Chronic Exertional Compartment Syndrome: The Silent Condition Runners Face

For many years I dealt with unbearable pain in my legs. Running was always like torture. My lower legs would hurt and burn. Sometimes, my limbs refused to respond I would be stuck (unable to move) mid-stride. I was told that it was Shin Splints by several physicians including Orthopedic Specialists but I always knew that Shin Splints was not the reason for my pain. The symptoms and patterns of my pain did not match those described by people who had Shin Splints; neither did it match the description in medical resource books. Last summer, a friend, who is also and athletic trainer, suggested that I may be dealing with Exertional Compartment Syndrome (ECS). I went to see my orthopedic specialist and requested to be examined for ECS. Then and only then did they run the appropriate tests. Sure enough, ECS was the culprit. The problem with ECS is that so few people have it that we are often ignored and lumped into the Shin Splints group. Pushing through the pain, especially while running can lead to permanent nerve damage. Here is what you need to know about ECS. The Mayo Clinic provides the following explanation:

"Chronic exertional compartment syndrome is an uncommon, exercise-induced neuromuscular condition that causes pain, swelling and sometimes even disability in affected muscles of your legs or arms. Anyone can develop chronic exertional compartment syndrome, but it's more common in athletes who participate in sports that involve repetitive movements, such as running, fast walking, biking and swimming."

Here is why it happens:
"Your arms and legs have several groupings, or compartments, of muscles, blood vessels and nerves. Each of these compartments is encased by a thick layer of connective tissue called fascia (FASH-ee-uh), which supports the compartments and holds the tissues within each compartment in place. The fascia is inelastic, which means it has little ability to stretch.
In chronic exertional compartment syndrome, exercise or even repetitive muscle contraction causes the tissue pressure within a compartment to increase to an abnormally high level. But because the fascia can't stretch, the tissues in that compartment aren't able to expand sufficiently under the increased pressure. Imagine shaking up a soda bottle but leaving the cap on — an enormous amount of pressure builds up.As the pressure builds up within one of your muscle compartments, with no outlet for release, nerves and blood vessels are compressed
Symptoms (All of which I experienced. Still, the condition was missed)."

If you are experiencing any of the following symptoms, I encourage you to talk to an Orthopedic Specialist and asked to be tested for ECS. You'll be glad you did.

- Aching, burning or cramping pain in the affected limb — usually the lower leg, but sometimes the thigh, upper arm, forearm or hand
- Tightness in the affected limb
- Numbness or tingling in the affected limb
- Weakness of the affected limb
- Foot drop, in severe cases, if nerves in your legs are affected
- Occasionally, swelling or bulging as a result of a muscle hernia
- Pain begins soon after you start exercising the affected limb
- Progressively worsens as long as you exercise
- Stops 15 to 30 minutes after the affected limb comes to rest
- Over time, may begin to persist longer after exercise, possibly lingering for a day or two.

Let's advocate for more research in this area. There are still too many unanswered questions. Today, I can run longer that I ever could and I am loving it! It is still a challenge, but now that I understand the pain, I know when to stop. That's empowered!

Reference: Mayo Clinic (2012). Chronic Exertional Compartment Syndrome. More info here: http://www.mayoclinic.com/health/chronic-exertional-compartment-syndrome/DS00789

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Empowered

Danielle Serrano

DrRonnie,

Thanks for sharing your story. All too often a health problem goes undiagnosed because doctors are not aware of it. Hopefully we can help to make others more aware and thus, more empowered! Keep on running and sharing!

Best,

Danielle.

April 16, 2012 - 7:37am