Guest author Nina Jurak explores her experiences with compartment syndrome and discusses effective treatment.
What started off as numb toes and shin pain was later diagnosed as compartment syndrome in both my lower legs by a doctor, physiotherapist and podiatrist. This was confirmed by a sport physician who conducted pressure tests. The next day I was whisked off to surgery and over a decade later, I am still suffering! But I have recently found a solution that helps me cope with the pain; more on that later.
According to medical journals, ‘compartment syndrome is a serious condition that involves increased pressure in a muscle compartment. It can lead to muscle and nerve damage and problems with blood flow. Thick layers of tissue, called fascia, separate groups of muscles in the arms and legs from each other. Inside each layer of fascia is a confined space, called a compartment. The compartment includes the muscle tissue, nerves, and blood vessels. Fascia surrounds these structures, similar to the way in which insulation covers wires’.
As fascia does not expand, ‘any swelling in a compartment will lead to increased pressure in that area, which will press on the muscles, blood vessels, and nerves. If this pressure is high enough, blood flow to the compartment will be blocked. This can lead to permanent injury to the muscle and nerves. If the pressure lasts long enough, the muscles may die and the limb may need to be amputated’. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002204/
I liken it to a hot sausage on a BBQ.
Swelling that leads to compartment syndrome may be caused by any of these factors: trauma such as a car accident or crush injury, or surgery; complex fractures or soft tissue injuries due to trauma; or repetitive activities, such as running (which was my cause). Do a Google search of any medical journal and you will find the only treatment to compartment syndrome is surgery, whereby long surgical cuts are made through the fascia to relieve the pressure. The prognosis or outlook is said to be excellent for your muscles and nerves and even better if you exercise hard straight after surgery.
I thought I had a high pain threshold having had two natural births without any pain relief but I met my match with compartment syndrome. The surgery was not complicated and although the recovery went seemingly well, it was extremely painful. However, 12 months post-surgery I was told I had to have surgery in my upper legs and my lower legs were showing signs of compartment syndrome again! My answer to the guys who wanted to cut me open again, ‘Hell No!’ (curse words omitted). I refused to believe this was my only option and so I reluctantly decided to live with the pain and lead a less active life. After 15 years of seeking alternatives to surgery, which included expensive orthotics and shoes, gym memberships and personal training, there have been none, until now.
When I first started at Range of Motion I thought the types of exercises CrossFit offered, such as box jumping and skipping would aggravate any leg pain I already had or worse still, bring on the symptoms of compartment syndrome that lead to surgery. I dreaded training and felt sick with fear beforehand but I wanted to give it a go! Ten months later, I have never been so happy to be proven wrong. My legs still swell during and after exercise and sometimes for no reason at all, but the severe pain is becoming a thing of the past. At ROM I have been taught how to warm up and use my muscles correctly and most importantly for me, how to roll out my calves correctly. No one can imagine the joy I feel when my calves that look like Popeye’s forearms after a can of spinach, hit my beloved foam roller! Thank you Dan and ROM! I only wish you were around years ago (and Azza thanks you as I am less cranky…yes Azza I can be even grumpier!).
Nina Jurak
