Some athletes experience exercise related pain in the lower leg caused by chronic exertional compartment syndrome. The American Journal of Sports Medicine published an excellent article on this in May, 2016. The research, by Dr. Winkes, took place at the Maxima Medical Center in Veldhoven, Holland.
Runners, soccer players and other distance athletes may experience chronic exertional compartment syndrome. It is a condition that plagues athletes with pain, tightness, numbness and tingling. These symptoms usually occur in the lower extremities with fitness. The symptoms subside with rest. As soon as athletes start to increase their activity level such as going out for a run, the symptoms return.
Overview of Compartment Syndrome
There are four compartments to the lower leg: the anterior compartment, the lateral compartment, the superficial posterior compartment, and the deep posterior compartment.
The anterior compartment is the front compartment of the leg and it is most commonly affected. This particular article examines patients that have high pressures or chronic exertional compartment syndrome, localized to the deep posterior compartment only.
Treatment for Chronic Exertional Compartment Syndrome
Treatment for chronic exertional compartment syndrome typically starts with rest. After adequate rest, physical therapy is often beneficial. Other things that help treat compartment syndrome include: adopting a forefoot strength running technique and shoe wear modification. Compartment pressures are tested in the office if those symptoms do not resolve with the above-mentioned treatment recommendations.
Diagnosing and Testing for Compartment Syndrome
A physician testing for compartment syndrome places a pressure catheter into the athlete’s leg in each compartment. Then the athlete will run on a treadmill and to monitor whether the pressure in the compartment increases. If the pressure increases abnormally, then the athlete has chronic exertional compartment syndrome. Some athletes have all four compartments of the leg affected. While other athletes just have the anterior compartment affected. And some athletes may just be affected in the posterior deep compartment.
Discussions and studies noted that surgical technique is not as successful when the posterior deep compartment pressure is involved.
Compartment Syndrome Research conclusion
This prospective study looks at 44 patients who have isolated deep posterior compartment chronic exertional compartment syndrome. Seventy-one percent of the patients benefited from a fasciotomy. This is a surgical technique where the surgeon goes in and releases the fascias surrounding that particular compartment. All of the study participants had deep compartment chronic exertional compartment syndrome in the lower leg.
Out of that 71% who benefited from fasciotomy, 47% of the studied patients experienced a good to excellent outcome. The researchers described outcomes as stable and long term. Based on the research, the authors determined that untreated conditions were often the cause of persistent complaints.