Hey RMA crew! Hope everyone had a great week. Ang has forgiven me for nearly breaking our daughter on the trampoline last week! Hope your partners are way more responsible than me!
This week I had a couple of people asking me about compartment syndrome, one of the trickier things that can affect runners. Basically I just wanted to chat about compartment syndrome so you can be aware of the symptoms and get it checked out. The muscle compartments in our body are surrounded by a glad wrap type tissue called fascia. Compartment syndrome is when, for whatever reason this fascia traps blood supply. There are two types to be aware of, firstly the one that rarely affects runners, acute compartment syndrome, it’s usually caused by some sort of trauma. This stuff is a medical emergency. You will feel tension and pain build up over a couple of hours. You might lose feeling and power. They can be warm to touch and tight!! It won’t happen to you but good to know about as a mum…you get to doc quick!
The second type is what can happen to us runners and it’s called ‘chronic exertional compartment syndrome’ which is basically an overuse injury. Same deal in that circulation is getting caught but it happens with effort, particularly running. It’s mostly the inside shin area involved but can be calf  and more rarely other areas of the leg. So usually about half an hour in (may vary) your leg might start to ache, burn or kind of cramp. You can feel tightness and it can progress to numbness and tingling, weakness and swelling. The pattern is usually symptoms begin soon after starting to run. They get worse as long as you keep running, then back off within a half an hour of finishing your run. Over time they can progress to lingering longer and longer after exercise even up to a couple of days.
These types of compartment syndromes often get misdiagnosed as shin splints so be aware. The good news is they will almost always come good. You will often have to have a period of rest (HATE THAT WORD!!) but also look into what might be contributing to it. Sometimes it’s mechanics that you can change to put less pressure through the area. Other times for whatever reason the glad wrap or fascia may be too rigid or tight. I would never work on that area when it is blown up and nasty with running but as it settles fully we can often get in and do fascial lengthening techniques to help relieve that slow leak type scenario. Because the circulation is involved you want to have someone that knows what they’re doing look at it for you. Most times they will come good. In rare cases if it’s not backing off and it’s really limiting your running surgery is an option. Don’t even want to talk about what they do, (think of filleting a fish) best avoid that one if you can! Long term the key is keep tissue long around the area. Self prevention strategies will involve calf release, shin trigger points through the front and then on the inside, remember don’t release a compartment syndrome! Puffy, swollen, red, warm, numb any of the above get doc to check it first!! The other piece is just check shoes, you might be too spongy on the inside heel which will make those inside shins work harder and be aware of feet that drop in as well. Mid foot strike will help that situation but you may need support too.
Hope this helps guys!
Special good luck to everyone doing Lamington this weekend. Big hi to running mum Shona Stephenson who is doing the 42 Saturday and the half out Sunday. Nice little training run! Happy running people!
Paul Trevethan
Running Physio
image from google.com.au
Hi Paul,
Thank you for your articles. I think I may have the latter if the compartment syndromes your talking about as the description certainly fits. I saw a Physio and sports Dr who have done ultra sounds and MRIs nothing to be found. Perhaps a very old slight tear in calf but nothing major. They thought compartment syndrome originally then perhaps an entrapped artery but have sinced ruled both out. It’s really uncomfortable to run with particularly from around 5mjns into a run and pretty much stays uncomfortable. Sometimes i feel numbness just below back of knee or in the foot too. Is there something else I should do or try as massages and trying release techniques haven’t worked either. Should I go back to the Physio? I live in Melb. Thanks
Marina