March 28, 2023
Compartment syndrome is often confused with shin splints - Here's what you need to know

Compartment syndrome is often confused with shin splints – Here’s what you need to know

To understand chronic compartment syndrome, an overuse injury that commonly causes calf pain, it’s helpful to start with a little anatomy lesson. Although most of us don’t think of our body as having “compartments,” if you use terms like “the front of my lower left leg” or “the back of my right thigh,” then you’ve already divided your body into sections or “apartments”.

Here are the anatomy details: Muscles, tissues, and nerves are bundled and divided into separate sections throughout our body. “These compartments are covered by fascia, a thin sheath of tissue that surrounds and holds the muscles in place,” explains Jill C. Mitchell, PT, DPT, a physical therapist with Thrive Physio and Wellness in Dallas, Texas. The runner’s world.

While mild and temporary swelling in compartments, such as those on your feet, is a typical consequence of exercise—because oxygen and blood flow to hard-working body parts—it’s possible, though unusual, that a compartment can’t to handle this extra flow. This can lead to chronic compartment syndrome, sometimes called exercise compartment syndrome.

What is apartment syndrome?

According to the American Academy of Orthopedic Surgeons, “compartment syndrome is a painful condition that occurs when the pressure inside the muscles increases to dangerous levels. This pressure can reduce blood flow, which prevents food and oxygen from reaching nerve and muscle cells.” This can occur in any of the body compartments, but most often occurs in the lower leg, which has four compartments (anterior, posterior, lateral, and deep).

“Exercise compartment syndrome often occurs due to overtraining without enough rest, meaning the tissues don’t have time to recover,” says Mitchell. “Think of it this way: Tissues swell as part of recovery, and if you don’t allow enough time [for this recovery]it just keeps swelling, and then the fascia doesn’t leave room for that recovery to happen.”

It is also important to note that another type of apartment syndrome, called acute apartment syndrome, can also occur. However, this problem is much more likely to be the result of an accident and is rarely related to excessive use or operation.

“Acid usually occurs when it’s combined with some kind of trauma,” says Mitchell. “This is often a medical emergency and, in this case, the priority is to release that pressure.” In severe cases, surgical ‘decompression’ may be required. In this procedure, doctors cut the fascia to relieve pressure on the muscle compartment. This is rarely something that runners who suffer from chronic compartment syndrome will experience.

Identifying the symptoms of compartment syndrome

The most common symptoms of chronic compartment syndrome include leg pain, unusual nerve sensations, and eventually muscle weakness. Specifically, there are “five Ps” to look for: Pain, no pulse (due to poor circulation), paralysis (muscle weakness), paresthesia (numbness), and pallor (white skin, again due to poor circulation).

“You may also find that the pain gets worse with activity and gets better with rest,” Mitchell says. “Also, stretching tends to increase pain, and the area can also be very sensitive to touch.”

When chronic compartment syndrome is in the shin, it is sometimes confused with shin splints. “A shin splint is an overuse injury of the tibial anterior attachment (tendon) to the tibia (tibia costus),” adds Gallucci. “Typically, the fibrous elements of the attachment to the bone become inflamed due to a change in surface, a change of shoe, repetitive impact on it, and yes, as this compartment of the tibia becomes more inflamed, it can develop into compartment syndrome if not properly treated.”

That tightness throughout your shin and calf can be significant, says John Gallucci Jr., PT, DPT, physical therapist and founder of JAG-ONE Physiotherapy in New York, he explains to The runner’s world. “It could start out feeling like a muscle strain, but most people realize compartment syndrome because they then start to feel a numbness or tingling that can go from the shin to the feet,” she adds.

To formally diagnose compartment syndrome, doctors use specific techniques and instruments to measure the amount of pressure on the compartment that is causing pain.

Prevention of Apartment Syndrome

While anyone can experience compartment syndrome, it most commonly occurs in athletes under the age of 30 who participate in sports that require repetitive motion, such as, you guessed it, running. “Both compartment syndrome and shin splints are overuse injuries, so cross-training is definitely a way to reduce the incidence of both,” advises Gallucci. “Overuse” can refer to doing too much new exercise too soon, increasing mileage or activity too quickly, or not resting or stretching properly to give muscles time to recover.

Additionally, it’s always a good idea to wear proper running shoes when you exercise and avoid constantly changing running surfaces, says Gallucci. “Marathon runners run on pavement, and then they’ll go from pavement to grass to concrete,” he says. “Just these small deviations can have a rebound effect in terms of how your muscles react.”

In addition to overtraining and wearing the wrong running shoes, impaired body mechanics (such as a very short stride or landing on your toes when running, which can put extra stress on the front of the lower leg), as well as poor stability can lead to chronic compartment syndrome, says Mitchell.

Treatment of Apartment Syndrome

“To really fully address this issue, you need a thorough evaluation by a physical therapist,” says Mitchell. A physical therapist can help you improve range of motion and proper mechanics in the foot, ankle, and hip—all of which can help you overcome this condition.

Strengthening your muscles would also be part of the program, says Mitchell, including not only the calf muscles that may be weak, but also other areas, such as the muscles surrounding the hips, as well as the core. Your calf can compensate for these muscles if they are weaker than needed for strong running.

“You may also need manual therapy to help with mobility and soft tissue healing,” says Mitchell.

Gallucci adds that, “to date, our research has shown that rest, ice, and reduced activity is the primary mode of treatment.” He says some anti-inflammatory drugs have also been used for more aggressive treatment, but this should only be done under a doctor’s supervision.

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