Compartment Syndrome and How I Manage It.

Chronic exertional compartment syndrome (CECS) is the increase in pressure and decrease in blood flow in specific muscle compartments. It is a common syndrome for athletes and those in the military. CECS is characterized by extreme pain following exercise that is very easily pinpointed to its location and diminishes quickly provided with rest. CECS is treated surgically by fasciotomy. A fasciotomy is the cutting away or removal of the fascia, the thin and tough tissue layer that surrounds the muscles. To diagnose compartment syndrome the patient is asked to preform an exercise until they feel the symptoms. After that, the patient then has a pressure monitor pushed into the compartments where the symptoms are felt. Those that undergo surgery generally feel satisfied with their results. In a study by Drexler et al. there was a 75.5% satisfaction rate but in that same study it was found that some patients incurred unsatisfactory results which include nerve damage (4.2%), reoccurrence of pain (8.4%) and infection(2.1%).

I first noticed a large degree of pain in my legs around the age of 9 or 10. I had collapsed in the middle of a soccer game due to the pain and was taken to the doctor after that. At the doctors I was asked to go outside and sprint for 10 minutes. I came back and what I can only describe as a meat thermometer was then pushed into my shin. After failing the pressure test miserably, I proceeded to have surgery and unfortunately I was not included in the 75% who were satisfied. I had all three of the negative outcomes. One of my incisions developed a pocket of fluid which I had to drain and pack. I have nerve damage in my shins and in my feet and my symptoms have not gone away. I have had the surgery twice now to try to both clear any scar tissue that had built up as well as cut away more fascia. To combat the symptoms on a daily basis I take large amounts of Tylenol, stretch for long periods, ice bath, foam roll and get massages. It is painful to stand for long periods of time, to walk long distances and to spontaneously run is extremely painful.  

There are far worse things to be diagnosed with and to live with on a daily basis but this is a small glimpse into the life of someone with compartment syndrome, a painful syndrome that not many people think about or know exists.

References

Drexler, M., Rutenberg, T., Rozen, N., Warschawski, Y., Rath, E., Chechik, O., & ... Rutenberg, T. F. (2017). Single minimal incision fasciotomy for the treatment of chronic exertional compartment syndrome: outcomes and complications. Archives Of Orthopaedic & Trauma Surgery, 137(1), 73-79. doi:10.1007/s00402-016-2569-7