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Compartment Syndrome Physiotherapy
Compartment syndrome is a serious medical condition that occurs when
there is increased pressure in the muscular compartment of the limbs. When this pressure increases and builds up, what happens is that it causes restricted blood flow to the
involved area that can compromise the health of the muscles and nerves.
Compartment syndrome is classified as either acute or chronic.
compartment syndrome is a medical emergency, usually due to a traumatic
injury, and must be addressed immediately to avoid irreversible
consequences, such as limb loss and requiring amputations.
- Chronic compartment syndrome develops
over time, usually due to excessive or inefficient exercise exertion.
Our senior physiotherapists can be effective to help identify the factors that may
influence the development of compartment syndrome.
What is Compartment Syndrome?
Our limbs (arms and legs) are divided into compartments that contain
different muscles, nerves, and blood vessels, and each compartment is
separated by fascia, which is a thick sheet-like tissue that does not stretch.
Usually, our bodies are able to handle small changes in the pressure levels
within these compartments. For example, our tissues may swell slightly
after a hard workout or a mild injury. But when there is excessive
swelling within a compartment due to a severe acute injury or chronic
overuse, pressure builds within that compartment as the fascia does/can-not
expand to accommodate the increased volume.
In rare circumstances, this
condition can be more than our bodies can handle, and the blood supply
to the area is restricted. If the condition persists, the muscle and
nerve tissue can be harmed (the pressure as well as lack of circulation
can cause cells to die) - it is absolutely essential to relieve the
immediately to avoid permanent damage.
Compartment syndrome is typically classified into 2 categories—acute or chronic—based on its cause and symptoms.
Acute Compartment Syndrome
Acute compartment syndrome (ACS) is a medical emergency.
develop as early as several hours following a severe injury and if it is left
untreated for even a few hours, irreversible tissue damage can occur.
ACS most often develops in the lower leg and forearm.
ACS is typically caused by a serious injury, such as:
- A direct hit or blow to the limb (athletics, a significant fall)
- Crush injuries (motor vehicle accident, work-site injury)
- Highly restrictive bandages
How Does It Feel?
The most common signs and symptoms of ACS include:
- Severe pain in the involved limb that may be out of proportion to the typical response to a certain injury
- Changes in sensation (tingling, burning, numbness)
- A sense that the limb is tight or full (from the swelling and increase in pressure)
- Discoloration of the limb
- Severe pain with stretching of the involved muscle
- Severe pain when the involved area is touched
- Significant pain or an inability to bear weight throughout the involved limb
How Is It Diagnosed?
It is critical that ACS is identified and treated immediately.
Following a severe injury, if an individual is showing signs of ACS, the
individual should be taken to the emergency room right away for
evaluation by a doctor. The doctor will be able to objectively
measure the levels of pressure in the involved compartment. If
necessary, surgery will be performed to alleviate pressure in the
compartment using a procedure called a fasciotomy.
During surgery, an
incision is made through the skin and fascia to drain the swelling and
relieve the pressure within the compartment. A patient undergoing a
fasciotomy will have to spend a period of time in the hospital to ensure
that the pressure normalizes and the wound heals properly.
fasciotomy surgery, physiotherapy is necessary to restore the
- motion / movement
- and function of the limb
Chronic Compartment Syndrome
Chronic compartment syndrome (CCS) is often referred to as
“exertional” compartment syndrome, and is typically caused by exercise
that involves repetitive movements, such as
Usually, excessive exercise causes the tissues of the leg to
be overworked without time to recover. The development of CCS may be
influenced by external factors, such as poor body control during
movement, poor footwear, uneven or too-firm training surfaces, or too
There have also been cases where excessive steroid use
has been linked to CCS.
How Does It Feel?
The symptoms for CCS may be similar to that of ACS, but less severe
and not a result of an acute traumatic injury. These may include:
- Pain and cramping in the involved limb that usually worsens with activity and subsides with rest
- Mild swelling
- Pain with stretching
- Numbness or tingling in the limb
How Is It Diagnosed?
Because the symptoms of CCS are similar to many other conditions, it
is important that a doctor or senior physiotherapist rules out other
possible diagnoses, such as
The examination may include the use of
diagnostic imaging, such as an
to assess the
tissues in the painful area.
If CCS is suspected, the patient will likely be referred to a
doctor for a specific test called the "compartment pressure
This test is only used in cases where CCS is strongly
suspected. It is performed in a medical office. During the test, the
pressure in the involved compartment is measured before, during, and
The goal of the test is to reproduce symptoms as they
occur during real-life activities.
If CCS is diagnosed, your medical
team will devise a plan to best treat your specific condition. For more
mild cases of CCS, you will likely be referred directly to see our senior physiotherapists. In more severe cases, individuals are likely to be referred to a
surgeon to discuss the option of a fasciotomy.
How Can our senior PhysioTherapist Help?
If you are diagnosed with compartment syndrome, our senior physiotherapist will play an important role in the treatment of the condition,
whether it requires surgery or not.
We will work
with you to design an individualized treatment program based on your
condition and your personal goals.
Our senior physiotherapist may
Restrictions in the
motion of your knee, foot, or ankle may be causing increased strain in
the muscles housed within the compartments of your lower leg. Stretching
techniques can be used to help restore motion in these joints to
minimize undue muscle tension.
Hip and core weakness can
influence how your lower body moves, and can cause imbalanced forces
through the lower-leg muscle groups that may contribute to compartment
Building core strength (in the muscles of the abdomen, low
back, and pelvis) is important; a strong midsection allows greater
stability through the body as the arms and legs perform different
For athletes engaged in endurance sports, it is important to
have a strong core to stabilize the hip and knee joints during
repetitive leg motions. We will be able to
determine which muscles are weak, and provide specific exercises to
target these areas.
All our senior physiotherapists are trained and experienced
in manual (hands-on) therapy, using their hands to move and manipulate
muscles and joints to improve motion and strength. These techniques can
target areas that are difficult to treat on your own.
We may use
as a part of your compartment syndrome physiotherapy program. These tools can help improve
tissue mobility and flexibility, and enhance recovery. We will discuss the purpose of each modality with you.
Your treatment will include education
about how to safely return to your previous activities, particularly if
your condition required a fasciotomy. We may
- Wearing more appropriate footwear
- Choosing more appropriate surfaces and terrain for exercise
- Pacing your activities
- Avoiding certain activities altogether
- Mastering strategies for recovery and maintenance of good health (e.g., allowing your muscles and joints proper rest time)
- Modifying your workplace to lower risk of injury
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At the first session, our specialist physiotherapists will carry out a thorough
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Follow up sessions are inline to provide
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