The Center for Podiatric Care and Sports Medicine

Big Name: Exercise-Induced Compartment Syndrome

Posted by on Friday, April 13th, 2012

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Exercise is good for you, but there’s no question that for some of us it’s fun and for others it’s a chore. Whichever camp you’re in (fun or chore), there still will be times when exercise hurts. The question is whether it’s a good hurt, like, “My legs are really sore because I just had an awesome run in preparation for the marathon” or “I keep feeling pain in this part of my leg and it feels like something is wrong.”

Today we’re going to talk about the latter, when pain from exercise is not good. Welcome to the wonderful world of Exercise-Induced Compartment Syndrome.

Ummm…what was that again? Exercise-induced compartment syndrome! Also known as exertional compartment syndrome, chronic compartment syndrome, or chronic exertional compartment syndrome.

Okay, now that we have all those bases covered, what is it? As you may guess from the name(s) of the condition, it is pain brought on by exercise. As you may guess from the fact that you’re reading this on a podiatry blog, it typically affects the lower extremities, particularly the shin area.

The problem comes from the fascia, or tissue, that wraps around muscles; the fascia separate the groups of muscles into compartments, hence the name. Usually the fascia can expand with muscles as they swell from an increase in the blood supply during exercise. For some people, though, the fascia doesn’t expand enough and remains wrapped tight as the muscles try to expand. This causes the pain.

Pain in my lower extremities from exercise? That could be anything. How do I know it’s this long-named thing? Well, for starters, it’s really, really bad pain, most often felt in the shin area. Think burning and cramping, sometimes with numbness and tingling. There may also be foot drop in severe cases (that’s when muscle weakness causes your foot to hang from your ankle); swelling may also occur.

You can also look out for when the pain occurs. If it starts soon after you begin exercising, gets worse, then disappears within fifteen or twenty minutes of stopping exercise. As time goes on, you may find that it takes longer for the pain to disappear.

Exercise-induced compartment syndrome is often mistaken for shin splints. If you think you have shin splints, are treating them, but they don’t seem to be getting better, you may have exercise-induced compartment syndrome. To get a definitive diagnosis and treatment, see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900).

So suppose I see a podiatrist and find out that I have exercise-induced compartment syndrome. What’s going to happen? The simplest treatment is to rest and avoid the activities that cause the pain. Try something different–if it happens when you run, try biking or swimming instead. Other options include  program of stretching, massage, anti-inflammatory medications, or even a review of the way you move, to see if biomechanics are causing the problem and can be adjusted (some think running with a forefoot strike is the answer).

However, surgery is often recommended to solve the problem once and for all. A podiatric surgeon can perform a fasciotomy, where small incisions are made in the tight fascia to allow for more room to expand, or a fasciectomy, where a section of fascia is removed.

These surgeries are generally the best option and are usually very effective. There are a few risk factors, though–there are some sensitive nerve areas (well, I guess all nerves are sensitive) involved, and if they’re affected, you could be left with a feeling of numbness in parts of your leg or foot. There could be some scarring as well. A podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) can talk about all these possibilities with you to decide whether surgery is right for you.

Again, exercise is good for you, and fear of exercise-induced compartment syndrome is no reason to avoid it; actually, it’s fairly uncommon. So get out, be active, and find the thing you love to do! However, if you think you have this condition, or any other foot or leg issues, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.

 

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.