Chronic exertional compartment syndrome is very different from acute compartment syndrome. From time to time we encounter the exertional type of compartment syndrome at our clinic, so it’s probably a good idea to distinguish between the two conditions for some of our readers.
What is Compartment Syndrome?
Various muscular areas of our body are sectioned off into compartments. Fascia, a strong connective tissue with limited ability to expand surrounds many different groups of muscles. Similar to the idea of a sausage with its skin, the muscle tissue is contained in a compartment. On occasion, injury within the compartment can cause increased pressure. This is a compartment syndrome. It is characterized by increased pressure within a compartment that won’t expand.
Symptoms of Compartment Syndrome
Among other things, blood vessels and nerves can get compressed when a compartment syndrome is present. This can cause a variety of symptoms such as numbness, swelling, lack of sensation, pins and needles and tingling. In very severe cases of compartment syndrome, tissues can deteriorate to a significant level if the blood vessels and nerves have been compressed long enough. Therefore, as mentioned above, it is very important to distinguish between acute compartment syndromes from chronic exertional compartment syndrome.
Chronic Exertional Compartment Syndrome
In the case of chronic compartment syndrome, it is usually related to some type of exercise or stress. Common in the lower limbs of athletes, the muscle gets overused to the point that it swells or increases in size. If the surrounding fascia doesn’t also expand (or have enough room in the compartment for this increase in size) the contents get compressed. In other words, a person uses the affected area and feels numbness, tingling and related symptoms. After discontinuing exercise (and the muscle “swelling” is decreased) the symptoms usually abate. This is the type of compartment syndrome that we treat at our physiotherapy clinic.
Acute Compartment Syndrome
Significant trauma (for example a car accident, fracture, surgery or crush injury) can lead to swelling. If this swelling builds quickly in a fascial compartment, it may compress blood vessels and nerves as described above. This situation is not usually related to exercise. Acute compartment syndrome is usually more of an emergency situation and not the type of compartment syndrome treated in a typical physiotherapy clinic. Surgery is often indicated for acute compartment syndrome.
Conservative treatment for chronic exertional compartment syndrome involves strategies that allow the muscle to expand during exercise without compressing the contents of that compartment. Active release technique (ART) or graston technique are usually the best treatment offered by our clinic. These help to relieve tissue tension and allow the muscle to expand easily. Rehabilitative stretching, strengthening, foam rolling and other home strategies are often part of the recovery process. For some stubborn cases of exertional compartment syndrome, medical referral is warranted to decipher whether surgical intervention is indicated. Unsure if you have compartment syndrome? Give our clinic a call…we can help! 905.220.7858.
Lutz U, Goodenough GK, Detmer DE. Chronic compartment syndrome. American Family Physician. 1989; 39: 191-196.
Pedowitz RA, Hargens AR, Mubarak SJ et al. Modified criteria for the objective diagnosis of chronic compartment syndrome of the leg. American Journal of Sports Medicine. 1990; 18: 35-40.