Compartment syndrome, pain in the shin and calf muscles caused by the pressure that builds up in the tight-fitting restraining
sheath or compartment that houses the muscle during and after running, is not a very common injury. However, it can cause extreme
discomfort and become a real danger when the blood flow to the muscle is obstructed. Fortunately the condition can be remedied with
the help of a simple surgical procedure with excellent outcomes.
Alternative Names
- Posterior and anterior compartment syndrome
- Acute and chronic compartment syndrome
What is it?
Compartment syndrome is a relatively uncommon sports injury that causes pain, during and after running, in the muscles of the
lower leg (shin and calf muscles). Pain occurs when the muscle expands, during exercise, and causes pressure to build up in the
tight-fitting restraining sheath or compartment in which it is enclosed. The pressure may become so great that it obstructs blood
flow to the muscles causing pain, numbness and a feeling of “pins and needles” in the afflicted area.
Anterior compartment syndrome is characterised by pain in the muscles on the upper and outer part of the shinbone and is often
confused with shinsplints. Posterior compartment syndrome occurs in the calf muscles.
Although most cases of chronic compartment syndrome develop gradually the acute form can develop very suddenly and without warning
and is deemed an emergency that needs immediate medical intervention.
Causes
The main cause associated with this injury - muscle compartments that are too small to accommodate normal swelling or the muscles
that they encase - is attributed to hereditary factors. However, acute (sudden onset) compartment syndrome is caused by the complete
obstruction of blood flow to the affected muscles and may cause muscle atrophy and death if not treated in time.
Diagnosis
The location, duration and nature of the pain experienced, is used as the main diagnostic tool.
Symptoms
- Pain is usually located in the shin muscles (anterior compartment syndrome) or in the calf muscle (posterior compartment syndrome)
- Pain may be present during running but usually worsens after running
- Pain may intensify suddenly and dramatically after a single exercise session causing the muscles to become rock-hard and the foot to be pulled into an awkward position (acute compartment syndrome)
- Pain does not subside and the condition does not improve after a period of enforced rest
Treatment
Unfortunately there is only one remedy for this condition - a surgical procedure during which the lining of the muscle compartment is slit
and the edges kept as far apart as possible so that they do not join back together. The hoped-for outcome is that the compartment or sheath
will repair itself by growing a pseudo-membrane that will allow the muscle more room to expand.
Outcome
The outcome of surgery to relieve compartment syndrome is usually excellent and the athlete should be pain-free and ready to resume
training soon after the wound has healed.