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Chronic Exertional Compartment Syndrome

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Jun 17, 2006.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1

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    Diagnosis and Management of Chronic Exertional Compartment Syndrome (CECS) in the United Kingdom.
    Clin J Sport Med. 2006 May;16(3):209-213
     
  2. I have been doing a little reading on Chronic exertional compartment syndrome and i have been curious on the use to non surgical means of treatment of the leg. The article above and a few others on the topic state the ineffectiveness of modalities such as deep massage, NSAID's, orthotics and stretching, though some did state that massage did elongate the time before the onset of pain.
    So i am just wondering what non surgical treatment options are available? I have been unable to locate any articles which describe these in detail on medline and embase but has anyone else come across any? maybe NewsBot can help??
    I know that this will depend on which compartment is involved and the aeitiology of the condition.
    Has anyone had a large amount of success with non surgical means?
    Also regarding surgery, fasciotomy is the treatment of choice it seems, how invasive are these procedures? i Believe that anterior and lateral compartments are less invasive than the deep posterior compartment. What is the length of the incision involved using the one incision or the two incision technique? I have read that they are using less invasive procedures though how less invasive are these?

    Any information will help.

    Thanks.

    Chris
     
  3. l.heys

    l.heys Member

    I too have been reading on compartment syndrome-with more interest on the anterior area being affected chronically :D

    I'm also dissapointed that most of the conservative modalities for treating the problem i.e. massage technique, ice packs, NSAID's etc. not being effective enough :mad:

    And I always think of surgery as the last resort :eek:

    Tish
     
  4. Secret Squirrel

    Secret Squirrel Active Member

    Intracompartmental pressure testing and the surgical option need to be high on list.
     
  5. daddycool81

    daddycool81 Member

    I myself suffer from anterior compartment syndrome ad it is about as annoying as it comes. I was diagnosed with a rediculously high reading as i was concerned. From age 18 i suffered whilst road running for football training. After 12 mins my foot would burn and my anterior calf would ache and then my foot would go lame and prevent any dorsi or plantar flexion. Funnily enough it occurs exactly 12 minuites into any running, moreso affected in the summer during increased exercise regime by pre-season and unforgiving ground. Control shoes for my mild pronation never helped but combined with functional orthoses completely solved the problem until i dislocated my right knee, now the compartment syndrome is back but switched to the left leg, I felt my orthoses helped tremendously and is always an easier option than surgery to start with. Funnily enough I can run all day in my nike mercurial football boots with no trouble at all, even running home in my boots on the pavement...........
     
  6. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Biomechanical overload syndrome: defining a new diagnosis
    Andrew Franklyn-Miller, Andrew Roberts, David Hulse, John Foster
    Br J Sports Med doi:10.1136/bjsports-2012-091241
     
  7. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Management of Chronic Exertional Compartment Syndrome and Fascial Hernias in the Anterior Lower Leg With the Forefoot Rise Test and Limited Fasciotomy.
    Finestone AS, Noff M, Nassar Y, Moshe S, Agar G, Tamir E.
    Foot Ankle Int. 2013 Nov 22.
     
  8. Leopold

    Leopold Member

    Of course conservative treatments do not get rid of the problem but with mild anterior CECS I have had success in helping to push the "exertion line" back a bit.
    I have a couple police officers who find that grinding the grip on the heel of their boot into a rocker helps.
    I have had a couple runners who found orthotics and consciously limiting a rearfoot strike helped. With the orthotic, round off the posterior heel post.
    Gradual warm up is critical.
    Calf stretching during warm up and during exercise can help.
    I've had success educating a couple people to massage their entire lower leg as symptoms are ramping up during a run or on an eliptical cross training machine. A quick 30 second massage on each each leg and a quick calf stretch can help push symptoms out for another few minutes, and occasionally keep them at bay for the rest of that workout session. Also educating people on where the exertional line is can help those who are trying to get gentle aerobic exercise.
    If any of these were put to the test they would all fail, but I have folks reporting some success and returning to have mods done to their newest boot.
     
  9. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Return to activity following fasciotomy for chronic exertional compartment syndrome
    Val Irion, Robert A. Magnussen, Timothy L. Miller, Christopher C. Kaeding
    European Journal of Orthopaedic Surgery & Traumatology; March 2014
     
  10. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Return to Duty After Elective Fasciotomy for Chronic Exertional Compartment Syndrome
    Jeremy R. McCallum et al
    Foot & Ankle International July 21, 2014
     
  11. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Intramuscular Compartment Pressure Measurement in Chronic Exertional Compartment Syndrome
    New and Improved Diagnostic Criteria

    David Roscoe, MRCGP, MFSEM(UK), MSc(SEM), DipIMC RCSEd, MPA, Andrew J. Roberts, MSc and David Hulse, MB ChB, MSc, FFSEM(UK)
    Am J Sports Med November 18, 2014
     
  12. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Feasibility and Safety of an Operative Tool for Anterior Chronic Exertional Compartment Syndrome Treatment
    Johan A. de Bruijn et al
    Foot & Ankle International July 28, 2015
     
  13. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Ultrasound-Guided, Percutaneous Needle Fascial Fenestration for the Treatment of Chronic Exertional Compartment Syndrome: A Case Report
    Jonathan T. Finnoff, DOcorrespondenceemail, Sathish Rajasekaran, MD
    PM & R: Article in Press
     
  14. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Isolated Chronic Exertional Compartment Syndrome of the Lateral Lower Leg
    A Case Series

    Aniek P.M. van Zantvoort et al
    Orthopaedic Journal of Sports Medicine November 2015 vol. 3 no. 11
     
  15. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Endoscopic-assisted Release of Lower Leg Chronic Exertional Compartment Syndromes: Results of a Systematic Literature Review
    Lohrer, Heinz MD, PhD; Nauck, Tanja PhD; Lohrer, Leif Stud. med.
    Sports Medicine & Arthroscopy Review: March 2016 - Volume 24 - Issue 1 - p 19?23
     
  16. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Botulinum Toxin for Chronic Exertional Compartment Syndrome: A Case Report With 14 Month Follow-Up.
    Baria, Michael R. MD; Sellon, Jacob L. MD
    Clinical Journal of Sport Medicine: January 16, 2016
     
  17. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Surgical Management for Chronic Exertional Compartment Syndrome of the Leg: A Systematic Review of the Literature
    Dominic Campano et al
    Arthroscopy: The Journal of Arthroscopic & Related Surgery; 24 March 2016
     
  18. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Ultrasound-Guided Fasciotomy for Chronic Exertional Compartment Syndrome: A Cadaveric Investigation
    Daniel R. Lueders, M.D., Jacob L. Sellon, M.D., Jay Smith, M.D., Jonathan T. Finnoff, D.O.
    PM & R; Article in Press
     
  19. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    BIOMECHANICAL DIFFERENCES BETWEEN CASES WITH CECS AND ASYMPTOMATIC CONTROLS DURING RUNNING
    A Roberts et al
    Br J Sports Med 2016;50:e4 doi:10.1136/bjsports-2016-096952.32
    Abstracts from the International Sports Science + Sports Medicine Conference 2016

     
  20. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    BAREFOOT PLANTAR PRESSURE MEASUREMENT IN CHRONIC EXERTIONAL COMPARTMENT SYNDROME
    D Roscoe et al
    Br J Sports Med 2016;50:e4 doi:10.1136/bjsports-2016-096952.19
    Abstracts from the International Sports Science + Sports Medicine Conference 2016

     
  21. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    BIOMECHANICAL DIFFERENCES BETWEEN CASES WITH CECS AND ASYMPTOMATIC CONTROLS DURING WALKING AND MARCHING
    A Roberts et al
    Br J Sports Med 2016;50:e4 doi:10.1136/bjsports-2016-096952.6
    Abstracts from the International Sports Science + Sports Medicine Conference 2016

     
  22. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    MODIFYING MARCHING TECHNIQUE IN MILITARY SERVICE MEMBERS WITH CHRONIC EXERTIONAL COMPARTMENT SYNDROME: A CASE SERIES.
    Helmhout PH et al
    Int J Sports Phys Ther. 2016 Dec;11(7):1106-1124.
     
  23. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Biomechanical differences between cases with chronic exertional compartment syndrome and asymptomatic controls during walking and marching gait
    Andrew Roberts' et al
    Gait and Posture; Article in Press
    Chronic exertional compartment syndrome is a significant problem in military populations that may be caused by specific military activities. This study aimed to investigate the kinematic and kinetic differences in military cases with chronic exertional compartment syndrome and asymptomatic controls.

    20 males with symptoms of chronic exertional compartment syndrome of the anterior compartment and 20 asymptomatic controls were studied. Three-dimensional lower limb kinematics and kinetics were compared during walking and marching.

    Cases were significantly shorter in stature and took a relatively longer stride in relation to leg length than controls. All kinematic differences identified were at the ankle. Cases demonstrated increased ankle plantarflexion from mid-stance to toe-off. Cases also demonstrated less ankle inversion at the end of stance and early swing phases. Lower ankle inversion moments were observed during mid-stance.

    The anthropometric and biomechanical differences demonstrated provide a plausible mechanism for the development of chronic exertional compartment syndrome in this population. The shorter stature in combination with the relatively longer stride length observed in cases may result in an increased demand on the anterior compartment musculature during ambulation. The results of this study, together with clinical insights and the literature suggest that the suppression of the walk-to-run stimulus during group marches may play a significant role in the development of chronic exertional compartment syndrome within a military population. The differences in joint angles and moments also suggest an impairment of the muscular control of ankle joint function, such as a reduced effectiveness of tibialis anterior. It is unclear whether this is a cause or consequence of chronic exertional compartment syndrome.
     
  24. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Selective Fasciotomy for Chronic Exertional Compartment Syndrome Detected With Exercise Magnetic Resonance Imaging
    Sehan Park, MD; Ho Seong Lee, MD, PhD; Sang Gyo Seo, MD
    Orthopedics. 2017; 40 (6): e1099-e1102HTTPS:10.3928/01477447-20170608-03
     
  25. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Factors Predicting Lower Leg Chronic Exertional Compartment Syndrome in a Large Population
    Johan A. de Bruijn et al
    Int J Sports Med; DOI: 10.1055/s-0043-119225
     
  26. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Patient pain drawing is a valuable instrument in assessing the causes of exercise-induced leg pain
    Kajsa Rennerfelt, Qiuxia Zhang, Jón Karlsson, Jorma Styf
    MJ Open Sport & Exercise Medicine 2018;4:e000262
     
  27. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Lower Leg Chronic Exertional Compartment Syndrome in Patients 50 Years of Age and Older
    Johan A. de Bruijn et al
    Orthopaedic Journal of Sports Medicine
     
  28. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Identifying prognostic factors for conservative treatment outcomes in servicemen with chronic exertional compartment syndrome treated at a rehabilitation center.
    Meulekamp MZ et al
    Mil Med Res. 2017 Nov 28;4(1):36. doi: 10.1186/s40779-017-0145-2.
     
  29. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Current Diagnosis and Management of Chronic Exertional Compartment Syndrome
    Jeremy HartmanScott Simpson
    Current Physical Medicine and Rehabilitation Reports: 24 March 2018
     
  30. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Barefoot Plantar Pressure Measurement in Chronic Exertional Compartment Syndrome
    D. Roscoe, A.J. Roberts, D. Hulse, A. Shaheen, M. Hughes, A. Bennett
    Gait and Posture; Article in Press
     
  31. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Patient-Reported Outcomes Following Fasciotomy for Chronic Exertional Compartment Syndrome
    Jacqueline M. Maher, BA, Emily M. Brook, BA, Christopher Chiodo, MD, , , ...
    Foot & Ankle Specialist June 22, 2018
     
  32. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Intracompartmental Pressure Measurements in 501 Service Members with Exercise-related Leg Pain
    Zimmermann, Wes O. et al
    Translational Journal of the American College of Sports Medicine: July 15, 2018 - Volume 3 - Issue 14 - p 107–112
     
  33. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Running mechanics of females with bilateral
    compartment syndrome

    Dai Sugimotoet al
    J. Phys. Ther. Sci. 30: 1056–1062, 2018
     
  34. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Fasciotomy for chronic exertional compartment syndrome of the leg: clinical outcome in a large retrospective cohort
    J. P. H. TamA. G. F. GibsonJ. R. D. MurrayM Hassaballa
    European Journal of Orthopaedic Surgery & Traumatology: 25 August 2018
     
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