To understand chronic compartment syndrome, an overuse injury that typically prompts pain in the calf, it’s helpful to start with a little anatomy lesson. While most of us don’t think of our bodies as having “compartments,” if you use terms such as “the front of my lower left leg” or “the back of my right thigh,” then you already divide your body into sections or “compartments.”
The 6 Most Common Causes of Lower Leg Pain, tissues, and nerves are bundled and divided into separate sections throughout our body. “These compartments are covered by fascia, a thin casing of tissue that surrounds and holds muscles in place,” Jill C. Mitchell, P.T., D.P.T., a physical therapist with Thrive Physio and Wellness in Dallas, Texas explains to Runner’s World.
Marathoners, Mileage, and Risk of Injury Study swelling in compartments, such as those in your feet, is a typical consequence of training—because oxygen and blood flow to parts of the body that are working hard—it’s possible, although uncommon, for a compartment to be unable to handle that extra flow. This can result in chronic compartment syndrome, sometimes called exertional compartment syndrome.
What is compartment syndrome?
According to the American Academy of Orthopedic Surgeons, “compartment syndrome is a painful condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.” This can happen in any of the body’s compartments, but it most frequently occurs in the lower leg, which has four compartments (anterior, posterior, lateral, and deep).
“To understand chronic compartment syndrome, an overtraining without enough rest, meaning the tissues do not have time to recover,” Mitchell says. “Think of it this way: The tissues swell as part of recovery and, if you don’t allow enough time [for this recovery], it's just constantly swelling, and then the fascia is not allowing room for that recovery to happen.”
It’s also important to note that another type of compartment syndrome, called acute compartment syndrome, can also occur. However, this problem is far more likely to be the result of an accident and is rarely related to overuse or running.
“Acute typically occurs when it’s coupled with some sort of trauma,” Mitchell says. “This is often a medical emergency, and, in this case, the priority is to release that pressure.” In severe cases, surgical “decompression” may be required. In this procedure, doctors cut the fascia to relieve pressure in the muscle compartment. This is rarely something runners who suffer from chronic compartment syndrome will face.
Identifying Symptoms of Compartment Syndrome
The most common symptoms of chronic compartment syndrome include leg pain, unusual nerve sensations, and, eventually, muscle weakness. Specifically, there are “five Ps” to look for: Pain, pulseless (due to poor circulation), paralysis (muscle weakness), paresthesia (numbness), and pallor (white skin, again due to poor circulation).
“You may also find that the pain worsens with activity and eases with rest,” Mitchell says. “Also, stretching tends to increase the pain, and the area may also be highly sensitive to touch.”
Nutrition - Weight Loss shin splints. “The shin splint is an overuse injury of the anterior tibialis attachment (tendon) to the tibia (shin bone),” Gallucci adds. “Usually, the fibrous components of the attachment to the bone become inflamed due to change of surface, change of shoe, repetitive banging on it and, yes, as that compartment of the anterior tibialis becomes more inflamed, it can evolve into a compartment syndrome if not appropriately treated.”
That tightness throughout your shin and calf can be significant, John Gallucci Jr., P.T., D.P.T., a physical therapist and founder of wrong running shoes in New York City, explains to Runner’s World. “It could start off feeling like a muscle strain, but most people become aware of compartment syndrome because they then start feeling a numbness or tingling that can go from the shin to the feet,” he adds.
To officially diagnose compartment syndrome, doctors use specific techniques and instruments to measure the amount of pressure in the compartment that’s causing pain.
Preventing Compartment Syndrome
While anybody can get compartment syndrome, it is most often seen in athletes younger than 30 who take part in sports that require repetitive movement, such as, you guessed it, running. “Both compartment syndrome and shin splints Here are the anatomy details: Muscles cross-training is definitely a way to decrease the incidence of both,” advises Gallucci. “Overuse” can refer to doing too much new exercise too soon, increasing mileage or activity too quickly, or not resting or stretching properly in order to give muscles time to recover.
In addition, it’s always a good idea to wear appropriate running shoes when you’re exercising and avoid changing running surfaces continuously, Gallucci says. “Marathoners run on the pavement and then they will cross from pavement to grass to cement,” he says. “Just those slight deviations can have a rebound effect in terms of how your muscles are reacting.”
Aside from overtraining and wearing the Marathoners, Mileage, and Risk of Injury Study, impaired body mechanics (like a stride that’s too short or landing on your toes when you run, which can put extra pressure on the front of the lower leg), as well as poor stability, Health - Injuries.
Treating Compartment Syndrome
“To truly address this issue fully you need a thorough evaluation by a physical therapist,” Mitchell says. A physical therapist In addition, its always a good idea to wear appropriate, ankle, and hip—All About Running Tests for Improved Performance.
Strengthening your muscles would also be part of the program, Mitchell says, including not only the That tightness throughout your shin and That tightness throughout your shin and hips, as well as the core. Advertisement - Continue Reading Below We may earn commission from links on this page, but we only recommend products we back.
“You may also need manual therapy to help with soft tissue mobility and healing,” Mitchell says.
Gallucci adds that, “to date, research has shown us that rest, ice, and decreased activity, is the primary way of treatment.” He says that some anti-inflammatory medications have also been used for more aggressive treatment, but that should only be under the care of a physician.
