Compartment Syndrome

This condition is often confused with shin splints as the symptoms are often similar. It can arise is any of the four compartments. Compartments are groups of muscles that are contained in a sheath of fibrous connective tissue.

The groups of, the Anterior Compartment, which houses the Anterior Tibialis, Flexor and Digitorum Longus Muscles.

The Medial Compartment housing the Posterior Tibialis, Flexor and Digitorum Longus. The Lateral Compartment housing the Peroneus group of muscles, and the Posterior Compartment housing the Soleus and Gastrocnemius.

It manifests in sportspersons, more commonly in walkers as the style leads to overuse of the Anterior group. Those who try to do too much training too soon with inadequate conditioning of the legs. It often starts early in the walk or run as a burning type sensation in the muscle, and can worsen until the runner has to stop. The foot may start to slap the ground as the Anterior Group weakens.

The compartment in question becomes rock hard to the feel, as the muscle expands with the limited space of the compartment. The inter-compartmental pressure increases eventually collapsing on the circulation within the compartment. Pain and loss of function force the sportsperson to stop activity until the pain subsides.

Stretching helps to reduce the pain, although continuing the activity bring it on again. The pain often clears by itself as the legs “warm up”, other times it gets worse inhibiting any further activity.

The cause of Compartment Syndrome can be a congenitally small compartment, or poor conditioning where the muscles expand too fast for the compartment to accommodate, or a biomechanical mal-function that forces the muscles in question to work harder than they are designed to.

It can be Acute or Chronic. The Acute type is more serious in that it needs to be cared for immediately pressures can stop blood supply to the foot. The Chronic type is the most common and it has a repeatability during exercise.

Treatment involves adequate stretching technique, improvement in biomechanics using the appropriate footwear and functional inserts or orthotics.

Biokinetics to improve muscle imbalances, and Physiotherapy to do fascia (sheath) stretching.

In chronic cases that do not respond to conservative care, a Sports Physician may apply inter-compartmental pressure testing to establish correct diagnosis, and may advise surgical release of the fascia to allow the muscle space to expand without compression.