Compartment Syndrome

MEGAN FLYNN, PTC, DPT.

The muscles in your body are grouped into different compartments which contain muscles, nerves, and blood vessels. These compartments are divided by fascia, which is a layer of connective tissue found throughout the body. The main purpose of fascia is to hold tissues in place. When there is excessive swelling in one of these compartments, it leads to something known as Compartment Syndrome.

Since fascia does not stretch or expand easily, swelling within a compartment leads to increased pressure on blood vessels, nerves, and muscles. As a result, the blood supply to muscles and nerves is disrupted, which can cause tissue damage. There are two different types of compartment syndrome: Acute and Chronic (exertional).

Acute compartment syndrome is a medical emergency and is usually caused by a traumatic event (ex: broken bone, severely bruised muscle, crush injuries). The pressure within the compartment has to be relieved as soon as possible, otherwise, permanent tissue damage can occur. Symptoms of compartment syndrome can be remembered with the “5 P’s”: Pain, Pallor (pale skin), Paresthesia (numbness), Pulselessness (weak pulse), and Paralysis (weakness). If someone demonstrates these signs after a traumatic event, the individual should be brought to the emergency room. A procedure called a fasciotomy may be performed to relieve the pressure by creating more room in the compartment.

On the other hand, chronic (exertional) compartment syndrome is caused by exercise, with higher incidences in repetitive sports including running, biking, or swimming. Some common symptoms of chronic compartment syndrome include pain or cramping during exercise, numbness, weakness, and visible muscle bulging. This type of compartment syndrome is not a medical emergency. A compartment pressure test is used to diagnose this type of compartment syndrome. It measures the amount of pressure within the compartment after ruling out other injuries (ex: bony stress, tendonitis).

Treatment for chronic compartment syndrome can be conservative or surgical. Conservative treatments can include physical therapy, orthotics, anti-inflammatories, and discontinuing the irritating activity. The surgical option is similar to the fasciotomy procedure in acute compartment syndrome, but it is done as an elective procedure–not an emergency!

More Info: AAOS.Org

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