Health in Sports Report - Issue 4
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Compartment syndrome occurs with increased pressure in a closed anatomical space, limiting the tissue circulation and function of that space. Reduced circulation may result in temporary or permanent damage to muscles and nerves. Compartment syndrome may be acute or chronic.
Acute Compartment Syndrome
Acute compartment syndrome (ACS) is usually caused by trauma, although the trauma may be relatively minor. ACS may also, though rarely, be caused by intense exercise. ACS is a medical emergency requiring prompt diagnosis and treatment. The hallmark finding is pain more severe than the obvious physical findings would indicate. Symptoms usually begin within a few hours of injury but can be delayed up to 64 hours.
Chronic Compartment Syndrome
Chronic compartment syndrome (CCS) is an exercise-induced condition characterized by recurrent pain and disability. Symptoms subside when the offending activity (usually running) stops but return when the activity is resumed. CCS may be considered an uncommon though important cause of exercise-induced leg and/or foot pain.
There are four requirements to diagnosis CCS:
- specific anatomic location.
- evidence of increased tissue pressure.
- compromised circulation.
- dysfunction of the nerves and muscles within the affected compartment.
Intracompartment pressure testing, before and after exercise, is considered the gold standard for confirmation of CCS.
Patients who have diagnosed CCS of the leg and/or foot may decide to live with their problem or opt for conservative or surgical treatment. Living with the problem would involve eliminating or limiting the offending activity and becoming educated about CCS and risks involved, i.e., increased chance of developing ACS.
Conservative treatment is limited for those who wish to continue vigorous exercise, but treatment options may involve prolonged rest, modifying offending activities and altering training regimens. Surgical treatment is also an option in certain circumstances.