Compartment Syndrome

Exertional compartment syndrome

Compartment Syndrome

There are many terms used to describe compartment syndromes: tibial syndrome; shin splints; exercise ischaemia and myositis (inflammation of muscle). Compartment syndrome is also known as exertional compartment syndrome.

A compartment, in this context, is a part of the leg that is bounded by bone, ligament, or fascia (thick flat tissue) in which the muscle or muscle sits. For example, the anterior

compartment binds the tibialis anterior muscle to the tibia (shin bone) and the fibula and deep fascia.

Broadly defined, compartment syndrome is a condition in which increased pressure within a muscle compartment, brought about by increased effort or exercise, impedes the blood flow to that compartment.

The most common compartment syndromes occur in the lower leg, in particular the anterior or deep posterior compartment, but can also happen in the peroneal compartment – the outside part of the shin.

Common Symptoms

Symptoms may include pain, muscle tightness or swelling, a cramp like feeling, weakness, or numbness during exercise. The symptoms often occur during weight bearing exercise, e.g. walking, running, jumping, and often at about the same time or intensity of exercise, e.g. 15 minutes into a run or a certain number of reps on the track.
Treatment of Compartment Syndrome

Acute – Requires surgery immediately. During a fasciotomy, the deep tissues are split to allow more room for the muscles to expand. Post-operative treatment includes motion exercises and physical therapy.

Chronic – Conservative treatment may be of some benefit e.g. physical therapy including deep massage of the compartments, ultrasound, interferential therapy, magnetic field therapy, stretching and ice. If treatment is not successful after 6 weeks, cessation of that particular sport or surgery should be considered.