This causes the muscles of the lower leg to work harder than they might otherwise, leading to muscle growth (hypertrophy) and therefore a chronic compartment syndrome. Gait analysisįull gait analysis can be done to analyze running style and any biomechanical dysfunction of the foot, especially overpronation where the foot rolls in or flattens. The aim of massage is to stretch and reduce the thickness of the myofascial sheath.Īcupuncture, also known as dry needling may help reduce symptoms. This should be done both passively (meaning the therapist moves the foot), and actively (meaning the patient lifts the foot). This may include cross-friction massage techniques or myofascial release techniques which involve working the muscle along its length, whilst the foot moves into dorsiflexion (foot and toes upwards). MassageĬhronic compartment syndrome may respond to massage techniques which aim to stretch the sheath creating more space for the muscle. Use a wet tea towel or commercially available cold packs to avoid skin burns. However, switching to other forms of exercise such as cycling or swimming, or even complete rest may be needed.Īpply ice or cold therapy for up to 20 minutes at a time. Simply reducing running mileage, or training load to 50% of normal may be enough. Treatment for chronic compartment syndrome is rest. Ibuprofen to help reduce pain and swelling and in more severe cases surgery may be indicated.Īlways check with a doctor before taking medication. Immediate medical attention should be sought for severe acute compartment syndrome as long-term damage to nerves and muscles can occur.Ī doctor may prescribe anti-inflammatory medication e.g. Treatment for posterior compartment syndrome Acute injuries Biomechanical factors, such as overpronation where the foot rolls in or flattens too much when running can abnormally increase the load on certain muscles making a compartment syndrome more likely. The muscle grows too big for the compartment or sheath that surrounds it increasing pressure within the compartment and causing pain. Chronic compartment syndromeĬhronic compartment syndrome usually comes on over a longer period of time through overuse. A muscle strain can also bleed within a muscle compartment having the same effect. The swelling increases pressure inside the compartment resulting in pain. Acute compartment syndromeĪcute compartment syndrome is caused by impact or trauma which causes bleeding within the muscle compartment. Occasionally in some people, an additional sheath surrounds the tibialis posterior muscle. The posterior deep compartment of the lower leg is surrounded by a sheath and contains the flexor hallucis longus, the flexor digitorum longus and tibialis posterior muscles. This is to ensure the pressure testing is valid.Īpproximately 10 minutes later, when symptoms have subsided your doctor will repeat the test. They then test compartment pressure immediately after exercise. It is important the patient exercises enough to bring on their symptoms. The doctor inserts a needle (Stryker catheter) into the muscle compartment. If they suspect chronic compartment syndrome then they will perform pressure tests both before and after exercise. To make an accurate diagnosis your doctor/physio will do compartment pressure tests for all lower leg compartments. There may be tenderness along the inside of the shin, although may not be as severe as medial tibial stress syndrome because the compartment is deeper. This is where the muscle has begun to protrude through the sheath that surrounds it. It is possible you will feel numbness or pins and needles under the foot, or lumps and bumps along the inside of the shin. Sometimes foot drop occurs, with significant weakness lifting the foot when walking.There may also be pain when pushing the foot and toes downwards (plantar flexing) against resistance, for example, when going up onto the toes.Patients often complain of a feeling of tightness or pressure.The pain usually comes on during a run and goes away with rest, only to return when training resumes.A chronic posterior compartment syndrome will cause deep aching pain in the lower leg.It may feel similar to medial tibial stress syndrome ( shin splints), or long-term, chronic calf pain.Pain in the lower leg, specifically over the inside of the tibia (shin bone).This is especially true if your pain becomes gradually worse, as this can lead to long-term or permanent injury to the leg.Ī chronic compartment syndrome, sometimes called a deep posterior compartment syndrome includes:.If you suspect an acute compartment syndrome then seek medical attention immediately.You may have restricted movement at the ankle.Pain in the lower leg, either in the calf muscle area or on the inside of the shin.An acute compartment syndrome can occur following a direct trauma or impact.
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