I was diagnosed several years ago with compartment syndrome, which affects one or both of my calf muscles periodically when I run. I have enjoyed racing for over 25 years but never know when I will be "struck down" in training or during a race.

I’ve read about compression socks and wondered whether they would benefit me. I’m now only attempting 5Ks and even then not able to complete them without pain or having to stop and walk to the finish. What can I do?

Tim

Tim,

I have some personal experience with this problem. After many years of intermittent lower leg pain and a summer with three weeks of hiking in the mountains of Montana and Utah combined with almost daily inline skating it became clear that I was having symptoms of chronic exertional compartment syndrome. I started having significant pain in my lower legs and developed a foot drop. I finally had my compartment pressures tested and documented the problem. A bilateral anterior and anterior lateral fasciotomy procedure resolved the problem, although I still have a bit of foot drop when I am overly fatigued.

Chronic exertional compartment syndrome is the result of increased pressure in one or more of the 4 compartments in each lower leg. Since the basic problem is increase in muscle compartment pressures, compression stockings will likely not help with your symptoms. The exact reason for the pressure changes is not known, but it is triggered by exercise.

Assuming the diagnosis is correct and documented, there are really three management strategies from my perspective. One is to back off your running to an enjoyable level and find other forms of exercise that do not trigger the pressure increases and pain. Second is to have your pressures tested to confirm the diagnosis and decide if you are a surgical candidate. And third is to alter your running style. There are several anecdotes of runners with compartment syndromes who have had the issue resolve by slowly transitioning to the minimally shod style of running and away from a heel strike dominate gait (if you not a heel striker, this option is not workable). If you choose option three and it fails, you can always move to one of the other choices.

From my personal experience, the longer you go with symptoms, the more likely they will have some “permanence,” so if you cannot control the symptoms, you should consider pressure testing and release. The surgery seems to be most successful for anterior compartment problems. Swelling and pressure in the anterior compartments and cause symptoms in the posterior compartment (deep in the back of the calf), so be sure to test the anterior compartment. There are some “confounding” conditions like popliteal artery entrapment syndrome that should be eliminated as causes before you have surgery.

Overuse Injuries Are Not as Obvious as You Think.

Cheers,

Bill

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