Compartment syndrome is a painful condition where an excessive amount of fluid builds up around muscle fibres that are enveloped with fascia (connective tissue). This increase in fluid causes an increase in pressure which can stretch the connective tissue and restrict blood flow causing pain.

The reduced blood flow can lead to a decreased oxygen and nutrient supply to the tissues. In extreme circumstances, this is a very serious condition and needs to be assessed by medical personnel immediately.

Although compartment syndrome is relatively uncommon. It can have serious consequences for the sufferer depending on the type of compartment syndrome. Acute and chronic compartment syndrome are the two types, and each has its own distinctive onset.

Different Types of Compartment Syndrome

There are different types of injury that fall into this category:

1. Acute Compartment Syndrome:
   This generally happens after a traumatic injury that involves a fracture or heavy bruising. It can also occur due to steroid use, vascular surgery or after a blood vessel has been reopened due to a blockage. The area around the injury will swell within a matter of hours and cause excruciating pain that may also numb the area.
2. Chronic (or Chronic Exertional) Compartment Syndrome
   This is more common in runners. The repetitive movement of running causes an increase in swelling due to the strain going through the muscles when a runner tries to slowly lower his or her toes as the heel strikes the ground. Exertional compartment syndrome is usually not a serious condition and goes away when activity is stopped. However, it can occur frequently during training, and can limit the intensity or duration of the workouts.

Compartment Syndrome Symptoms

The symptoms of chronic exertional compartment syndrome (CECS) usually start during a run and decrease once you stop. Commonly the affected area is the tibialis anterior muscle at the front of the shin.

These symptoms include:

• Pain or cramping sensation
• Visible muscle bulge at the front of the lower leg
• Difficulty dorsiflexing (lifting the foot at the ankle)
• Numbness

Examination and diagnosis

The diagnosis of CECS can generally be done through a consultation and physical examination. In extreme cases, the pressures in the leg can be measured before and after exercise to see if it increases.

Compartment Syndrome Treatment

Treatment for CECS uses a variety of stretching and strengthening exercises, massage and dry needling. The latter are designed to decrease the tension within the muscles and lower the pressure within the anterior compartment. General strengthening of muscles around the ankle will potentially enable tibialis anterior to better withstand the forces going through it.

Altering your gait pattern to a forefoot or mid-foot strike will take some stress off the involved muscle, tibialis anterior. You can learn more about this here: Forefoot Running for CECS.

Only in extreme circumstances should surgery be considered for CECS.

Last updated on March 2nd, 2021.