This is often referred to as acute or chronic exertional compartment syndrome.
Compartment syndrome is the increased pressure within one of the four muscle compartments in your lower leg, which are each surrounded by a connective tissue called the fascia. This fascia keeps the muscles together in the compartment so does not allow for much stretch. Each compartment contains muscles, nerves, blood vessels and connective tissues. The muscles in each compartment work together to produce movement.
When the pressure within a muscle compartment exceeds what is normal (from injury or other causes described below), symptoms of compartment syndrome begin. As these compartments are not designed to expand, the muscles, blood vessels and nerves within the compartment are compressed. This can restrict circulation, nerve and muscle function, and can cause a large amount of pain for those affected.
There are two primary types of compartment syndrome: acute and chronic exertional compartment syndrome. They’re distinguished by the cause of the pressure increase. It’s important to diagnose and manage this condition promptly as restrictions in blood flow, and oxygen can cause tissue death.
Acute compartment syndrome occurs following trauma or injury that results in bleeding and/or swelling in a compartment, taking up more room in the compartment and increasing the pressure. This can compress nerves and blood vessels to the point that they’re unable to function effectively. Examples of injuries include fractures and muscle bruising, among others.
Chronic exertional compartment syndrome tends to affect physically active individuals. Strenuous or high-impact activities increase the blood flow to muscle groups and can cause swelling, thereby increasing pressure within the compartment. Running is a typical example.
Initially, symptoms to the affected compartment can include:
If the pain worsens or doesn’t settle, the tissues may not be getting enough blood or oxygen, and should be seen to immediately. Athletes who suffer from chronic exertional compartment syndrome may develop ongoing pain and muscle weakness.
Acute compartment syndrome must be seen to immediately by your GP. This usually requires surgery. Chronic exertional compartment syndrome may be managed conservatively with your Podiatrist following a visit to your GP. The initial appointment is essential in determining whether your symptoms are acute or chronic in nature, and hence the best treatment for you.
For chronic cases, your long-term treatment needs to focus on reducing the load on the tissues and therefore the swelling and pressure. This can be done through modifying regular activities, working on gait retraining and techniques, looking at the biomechanics of your feet and the use of orthotics, checking your footwear, and physical therapy.