Table of Contents:
Compartment syndrome causes, symptoms, diagnosis, treatment, pathology
Video taken from the channel: Osmosis
Chronic Exertional Compartment Syndrome in the Athlete
Video taken from the channel: University of Colorado Anschutz Medical Campus
Chronic Exertional Compartment Syndrome
Video taken from the channel: Integrated Orthopedics Brian Gruber, MD
Chronic Exertional Compartment Syndrome Everything You Need To Know Dr. Nabil Ebraheim
Video taken from the channel: nabil ebraheim
Exercise Induced Compartment Syndrome Signs and Symptoms
Video taken from the channel: Ortho EVAL Pal With Paul Marquis
Episode 63-Chronic Exertional Compartment Syndrome
Video taken from the channel: Ortho EVAL Pal With Paul Marquis
Compartment Syndrome: Jeff’s Story
Video taken from the channel: UW Health
The main symptoms of compartment syndrome are caused by compression of the soft tissues in and around the affected muscle group. Symptoms of nerve and tissue compression such as numbness, tingling, pain, weakness, and burning are most commonly felt along the front of the lower leg. Other symptoms include foot drop in the affected leg.There are two kinds of compartment syndrome: acute and chronic.
It is caused by severe injury, or athletic fatigue and exertion. Symptoms include pain and paresthesia (prickling or tingling.Chronic compartment syndrome Symptoms may go away when the physical activity that causes the pain comes to an end. Cross-training and low-impact activities are suggested. For some people, symptoms are worse on certain surfaces, so changing surfaces may also help reduce the pain.
The front of the lower leg is the most common area for the pain and swelling of chronic compartment syndrome to occur. It is commonly found in athletes who run a lot. It is also found among swimmers and cyclists and other athletes who repeat motions. The pain is usually relieved by discontinuing the exercise.
What are the symptoms of compartment syndrome? Acute compartment syndrome symptoms.Symptoms of chronic compartment syndrome (exertional compartment syndrome) include worsening aching or cramping in the affected muscle (buttock, thigh, or lower leg) within a half-hour of starting.
Chronic exertional compartment syndrome is an activity-induced pathological elevation of tissue pressures within an osteofascial envelope that results in debilitating symptoms of pain and neurological dysfunction.Symptoms include severe pain, numbness, and decreased range of motion. Surgery (fasciotomy) is the only treatment for acute compartment syndrome. The muscle compartment is cut open to allow muscle tissue to swell, decrease pressure and restore blood flow.
Compartment syndrome is a fairly common condition noted in patients with fractures or crush injuries to the extremities (acute compartment syndrome) and in athletes (chronic compartment syndrome). Compartments bound by fascia are found in the extremities, buttocks, and abdomen; conditions that cause intracompartmental swelling and hypertension.Chronic compartment syndrome Pain or cramping when you exercise is the most common symptom of chronic compartment syndrome.
After you stop exercising, the pain or cramping usually goes away within.Chronic (Exertional) Compartment Syndrome. Nonsurgical treatment.
Physical therapy, orthotics (inserts for shoes), and anti-inflammatory medicines are sometimes suggested. They have had questionable results for relieving symptoms. Your symptoms may subside.They include aching or cramping in the affected muscle (buttock, thigh, or lower leg) that gets worse within a half-hour of starting exercise. Symptoms usually go away with rest, and muscle.
The symptoms most commonly associated with compartment syndrome are intense pain, swelling, numbness or tingling in the compartment and distally, possible paralysis of the muscles, which usually indicates permanent damage to the contents of the compartment.Chronic compartment syndrome. Chronic compartment syndrome is not usually dangerous, and can sometimes be relieved by stopping the exercise that triggers it and switching to a less strenuous activity.
Physiotherapy, shoe inserts (orthotics) and non-steroidal anti-inflammatory medicines may help – speak to your GP about this.Treatment is by surgery to open the compartment, completed in a timely manner. If not treated within six hours, permanent muscle or nerve damage can result. In chronic compartment syndrome, there is generally pain with exercise. Other symptoms may include numbness.
Intense exercise can also cause acute compartment syndrome. Acute compartment syndrome requires prompt diagnosis and urgent treatment. Chronic compartment syndrome is usually caused by exercise and presents with recurrent pain and disability, which subside when the cause (usually running) is stopped but return when the activity is resumed.
List of related literature:
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from Adaptive Sports Medicine: A Clinical Guide |
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from Surgery: A Case Based Clinical Review |
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from Rutherford’s Vascular Surgery, 2-Volume Set |
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from Essentials of Physical Medicine and Rehabilitation E-Book |
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from Comprehensive Pediatric Hospital Medicine E-Book |
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from Operative Techniques in Orthopaedic Surgery |
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from Athletic Training and Sports Medicine |
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from Vascular Medicine: A Companion to Braunwald’s Heart Disease E-Book |
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from Textbook of Remedial Massage |
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from Current Therapy of Trauma and Surgical Critical Care E-Book |
48 comments
i am not a medical student yet i understood most of the topic but why i had a question i am asking specifically about the crush syndrome in cases of building falling if the patient was under a large mass of rocks can a normal IV of saline save his life and what else can be helpful to him.
I am sorry if i was asking something easy but i ain’t no medical student so i don’t know all the details of the story if you can answer me in a simple clear manner i would be very thankful to you.
Learn how the Compartment Syndrome Clinic helped Jeff get back to doing two of his favorite things: playing the drums and running.
When you are naming the differential diagnoses, does that mean that if you have one of these diagnosed issues, then you do NOT have chronic exertional compartment syndrome also? Because I have a common peroneal nerve entrapment that is going to be operated on as soon as I am ready to schedule it. A new doctor thought I also have CECS but did not test or measure the pressure, he just wants to do the fasciotomy at the same time as the nerve decompression surgery. Is it possible that the fasciotomy may not be necessary, and that my symptoms could resolve from the peroneal nerve decompression alone?
Could you refer me where at UW i can get the stryker test done for compartment syndrome. I gave them a call and the closest I got was Sports and Spine in Harbor View.
I hope this reaches you.
para que sirve esa tela que se corto, ahora que la corten? no hay algun problema secundario?, no es para protejer el musculo? si lo cortan en tonces nada proteje al musculo, no es peligroso?
I need to come see you sir. I work at lowes on my feet all day lot of walking and standing no sitting at all 9 hour shifts. Get calf knee swelling with foot pain in my arches. I feel better when my shift is done i go home elevate and ice
I’ve had 4 Compartment syndrome in both my legs I would like to meet others who have been though the same??
Hey Paul great video superb info. After watching your video I realized I have all the symptoms that you indicated with this syndrome except my numbness goes away after about 30 sec to 1 min completely and I regain control over my toes and the rotation my ankle again, also feel that the slapping motion you mention which is so accurate goes away. Do you think this could be chronic exertional compartment syndrome? Or could it possibly be something else? I’ve been experiencing this for the last 4 years on long hikes ( Rucking ) with moderate to heavy load with a fast speed, I also get it during running but its not as bad which I think has something to do with the placement of my feel while running. Any help will be greatly appreciated.
Cheers
Good video. I experience chronic exertion compartment syndrome from running and have been doing my best to avoid surgery. Had it 8 years ago or so, (80mile/Wk training) managed to get past it with really intense massage and rest. Symptoms Came back this year due to increased training load, only 40-50miles, but 37 y/o now. Hoping I can avoid surgery again, but this option remains on my mind. Question though what have you seen in terms of success rate? Risks?
This is the best, most well-presented explanation on the subject. Great job!
This is very helpful. I think I have this…will orthotics help?
Dr Ebraheim, very nice video.
Do you have any non-surgical recommendations for this condition (that work)? I can’t get the VA to even do a proper test for this.
I have pain in my lateral compartment of my lower legs…what should I do? I experience swelling, pain, tightness, pressure and warmth on that tissue area. It’s on and off, especially after long time standing or walking. I have seen many videos on pain in the inside and back of the leg but not on the lateral part. Thank you so much x
Hi Paul, could you add subtitles to the videos? Sometimes it’s getting difficult to keep up with you:) In this video, I couldn’t understand the part starting from 2:04😀
I watch Osmosis videos while having my afternoon tea. They’re great to help refresh topics and retain them better
I like the way you make learning so easy. The way you combine every aspect of the topic makes learning interesting.
I think I have these symptoms through running. What’s the fix
Good explanation
But Why you keep using acute renal failure instead of AKI
Yea I think I have Compartment Syndrome because when-ever I start walking not at the very second but for 20 mins my calf will start aching and if I ignore the aching then its stat getting painful to continue walking to the point where I have to sit down. I started doing calf exercises but it hasn’t helped get rid of the pain all together because when I did my calf exercise this morning I didn’t feel any pain when I started walking but I felt it coming back after I kept walking. after I didn’t feel any pain in my calf yet but my ankle started hurting and becoming numb and aching to the point where I had to sit down. This has been happening to me for about a month It’s time to get it checked out.
Anterior Compartment of vein and artery why come out the above shine bone solution for this veins
Hello well I broke my leg June 23rd 2019. My right leg looks pretty bag compartment syndrome and started towalk with a Walker but it hurts. Will I have long term damage or would I be able to walk normal.
I have this, just had surgery, and I asked my GP the same question and he didnt know, I will ask the consultant next week and post the answer.
There are several factors in reducing medial tibial stress syndrom at home. One resource I discovered that successfully combines these is the Remedy Fixer Blueprint (check it out on google) it’s the no.1 guide that I have ever seen. Check out all the incredible information.
thank you for this excelent video
can un unilateral solear muscl hypertrophy produce Chronic Exertional Compartment Syndrome
What are your thoughts on 0 drop shoes and calf compartment syndrome?
Once again, Thanks Dr. Ebraheim.
If the fascia is not stretching how do body builders get so big?
Thankyou so much for this! I have been having pain for almost 10months and I am had to stop exercising and doing what I love and got quite depressed. I have all these symptoms that you are explaining <3 Super informative thanks!
Why was my comment removed when I was seeking advice from you?
Why be satisfied with “appears to be” do the needle pressure test to be sure, x-ray for fractures, do a Doppler and then cut the fascia. With the pressure test available I don’t understand why that is not used.
I am not a runner I don’t even know what I have, I have been in excruciating calf’s (more than hamstrings ) pain last 15 years it’s so bad I even tried to commit suicide, I am 62 years old tired of ignorant doctors, my legs pain stops me enjoying life my 4 year old daughter, I can’t work because I can’t focus I can’t get any disability because I can’t proof what’s wrong with me. And that’s my life!
What about just doing alot of standing and walking for 9 hours non stop. I work at Lowes and im on my feet all day and my calves and feet and knees hurt. Calves swell knees swell. When i come home elevate my legs ice them. I feel better and swelling goes down
@MrPKDawson In body building the fascia stretches slowly and overtimein compartment syndrome acute or chronic the fascia does not have enough time to strech
I used to play 2 sports simultaneously years ago in my teens without issue, I’m 24 now and start walking again to get back fit (before getting into running) and found I couldn’t even walk a single kilometre without my ankles and anterior tibial being in excruciating pain. Went to the Physio and found out I have CS. Got my feet scanned for custom made insoles and will be getting the pressure test soon.
I’ve had this for the past 15 years. What’s puzzling is that I never know when I’ll get it. I’ve run marathons, half marathons, countless 10k’s and 5k’s without getting it but I’ve also had races where I do get this. My best guess as to why I don’t get it sometimes is if I workout the day before a race, massage before running and I’ve lost weight. But, it has happened even if I do all these things. Lately, I’ve been using a heel wedge and I’ve been getting less “shin lockage.” Thoughts?
How much compartment pressure? And what increase value causes compartment syndrome?
Thank you for uploading these videos! They are very helpful. I was wondering how you can distinguish between exercise induced compartment syndrom and PAD Fontaine Stage IIA. Is there a clinical test (like abi) or would you do an angiography?
Thanks for the reply.
Do you have an opinion on this issue with overweight people? Does the fascia every stretch?
In a scenario where you have a patient come in who thinks they might have CECS, and after the pressure test you find that that is not the case In your experience what has the underlying issue actually ended up being (for the most part)?
What’s the difference between compatment(title) syndrome, and compartment syndrome?
Nice video explaining what I have self diagnosed as CECS.
Do you have MRI tests to diagnose here in Toledo?
Do compresion socks help recovery from a workout that induces CECS pain?
I’m entering military but I’m having this lower leg shin pain.
Can you make a video about the tracheoesophagealfistula thanks so much
I was diagnosed with compartment syndrome 10 years ago on the bottom parts of my legs, yes both! I used to run so much! I was extremely sad and depressed for so long. I was told my only option was to cut my facia. I have hope again. I wish more medical professionals cared to explain and work on finding solutions. I will work on this.
My former doctor said I had patella tendonitis and all I need is rest. I have rested my legs for about 6 months. I realized that the muscle on the lateral side of my tibia feels very tender and uncomfortable every time I exercise and it kept me from being active for a long time. If my condition is proven to be chronic compartment syndrome, do you think it will create any complications after leaving it untreated for 6 months? Thanks a lot Dr Ebraheim!
I’m thinking peroneal nerve flossing, hip flexor strengthening and using dr Schols plantar fasciitis insoles has helped me. And I usually have hip snapping aka dancers hip when my runners compartmental syndrome acts up so I do stretches that help that too. I haven’t been able to pick which treatment is helping but something or all helps it. The game changer was the plantar fasciitis insoles. Basically everything he said in the video
I have had surgery for Chronic compartment syndrome 10 yrs ago in one leg. I have been told so many times that I may have it in both legs post surgery, but I cant seem to get any orthopedic doctor nor pain management to get tests that need to be done. I suffered for 11yrs with ultimately being told it was Fibro. Some though MS etc. I got lucky with one podiatrist, he knew in 5 min of me explaining symptoms what it was. I had the surgery (fascia decompression) in the compartment area and never had issues again. But now here i am suffering again in other areas, and was told i may have reactivated it where i had surgery, but can’t seem to get anyone to listen and do anything. Pain meds do not help at all!!! and am literally in tears because I can’t get anyone to listen. My Podiatrist retired. His old office can’t find my records of the diagnosis or surgery. And i’m so frustrated to where I wish I could just cut my legs off. No worries i won’t do that promise:).. plz any advice on what I can do to get someone to listen? even My physical therapist believes I suffer from it.
This is a pain I wish on no one!!! Thank You.. Christina from Phx AZ,, Email: [email protected] gmail.com
I had this problem where my toes would spazz out. I got an mri and it showed that I had a torn right ligament in my ankle. Also, my shins got really really tight. I got surgery to reconstruct my ligaments and also had an arthroscopic procedure done to get rid of built up fluid in the ankle joint. I suggest folks get an mri to make sure they don’t have any torn ligaments because that could be the problem. I have since been able to jobs and speed walk without my shins and toes spazzing out. Thank god
We learned about this in traumatology and orthopeadics. Best explanation so far.