead to a very serious medical condition where the muscle tissue dies – due to lack of oxygen and nutrients.

Symptoms of Compartment syndrome

• Pain is often reported early and almost universally. The description is usually of severe, deep, constant, and hard to locate. The pain is aggravated by stretching the muscle group within the compartment and is not relieved by pain-relief medication. The pain increases during exercise which eventually makes running impossible. Pain goes after a short rest but comes back again during exercise.

• Paresthesia (alterated sensation e.g. “pins & needles”) in the cutaneous nerves of the affected compartment is another typical sign.

• Paralysis of the limb is usually a late finding. The compartment may feel very tense and firm as well (pressure). In some cases, some find that their feet and even legs fall asleep. This is because compartment syndrome prevents adequate blood flow to the rest of the leg.

• Tense and swollen shiny skin
• Difficulty in lifting the toes and foot up.
• Pain when pulling the toes and foot downwards.

Treatment: Acute compartment syndrome is a medical emergency requiring immediate surgical treatment known as a fasciotomy to allow the pressure to return to normal.

Subacute compartment syndrome, while not quite as much of an emergency, usually requires urgent surgical treatment similar to acute compartment syndrome.

Chronic compartment syndrome in the lower leg can be treated conservatively or surgically.

What can the athlete do?

Rest, but try to exercise your upper body or cycle if it is not painful. Apply ice and compression for 20 minutes at a time. Rest until there is no pain. Apply sports massage techniques to increase the elasticity of the muscle sheath.

Apply heat and use a heat retainer.  See a sports injury professional who can advise on rehabilitation.

What can a sports injury specialist, biokineticist or doctor do?

Prescribe diuretics and anti-inflammatory medication e.g. ibuprofen. Correct any biomechanical dysfunction with orthotic devices, or by correcting gait patterns and muscle imbalances. Analyse your training methods, running gait and types of shoe to determine any contributory factors. Use sports massage techniques to stretch the muscle sheath. Operate. They could make a small cut or two in the muscle sheath to allow the muscle to expand out.

Article contributed by Angela Paterson – biokineticist and sports massage therapist at the Renaissance Body Science Institute