Compartment Syndrome is a painful buildup of pressure around your muscles. Acute compartment syndrome is a medical emergency that happens after severe injuries or as a surgery complication. Chronic compartment syndrome happens over time when you exercise too hard or too often. You can usually treat chronic compartment syndrome by tweaking your workout routine.
Compartment syndrome happens when there’s too much pressure around your muscles. The pressure restricts (reduces) the flow of blood, fresh oxygen and nutrients to your muscles and nerves. Compartment syndrome is extremely painful.
A “compartment” is the medical term for a group of muscles, nerves and blood vessels. Compartments are covered by a fascia — a thin, firm membrane. Compartment syndrome happens when extra pressure builds up inside a compartment and your muscles press against the fascia more than they should.
Compartment syndrome can happen to any muscle group, but it’s most common in your:
There are two types of compartment syndrome:
The most common signs and symptoms of compartment syndrome include:
Compartment syndrome happens when an injury or repeated stress causes swelling and bleeding inside a muscle compartment. If the pressure builds too much, your muscles press against the fascia that holds them in place.
The fascia has some natural ability to stretch and expand, but not much. If pressure keeps building in the compartment, the fascia eventually runs out of room and starts squeezing against your muscles and nerves. This squeezing is what causes pain and other symptoms.
If you’ve ever worn a pair of shoes that’s a size or two too small, you’ve probably experienced a similar buildup of pressure. Early in the day, your feet may fit comfortably in the shoes. But as the day goes on and you walk and move, your feet naturally start to swell. By the end of the day, those shoes that felt “fine enough” in the morning may feel like they’re vice grips on your feet. Compartment syndrome is much more dangerous because that kind of pressure happens inside your body.
What causes compartment syndrome depends on which type you have.
Severe injuries are the most common cause of acute compartment syndrome, including:
Chronic (exertional) compartment syndrome usually builds up over time. Frequent, intense exercise is the most common cause. Doing the same kind of workout or training can put repeated stress on the same muscles and cause a pressure build-up. Some common causes include:
It’s less common, but doing a repetitive motion at work or for a hobby can also cause chronic compartment syndrome.
Anyone can develop acute compartment syndrome because it happens after sudden injuries.
Athletes and people with physically demanding jobs are more likely to overtrain or overwork their muscles and develop chronic compartment syndrome.
People with hemophilia and other types of blood disorders may have an increased risk.
Compartment syndrome can cause serious complications.
If the pressure in a muscle compartment gets too high, your tissues won’t get enough fresh blood, oxygen and nutrients. This can lead to tissue death (necrosis), which causes permanent damage.
Acute compartment syndrome can be fatal if it’s not treated right away. Go to the emergency room if you think you have acute compartment syndrome.
A healthcare provider will diagnose compartment syndrome with a physical exam and tests. They’ll examine your muscles and the area around them. They might first rule out other issues (like tendinitis or shin splints) that can cause similar symptoms.
Tell your provider what you were doing when you first noticed pain and other symptoms. Tell them if certain activities seem to make your symptoms better or worse.
Your provider may use a few tests to diagnose compartment syndrome, including:
How providers treat compartment syndrome depends on which type you have.
Acute compartment syndrome is a medical emergency that needs immediate surgery. Chronic compartment syndrome usually gets better after you tweak your exercise habits or routine.
A surgeon will perform an operation called a fasciotomy. They’ll make an incision (cut) through your skin and fascia to relieve the pressure in your affected muscle compartment.
They’ll close the incision after the swelling and pressure go away. Sometimes, that can’t happen immediately. Your surgeon may do a skin graft, taking skin from another area of your body to cover the incision.
Chronic (exertional) compartment syndrome usually gets better and goes away if you rest your affected muscle compartments and avoid overusing them in the future. Your provider will suggest treatments to manage your symptoms and prevent pressure buildup, including:
You may need a fasciotomy if other treatments don’t work or the compartment syndrome comes back (recurs). Your provider will let you know when you should consider surgery and what to expect.
If you have acute compartment syndrome, you should feel better after you’ve recovered from the fasciotomy. Most people need to rest for around a month before using those muscles. Your surgeon will tell you when it’s safe to start moving again, and how long you should wait before resuming physical activities.
Managing chronic compartment syndrome may take longer, especially at first. It might take a few months to find a combination of treatments and exercise modifications that manage your symptoms. Your symptoms should improve gradually as you find ways to avoid putting too much pressure on your affected muscles.
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