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Click to view Alpha Crow's profile Amateur 14 posts since
Nov 4, 2006

Jan 11, 2007 4:27 PM

Exertional Compartment Syndrome

Ok, more doctors and more tests.

It appears that I have compartment syndrome on my left calf, apparently genetic in origin. Doctors think that when I run, the muscles swell with blood and the fascia restricts the expansion, causing the peroneal nerve to be irritated. My symptoms are ankle fatigue and slight cramping and numbness of the foot starting with the outside toes.

Anyone have any similar experiences? My doctors pretty much said they give up and don't know what to tell me other than to stop running.

I would beg on my knees for anything to help me get around this. Anything that alleviates the problem? I've done research, but not finding a lot so far.

Please help if you know anything, I'm so near tears at this point that my manliness is in question.

Thanks,
Brian
Click to view NGeorgiaTR's profile Pro 93 posts since
Feb 8, 2006
2. Jan 11, 2007 10:27 PM in response to: Alpha Crow
This is exactly what kept me from running for 10 years. Went through a bunch of doctors. Since nothing was broken, torn etc. they couldn't do anything. Saw a bunch of specialists and had several bone scans.

Well, my (DW's actually) midwife had a great chiropractor that she recommended. He was extremely experienced in sports medicine. I forget which certification for the specific technique but have it somewhere around here. As soon as he got me on the table, he noticed my ankle hanging strangely. He aligned it and I was off and running. It took about 3-4 runs to be pain free. I actually went back and did the c25k program from this site to make sure i came back slowly. At the beginning, I had to go back more often, but in the past two years it is getting stronger. I moved from CO to GA so had to find a new chiro here. So far so good.

The compartment syndrome was a secondary (tertiary or quaternary, etc.) symptom in my case. After some later work looking to return full strength to my legs, It was found that I had a slight spine injury, likely from my very bad mtn bike accident years ago. My hip was out of alignment, changing my gait, which affected my ankle. It wasn't until looking into all of this that I am getting significantly stronger.

so much so that I've been averaging almost 40 mpw lately and managed to make my knees sore... but thats another story of just breaking the mileage rules..

This was an incredibly annoying and frustrating experience. I had truly ruled out running ever again and was feeling the same as you, I believe. I even had a doctor ask me if I could live with it. I'm a pacifist, but I almost hit him.

I'll see if I can find the certification in my work email tomorrow and if you live in GA or CO, I can hook you up with a chiro. Feel free to email me about this.
Click to view NGeorgiaTR's profile Pro 93 posts since
Feb 8, 2006
3. Jan 11, 2007 10:41 PM in response to: Alpha Crow
The muscle that was weakened for me was the peroneus tertius, causing swelling in the extensor digitorum longus. Its kind of cool that almost 20% of the population don't even have it. I would have been glad to be without it

Its nice that once the structural issues are corrected, the soft tissue can begin to heal.
Click to view NGeorgiaTR's profile Pro 93 posts since
Feb 8, 2006
5. Jan 12, 2007 8:35 AM in response to: Alpha Crow
quote:<HR>Originally posted by Alpha Crow:
That may be a great idea to check into hip and back issues. While it appears to be genetic mostly (brother and father suffer from a very mild case), I know I do have a heavier stride on my left side, but I feel like that is caused by the ankle fatigue and tightness more so than natural. I will try to look into a hip alignment, I do have a memory way back when I was in marine corps boot camp and while learning to march all day on the parade deck, my left hip burned like fire after an hour out there. I know this sounds idiotic, but a drill instructor seemed to have fixed it accidentally when he saw me rubbing it and walked up and kneed me there (unofficial punishment for moving I suppose). It gave me a flash of blinding pain for a split second and then all pain was gone and didn't bother me anymore.

I wonder if chiro is covered by insurance at all. Doubt it, but I'll be willing to pay to try it out. Anything at this point.
<HR>


Chiro is covered by most insurance.

The stiffness in the ankle is exactly what it felt like until the ankle was adjusted. The relief from the stiffness can be felt almost immediatly after adjustment. But I may be more sensitive to it as I started with the chiro about two years ago. The hip and back stuff just has helped the ankle stay aligned longer.
Click to view me1ani's profile Amateur 13 posts since
Jan 2, 2006
6. Jan 12, 2007 9:10 PM in response to: Alpha Crow
I had ecs last year and underwent three months of aggressive physical therapy. My orthopedist believed p/t should be exhausted before any invasive methods were to be considered. It worked!

I underwent a combination of ultrasound, deep tissue massage (painful, but it loosed the fascia), icing and specific calf exercises. For several weeks I ran only on softer surfaces and stretched like mad.

To date I've had no relapse even after mileage increases and resuming milage on harder surfaces.
Click to view NGeorgiaTR's profile Pro 93 posts since
Feb 8, 2006
8. Jan 14, 2007 9:53 AM in response to: Alpha Crow
quote:<HR>Originally posted by Alpha Crow:

Had a lot of doctors and friends tell me maybe I'm not meant to run, but the heck if I'm giving up. I've been running for 14 years now and it's not over till I'm dead!
<HR>


All people are made to run! I love when people are so helpful.

Anyway, good luck next week!
Click to view carina079's profile Amateur 39 posts since
Oct 29, 2002
9. Dec 26, 2007 2:20 PM in response to: Alpha Crow
I had bilateral exertional compartment syndrome. I had the surgery for it back in '94 and repeated in '96. There is NO way it can be cured via chiropractic treatment. Maybe the surgery is more effective now than it was then, but it was not very successful for me (worse progosis for females). Of course, my case was very severe. If you are interested in more info, please incidate this, and I will send my current email (my email associated w/ my CR account is inactive). And yes, I have found things that help.

Karen

http://This message has been edited by carina (edited Jan-15-2007).
Click to view NGeorgiaTR's profile Pro 93 posts since
Feb 8, 2006
10. Dec 26, 2007 2:20 PM in response to: Alpha Crow
I don't know about the bilateral part, does that involve both the lateral and the anterior compartment simultaneously (and maybe the posterior, also)? That sounds unbelievably painful. Just having it in the anterior compartment was bad enough for me.

I do know that, at least, ECS in the anterior compartment can be cured by chiropractic treatment.

http://This message has been edited by NGeorgiaTR (edited Jan-15-2007).
Click to view carina079's profile Amateur 39 posts since
Oct 29, 2002
11. Jan 15, 2007 7:59 PM in response to: Alpha Crow
Sorry I didn't clarify which compartments were involved. Bilateral means both legs. As for compartments, I had all four compartments on both legs (anterior, posterior, lateral, and deep posterior). True, it is not necessary to have surgery for anterior CS, unless it doesn't respond to other types of treatment. I know some chiro docs can do wonders.

Because I had both legs affected, they had to do the surgeries separately. When I recovered from one enought to walk without pain, they did the other one. Unfortunately, even though I had a great surgeon, the surgery was not successful, so it had to be repeated a couple years later.

Even after the second round of surgeries, I was marginally better, but still in constant pain during my run. I could run, but only with massive doses of ibuprofen, and I couldn't run very far. Cross training, for the most part, did not hurt (of course, it depended on the sport; I could not do, for example, the revolving staircase). To some extent, I learned to live with the pain, but I couldn't do what I really wanted: run the marathon.

For sixteen years, I ran on megadoses of ibuprofen. I also tried deep, "crime-scene" massage, which was helpful for short periods of time; that is, it did not provide lasting relief. I also used the Stick (www.thestick.com) before EVERY run. The Stick is GREAT. I can't recommend it highly enough. I use the Sprinter stick, which is a very rigid stick, and it is ideal for dense tight calf muscles.
Click to view irishgator1's profile Rookie 3 posts since
Dec 14, 2007
12. Jan 16, 2007 10:24 AM in response to: Alpha Crow
quote:<HR>Originally posted by carina:


For sixteen years, I ran on megadoses of ibuprofen. I also tried deep, "crime-scene" massage, which was helpful for short periods of time; that is, it did not provide lasting relief. I also used the Stick (www.thestick.com) before EVERY run. The Stick is GREAT. I can't recommend it highly enough. I use the Sprinter stick, which is a very rigid stick, and it is ideal for dense tight calf muscles.

<HR>


Carina- I have a question for you regarding the Stick. I just got mine a couple of weeks ago and have been using it on my outer shin muscles. I also have what seem to be compartment-like issues- painful burning in shin muscles, numb feet, and not being about to pick my feet up off the ground when running. The physical therapist said it's tight shin muscles but even with PT and using the stick, the problem is still there. Do you roll over the calf muscles as well as the shin muscles?
Click to view carina079's profile Amateur 39 posts since
Oct 29, 2002
13. Jan 16, 2007 6:54 PM in response to: Alpha Crow
Irishgator, I roll all over the calf muscle. Just don't roll on bone. Anywhere there is meat, you need to roll. I roll vigorously, to the point of getting out of breath, but that is what works for me. Also, you might not have the right Stick for your muscle type. The original Stick, which is the one you can get in running stores, isn't rigid enough for me. You can go to their website (thestick.com) to see the other models. They aren't cheap, but they are definitely worth the investment.

I am personally not a big fan of PT (many folks swear by it though). However, if you have persistent numbness in your feet (and it isn't resolved by loosening your laces), I would get it checked out by a sports doc.
Click to view irishgator1's profile Rookie 3 posts since
Dec 14, 2007
14. Jan 17, 2007 1:47 PM in response to: Alpha Crow
quote:<HR>Originally posted by carina:
Irishgator, I roll all over the calf muscle. Just don't roll on bone. Anywhere there is meat, you need to roll. I roll vigorously, to the point of getting out of breath, but that is what works for me. Also, you might not have the right Stick for your muscle type. The original Stick, which is the one you can get in running stores, isn't rigid enough for me. You can go to their website (thestick.com) to see the other models. They aren't cheap, but they are definitely worth the investment.

I am personally not a big fan of PT (many folks swear by it though). However, if you have persistent numbness in your feet (and it isn't resolved by loosening your laces), I would get it checked out by a sports doc.
<HR>


Thanks. I have the travel version- not sure if it's rigid enough but it certainly leaves my shins all painful when I'm done (the same feeling after the PT gets done with the myo-fascial massage thing). I'm only using it on my shins and not my calves so I'll give that a try.

The depressing thing is, my sports orthopedist prescribed PT. I've seen 2 sports podiatrists and two sports orthopedists and none of them is taking me seriously, or at least I feel like that. They keep saying it's shin splints, and it may well be, but I've had shin splints before and in my case, they were sharp shooting pains in my inner shin muscles. This pain is a burning, duller pain- the kind that you get if you were to flex your foot and keep like that until it really started to burn.