Exertional (Chronic) Compartment Syndrome

Exertional (Chronic) Compartment Syndrome



Description


The leg is divided up into four main compartments that are separated by thick ligament-like tissue called fascia. Within these compartments are muscles, nerves, arteries, and veins. When swelling occurs within a compartment, the fascia does not stretch, which leads to increased pressure. This increased pressure eventually stops blood flow in the veins and arteries and results in injury of muscle and nerves by direct pressure and loss of blood supply. This is called compartment syndrome. Chronic compartment syndrome involves increased pressure within muscle and is associated with exercise.



Common signs and symptoms



• Leg pain that begins at the same time or distance from the onset of exercise and gets better after stopping, although more severe pain may persist for hours or days.

• A feeling of fullness, pressure, or ache in the leg; occasionally the pain may be sharp.

• Numbness, tingling, or burning may occur in the leg, foot, or ankle.

• Weakness of the muscles of the foot and ankle may be apparent.


Causes


The exact cause of chronic exertional compartment syndrome is unknown, but it is thought to be the result of increased pressure within muscle—because muscles enlarge from exercise or training (hypertrophy), and fascia thickens—or some other inciting factor.



Factors that increase risk



• Sports that require endurance training or competition

• Poor physical conditioning (strength, flexibility)

• Defects in the fascia where muscle can poke through

• Poor running technique


Preventive measures


No preventive measures are known, although appropriately warming up and stretching before practice or competition and maintaining appropriate conditioning, flexibility, and strength may help.



Expected outcome


Comparment syndrome is usually curable with appropriate treatment, commonly surgery.



Possible complications



• Symptoms may recur frequently, resulting in a chronic problem.

• Permanent injury to muscles and nerves of the leg, foot, and ankle may occur.

• Performance will be affected, and you may even have to stop performing because of pain if activity is continued without treatment.


General treatment considerations


Initial treatment consists of medications and ice to relieve pain; stretching and strengthening exercises of the foot, ankle, and leg; rest; and modification of the activity that initially caused the problem. These can all be carried out at home for acute cases, although referral to a physical therapist or athletic trainer for further evaluation and treatment may be recommended. Usually, however, these treatments are unsuccessful. Some may wish to alter their activity to avoid exertional pain. Otherwise, surgery is recommended to release (cut) the fascia to relieve pressure on the structures within the compartment. Returning to the same level of sports activity may be difficult following surgery.

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Jul 18, 2016 | Posted by in SPORT MEDICINE | Comments Off on Exertional (Chronic) Compartment Syndrome

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