anterior compartment syndrome questions
I was just told that the pain that I have been trying to find a cure for is compartment syndrome in my lower right leg. Has anyone ever had any experience with this? I was told that I need to have a test in the next week to check the pressures for it to see how bad it is and that I cannot run until then. Biking is OK and swimming is really good since I am not using my legs that much. Anyone have any good or bad experiences with this?
Thanks,
Ned
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Who gave you the compartment syndrome diagnosis and what were the symptoms leading up to that visit? how long have you been having them? when did they start? what have you done for them so far?
The reason I ask is that regardless of whether those pressure readings come out high or low, you still need to figure out the root cause (muscular, mechanical, etc) to fix the problem once and for all.
As far as your doctor is concerned: if the readings are high...he has a few options: 1) you stop running entirely till it goes away (the good ole stop if it hurts treatment method), 2) PT, 3) surgery (at which point they slice down the anterior part of your leg to relieve the pressure manually). Has there been any other treatment to date?
The test itself isn't horrible. Most of the ones I've seen include running on a treadmill till the symptoms start and then using a pressure needle.
The pain has been off and on for a while. When I run, after about a mile, it sets in and moves up a sclae of pain for the next 3 miles and then will start to go away. She told me that the feeling goes away because the nerves are giving out or something like that. I thought that they were bad shin splints. The muscle inbetween the two bones gets insanely tight and about as solid as concrete. If I stop running, I usually am limping at this point. Right now, I am putting vlotaren gel on the place it normally hurts and not running. I am doing self massag and will be going in later this week to have the massage therapist work on it. She said to do that one every 10 days or so. It came up right after Beach 2 Battleship with full effect. I did not have this problem after IMLouisville. I did have it last year for a while and the previous year, but it went away.
As far as causes, I could not say. I am not the most flexible person in the world and have soem pretty tight IT band issues. I am working with a foam roller for those right now. Other than that, I have no idea what caused it. Like I said, it hurts for the first 2 to 5 miles and then goes away and I can go on as if it never happened. the first little bit though is pretty bad. I would like to avoid having to take off from running with a race in March and Eagleman coming up and I certainly do not want to cause any perm damage either. It is becoming a little frustrating becasue I had this same exact thing explained as shin splints two years ago.
Thanks
You need compartment pressure measurements before and right after exercising. The diagnosis of compartment syndrome is based alot on these numbers.
Do you have numbness/loss of sensation on top of you foot....near 1st web space (loc. of nerve in ant. comprt)
If diagnosis is confirmed, if the symptoms are functionally disabling then a compartment release rec. and usual helps solve the problem.
Be sure to do your research in the Managing Injuries section of the wiki (thanks Leigh!!!!).
P
Luckily I have not had any numbness in my foot at all. My only issue is how hot the bottom of my feet get after about 13 miles. Did someone say that they stick a needle in my leg to check the pressure? I had not given any thought as to how they would check that. Now I am really looking forward to having this test done. Who would not want to go a day without a needle stuck in your leg? It is odd how this comes and goes. It usually only creeps up in the begining and at the end of the season. I cannot remember a time when it has been during the middle.
Thanks for the help.
The testers put you on a treadmill. THey measure the pressures by using a device with a long needle on it that gets stuck into your leg. Its measured at several times before and after exercising.
Good thing you said it was a long needle and that it was done several times.
so here's my advice- you really have to start working on your lower leg to loosen it up. as in priority number one and get some help.
it could be something as simple as bad shoe set up or poor run mechanics (short stride, no push off, etc)- my point being....even if that test comes back 100%...it's just a pressure number and even surgery won't change the outcome if it's a repetitive overuse injury.
what kind of specialists do you or your local training buddies know?? are there any soft tissue people or sports specialists???
The doc is a sports med doc and can do a gait anaalysis. She competes regularly in duathlona nd triathlon and has done an IM. That is why I went to her in the first place, becasue she could relate or at least understand. There are a number of resources in town I can go to, so that's not a problem. Do you have any suggestions on what I can do to loosen it up? I watched the video on the site for loosening up the lower leg and do that every other day. I can switch and do it twice a day if that will work. I will admit that there is probably some strength work I could do with my lower legs or legs in general.
I am open to any advice if you have it.
Hey Ned, sounds like your in good hands doc wise. such a plus in helping to sort out these kinds of injuries.
Lower leg work is a great start. The key with any kind of soft tissue mobilization/flexibility work is frequency. Killing yourself for an hour every 2-3 days isn't as good as say...something manageable 1-2x/day. As far as digging stuff out is concerned. Stick with the once a day for now. As you start to break up old adhesions and tension in the muscle, you may be sore and even bruised. Think of it more as...following your workout- shoot for 10-15 minutes of stretching just to prevent stuff from stiffening up. Then later in the day after the workout effects are gone, make some time to go to work with the soft tissue stuff. Gentle stretching afterwards is great if you've got the time. Have you ever heard of ART?? (active release technique) or do you know any good sports massage people?? Would be beneficial to let someone else start digging to help speed up the process and they can provide some good insight on any other possible areas that are contributing. Doesn't have to be a 2+x/week or something, but maybe every other week to start the healing process in full??
As far as strengthening- if you hit up the train map download section, there is a lower extremity strengthening routine with video's that you can download. It gives you some different starting points and ways to make it more challenging as well.
Lastly- time to start thinking about run mechanics/shoes. we can help get you started. needed info would be your shoe type (brand/model), any special inserts or orthotics you may be using (if at all), and a video of you running at your LRP (from the back and a side view; treadmill might be the easiest versus someone running next to you
).
that make sense??
Thanks for all the info. I will follow your advice by doing it more frequently. It snowed today and we cannot do anything so it will be a great day to start. I will use her mt every 10 days like she was saying to have someone who knows what they are doing work on it.
I run mostly in Newtons, the Sir Isaacs. I ran in the cushion shoes for a long time and then switched the evening before IM Louisville. You would think stupid, but I had the best marathon in an IM I have ever had. Honestly, it has been really difficult to find a pair of shoes that feel good to run in and they have been the best over the past couple of years. The more I think about it though, I would switch when I would have this problem come up so I have probably been running in some others that were perfectly fine. I have used Miz Wave Riders and Brooks Adrenalines. I need a wide toe box and a high arch support. I tried the Zoot's, but then started to develop some PF-like issues. I will video myself running, although I think that there are certain laws against such things. I believe that the combination of video and me does not make a good match. I will do it as soon as I can figure out how to tape myself with the camera.
I went to the doc this AM and she kindly stuck a BIc pen sized needle into my leg before I ran and said that I definately had comparment syndrome. She had me run anyways and then stuck me again and I was then told that I had the second highest pressure (109) she had ever seen. I am now waiting for the referral to the doc who will determine if surgery is necessary, which they say it should be. From what I understand , there is a nice 6 week recovery from this so I will be canning my first race, but should be fine for Eagleman, thankfully. Anyone have any good swim workouts since that will be the main workout for the next few weeks? Injuries suck!