Compartment Syndrome and What To Do About It


As the days get longer and we move more definitely into summer, many of us are hitting the high points in our training - whether it be lifting, running, cycling riding, or climbing.


With that added training comes the potential for overuse injuries. We are all pretty familiar with the sprains, strains and long list of “-itis” injuries...but what about compartment syndrome? This is often overlooked, misunderstood, wrongly diagnosed, and ineffectively treated.


Compartment Syndrome? What's That?


Well, when intensity and volume of training increase, so does the demand on the muscle and fascia. As we know, training is “induced stress” - POSITIVE stress that promotes adaptations within the muscle fibers and soft tissues. Muscle fibers hypertrophy. Soft tissue begins to produce stronger and more organized collagen.


There are some chemical by products - lactic acid, for one, makes us sore. Low grade inflammation occurs in response to microtearing of the muscle fibers and soft tissues - all of this is usually not a problem with adequate recovery.  


However, when the demands exceed recovery ability, the tissue swells! Residual swelling from the last training session lingers into the next, high demand for blood flow and oxygen causes the capillary beds to expand, and suddenly there is more fluid in the tissue than can be managed!


Muscles exist in closed compartments. There are multiple layers of myofibrils contained within muscle fibers contained within fascial sheaths. All of this can only expand so much until the pressure becomes overwhelming! The pressure on the vascular structures as well as on the nerves becomes painful and can ultimately be dangerous if not managed.


The most common areas affected are the calves, thigh (both hamstring and quad), and the forearms. Signs and symptoms include tenderness to touch or to impact, increased warmth of the affected area, possible feeling of cramping, numbness/tingling and/or throbbing.


At this point, the traditional RICE (Rest, Ice, Compression, Elevation) approach is appropriate, however, the tissue is now so saturated (think “soaked sponge”) that something more needs to be done to facilitate that fluid being flushed out!


So What Do I Need?


Manual therapy! Specific massage work that employs various techniques of myofascial release, neural and joint mobilization.


You could lose 6 weeks of summer training “waiting it out” OR you could get worked on a couple of times and keep going - doing what you do!