Compartment Syndrome

Compartment syndrome is a condition seen at The Footcare Centre especially amongst patients who do repetitive exercise. It is a condition that is often misdiagnosed (in the chronic stage).  Compartment syndrome can occur in various parts of the body but we are going to concentrate on the lower limb.

The blog covers:

  1. Types of compartment syndrome
  2. Symptoms
  3. Causes
  4. Treatments

Compartment syndrome occurs when the pressure within a muscle compartment increases, restricting oxygen and blood flow (ischaemia) to the area and potentially damaging the muscles and compressing the nerves.

There are four fascial compartments in the leg below the knee.  The most common compartment syndrome that occurs affects the front (anterior) fascial compartment below the knee.

It is caused by swelling of one of the muscles of the lower leg, called the tibialis anterior muscle.  The muscle can swell during exercise such as long-distance running. It tends to cause pain in the shin on the outer (lateral) side.  The pain is relieved by resting but the onset can return each time you run. Compartment syndrome should not be confused with shin splints i.e. Medial Tibial Stress Syndrome.

There are two main types:

Acute:

It occurs suddenly, usually after a fracture or severe trauma. This needs urgent medical attention as it’s a medical emergency and can lead to permanent muscle damage. Symptoms include severe pain which is intensified upon stretching the affected muscle, tightness and tenderness, paraesthesia, weakness and neuropathy. This type is highly unlikely to be seen in our clinical environment.

Chronic:

This type does not cause permanent damage but is very uncomfortable and will halt your activity; the pain will then subside after a couple of minutes rest.

There is gradual onset usually during and immediately after long distance running or vigorous exercise. Symptoms include a cramping or spasm feeling, oedema (swelling), and in rare severe cases temporary paralysis in that muscle.

We see this type fairly often and we treat in two main ways:

  1. Physiotherapy referral for manual therapy
  2. If indicated then the prescription of bespoke orthoses via a biomechanical assessment or over the counter insoles.

 

If this fails to improve the situation then a surgical referral for either a fasciotomy or fasciectomy is advised.

So please come and see a Podiatrist at The Footcare Centre if your symptoms fit with the discussed by either booking online or phoning 01932 849373 as first line care can often resolve the symptoms.

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