Month: July 2024

Compartment Syndrome

Compartment Syndrome 

Author: Jerry Song

Compartment syndrome is a condition where elevated pressure within a closed muscle compartment compromises circulation and function of the tissues within that space. It can be acute or chronic, with acute compartment syndrome (ACS) being a medical emergency requiring prompt surgical intervention. Chronic exertional compartment syndrome (CECS) is less urgent but can severely impact an individual’s ability to perform physical activities.

The causes of compartment syndrome vary based on whether it is acute or chronic:

1. Acute Compartment Syndrome (ACS):
   • Trauma: Fractures, crush injuries, or severe contusions can lead to swelling or bleeding within a compartment.
   • Surgery: Postoperative complications can include bleeding or oedema causing elevated compartment pressures.
   • Vascular Injury: Trauma or surgery involving blood vessels can result in haemorrhage within a compartment.
   • Tight Casts or Dressings: External compression from casts or dressings can increase compartment pressures.
2. Chronic Exertional Compartment Syndrome (CECS):
   • Repetitive Exercise: Activities involving repetitive muscle contractions, such as running or cycling, can increase compartment pressures over time.
   • Muscle Hypertrophy: Intense physical training leading to muscle hypertrophy can increase compartment size relative to its surrounding fascia, raising internal pressures.
   • Anatomic Abnormalities: Variations in fascial anatomy or muscle size can predispose individuals to CECS.

 

 

 Compartment syndrome affects various populations based on its type:

1. Acute Compartment Syndrome:
   • Age: Can occur at any age but is more common in younger individuals due to higher incidence of trauma and sports injuries.
   • Gender: Males are more frequently affected, likely due to higher participation in high-risk activities and occupations.
   • Activities: Those involved in contact sports, high-impact activities, or occupations with a risk of severe injury are at increased risk.
2. Chronic Exertional Compartment Syndrome:
   • Age: Commonly affects young athletes, typically in their late teens to early 30s.
   • Gender: Both genders are affected, but some studies suggest a higher incidence in females due to different biomechanics and muscle structures.
   • Sports and Activities: Athletes involved in repetitive, high-impact activities such as running, soccer, or military training are at greater risk.

Manual therapy plays a supportive role in managing chronic exertional compartment syndrome by alleviating symptoms, improving muscle function, and addressing contributing factors. Key manual therapy interventions include:

1. Dry Needling

Dry needling involves the insertion of fine needles into specific trigger points or areas of muscle tightness to promote pain relief and muscle relaxation. Benefits of dry needling for compartment syndrome include:

• Reduction of Muscle Tightness: Targeting trigger points in the affected muscles can alleviate tightness and improve muscle flexibility.
• Pain Relief: By disrupting pain signals and promoting local blood flow, dry needling can effectively reduce muscle pain and discomfort.
• Improved Muscle Function: Enhancing muscle function around the affected compartment can aid in reducing abnormal pressures and improving overall muscle performance.

2. Myofascial Cupping

Myofascial cupping involves the use of suction cups to create negative pressure on the skin, lifting and separating the underlying tissues. This technique can:

• Enhance Blood Circulation: Improved blood flow aids in nutrient delivery and waste removal, promoting tissue healing and reducing inflammation.
• Release Myofascial Restrictions: Loosening tight fascia and muscle adhesions can restore normal tissue mobility and reduce pain.
• Reduce Muscle Spasms: The negative pressure can relax muscle spasms, improving muscle tone and function within the affected compartment.

3. Soft Tissue Mobilisation

Soft tissue mobilisation includes techniques such as massage and myofascial release to manipulate the soft tissues around the affected compartment:

• Massage Therapy: Techniques like deep tissue massage can reduce muscle tension, improve circulation, and decrease pain, facilitating recovery of muscle function and flexibility.
• Myofascial Release: Applying sustained pressure to myofascial restrictions can eliminate pain and restore motion, addressing tightness in the fascia and muscles.

4. Joint Mobilisation

Joint mobilisation involves applying controlled forces to improve the range of motion and alleviate pain in the joints near the affected compartment:

• Ankle and Knee Mobilisation: Techniques to mobilise the ankle and knee joints can enhance mobility, reduce stiffness, and correct abnormal mechanics contributing to compartment syndrome.

5. Manual Stretching

Manual stretching techniques aim to improve flexibility and reduce tension in the muscles around the affected compartment:

• Calf and Shin Stretching: Stretching the calf and shin muscles can relieve tension and improve muscle balance.
• Quadriceps and Hamstring Stretching: Addressing tightness in the quadriceps and hamstrings can reduce stress on the affected compartment and improve overall limb function.

6. Proprioceptive Neuromuscular Facilitation (PNF)

PNF stretching combines stretching and contracting targeted muscle groups to enhance flexibility and strength:

• PNF Techniques: Effective for improving the flexibility and strength of the muscles within the affected compartment, promoting better mechanics and reducing pain.

If you or someone you know are dealing with Chronic Exertional Compartment Syndrome, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain. Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.