Compartment syndrome is increased tissue pressure within a closed fascial space, resulting in tissue ischemia.
Chronic compartment syndrome causes nerve compression and pain, most often in the front of the lower leg. It occurs due to excessive muscle swelling during activity that puts pressure on these blood vessels and nerves, and results in pain, swelling, weakness and possibly loss of muscle coordination. The condition can occur in both beginning and seasoned athletes in sports that involve repetitive movements, such as running, fast walking, biking and swimming. Compartment syndrome occurs more often in runners.
The condition seems to affect primarily young athletes in their 20s, although younger and older people also can develop the condition. Common causes of compartment syndrome include tibial or forearm fractures, ischemic-reperfusion following injury, hemorrhage, vascular puncture, intravenous drug injection, casts, prolonged limb compression, crush injuries and burns. The most common symptom of exercise induced compartment syndrome is pain associated with activity that is quickly relieved with rest. Patients may notice a tingling or numbness in the leg or foot due to lack of blood flow to the nerves.
When compartment syndrome is caused by repetitive heavy use of the muscles, as in a runner, it is known as chronic compartment syndrome Options to treat chronic exertional compartment syndrome include both conservative and surgical methods. Chronic compartment syndrome may be treated conservatively first, icing the lower leg after exercise to reduce swelling. In many cases compartment syndrome is treated with surgery to release the fascia and allow more room in the compartment. If surgery is required to relieve the pressure, the physician will make an incision and cut open the skin and fascia covering the affected compartment.
This reduces the pressure in the compartment. The skin incision is surgically repaired when swelling recedes. Sometimes a skin graft may be needed. Conservative treatment includes rest, anti-inflammatories,elevation of the limb, and stretching. In cases where symptoms persist the condition should be treated by a surgical procedure, subcutaneous fasciotomy or open fasciectomy To avoid compartment syndrome, it is helpful to wear the right footwear, and rung on soft surfaces. Decreasing training time, and intensity may also limit the chance of this syndrome.
