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.
Our senior physiotherapists can be effective to help identify the factors that may influence the development of 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.
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.
It can 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:
How Does It Feel?
The most common signs and symptoms of ACS include:
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.
Following a fasciotomy surgery, physiotherapy is necessary to restore the
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 much training.
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:
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 measurement."
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 after exercise.
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.
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 recommend:
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 syndrome.
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 motions.
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 modalities e.g.
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 recommend: