Lower Limb Compartment Syndrome

Acute compartment syndrome can start after a direct blow to a muscle belly.  This should be looked at straight away.  If you are at all unsure consult either a physiotherapist or a doctor straight away.

Seen predominantly in runners, this is a common cause of shin and calf pain.  It is typified by pain that presents on exercise.  It can have a gradual onset (the condition) but once established, any symptoms can be quick in their onset.

There remains some debate over the actual cause of this problem.  It is thought that an inflammatory process is started in the connective tissue (fascia) that houses the muscles in your shin and calf.  This process reduces the amount of stretch available in the fascia, so when (during exercise) the muscle tissue tries to expand it is met by resistance from the fascia resulting in pressure build up.  This pressure causes pain.

Tender to touch

Pins and needles may be present (if the nerve within the compartment is also compressed)

Clinical testing using functional tests (exercise) and palpation (feeling) of the area will aim to highlight the problem more accurately.

Further investigation will be required if compartment syndrome is suspected.

Definitive test is a compartment pressure test.  Catheters are inserted into the muscle through two layers of the connective tissue and the muscles are the exercised and the pressure readings taken.  If the pressure exceeds a retain value both during and after exercise, a firm diagnosis is made.

Surgery called a ‘fasciotomy’ may be necessary if the pain continues.  This is where the fascia is cut to relieve tension or pressure.