Compartment syndrome commonly affects runners who suddenly increase their training load.

 

The sheaths that surround the muscles of the lower leg can be the site of a fairly common running injury called compartment syndrome. There are four types, depending on which sheath is affected: anterior, lateral, deep posterior and superficial posterior.

 

Causes

 

The pain of compartment syndrome is caused by the constriction of the flow of blood to the muscle fibres within the sheath, due to excessive swelling of the muscle. Exercise, of course, causes an increased blood flow trough the muscle, which results in pain.

 

Compartment syndrome commonly affects runners who suddenly increase their training load. This can include relatively novice runners who run longer than their legs are prepared for. Experienced runners can also suffer if they indulge in chronic over-training.

Symptoms

 

With anterior compartment syndrome, the pain on exertion is felt in the outer border of the tibia (shin bone). Deep posterior compartment syndrome is usually felt as an ache in the inner border of the tibia or as chronic calf pain. You feel tightness or a 'bursting' sensation, and the pain increases with exercise. You may also suffer from pins and needles and weakness.

 

In the compartments, other than deep posterior, the pain felt may well be more acute than the dull, cramping pain in the deep posterior area. Mild cases will cause more localised pain, while serious cases may result in severe swelling and perhaps extensive muscle damage.

 

With deep posterior compartment syndrome, the pain comes at the end of a run, while the other types develop during a long distance run. In all cases, pain persists after running.

 

Treatment

 

If you think that you have compartment syndrome, stop running immediately and seek treatment. Conservative treatments consisting of reduced exercise and deep soft tissue massage are often successful in treating compartment syndrome.

However, unfortunately in more stubborn cases, if the conservative treatment fails, then you may need surgery. This includes fasciotomy (release of the fascial sheath around the compartment) and fasciectomy (removal of the fascial sheath).

 

Prevention

 

To prevent compartment syndrome, make sure that you don't suddenly increase your training load. Regular preventative treatment - including correction of any bio-mechanical faults - by your sports osteopath, would be a wise investment.

 

 

Graeme Stroud ND, MRN, DO, ACOH is an osteopath, naturopath, certified zen body therapist and a qualified healer.