Compartment syndrome is defined as increased pressure in the four compartments as outlined below, leading to compromised blood flow and tissue perfusion, which leads to ischaemic pain (pain caused by a lack of circulation to the area). If untreated, it may lead to permanent damage of the tissues in the compartment via nerve and blood vessel compression. This syndrome is common among runners, athletes, military personal and triathletes.
What are the compartments of the leg?
In the lower leg, there are four compartments or fibro-osseous spaces, which contain the muscles, nerves and blood vessels. They are separated by bones of the leg (tibia and fibula), interosseous membrane and anterior intermuscular septum. This is covered by fascia which is not elastic in nature. The four compartments are:
3. Superficial posterior
4. Deep posterior
What are the causes of compartment syndrome?
There are 2 major types of compartment syndrome:
1. Acute compartment syndrome
Acute compartment syndrome often results as a secondary condition following:
– Acute injuries and trauma
– Muscle rupture or tear
– Fracture of the leg bones
– Blood disease – sickle cell anaemia
– Extreme exercise activities
2. Chronic exertional compartment syndrome
The exact cause and mechanism of chronic exertional compartment syndrome is not known, but it’s believed that it can be caused by repeated overuse following inflammation, which can lead to to the development of fibrosis (hardening, and/or scarring of various tissues). This causes the fascia (connective tissue) to thicken, which in turn limits the expansion of muscles during exercises, and causes compression of the nerves and blood vessels, which results in ischemic pain.
Foam rolling can help to relieve pain and discomfort over the affected area.
Observation and analysis of movement pattern during the pain-provoking activity can help to know the areas of faulty movement strategies. This can assist to reduce the abnormal biomechanics and strain in the leg muscles.