Sunday, March 30, 2008

Compartment Syndrome?

The 5K run is coming up in one week and, although I am not yet nervous, I am becoming ever more curious as to whether my body will be able to hold up. I've been doing some research on the chronically tight calves that I have, that cause pain and numbness on many of my 2+ mile runs. Although shin splints do share some of the same symptoms, a telltale sign of shin splints is that the pain continues even after exercise ceases. In my case, the pain and numbness dissipate very quickly as soon as the exercise is over.

After much Googling, I am afraid I have come to the conclusion that I am most likely afflicted with what is known as "exercise-induced compartment syndrome," also known as chronic exertional compartment syndrome, which basically means that when I exercise, my calf muscles connected to my shin expand to such a degree that the sheath that contains the muscles, known as the fascia, does not have enough flexibility to expand and allow the muscle to function properly. According to the various websites I've seen, this leads to a very tight feeling in the legs, pain with each step, and tingling or numbness in the front of the lower legs and on the top of the feet as the expanding muscles and tight muscle sheath cut off blood flow to the peroneal nerve. Sound familiar?

The bad news about exercise-induced compartment syndrome is that the only foolproof method to completely relieve the symptoms is surgery. Apparently they cut along the length of the fascia, which gives the muscle room to expand without pain. However, surgery, like war, is a last resort. I have had this problem in the past, and I know from experience that when I drop a lot of weight, and generally get into better shape, my compartment syndrome symptoms virtually disappear. So I am hopeful that I can avoid a trip under the knife.

Currently, I have been able to reduce the symptoms by frequent deep tissue self-massage using The Stick. By massaging my tight calf muscles several times a day, I am able to effectively "pre-stretch" the muscles -- and possibly the fascia -- so that I do not get the symptoms while running. Most of the time, this is effective. Yesterday, I flung myself out the door and jogged 2 miles, walking twice for about 1-2 minutes each time, and I am very pleased to say that my legs were neither tight nor numb! However, a few days before that, I attempted a two-mile walk/jog, and my calves tightened up to the point where the pain was excruciating, and I had to walk most of the route. So, who knows. I have one week left until the race, and I will just do the best I can to keep my muscles limber until then.

I am also going to look into getting new shoes. I am told that several symptoms of compartment syndrome, and tight calves, and numbness, can be alleviated with the proper running shoes. Now, I had thought that my running shoes fit me just fine. But I haven't actually gotten fit for running shoes in seven years -- I have been using the same model ever since I was fit in a New Balance running store in 2001. All my friends who run in DC tell me to go to the Georgetown running company, where they will watch me run on a treadmill, and give me a shoe that will solve all of my problems. I am looking forward to this magical shoe, and I plan to go there as soon as the 5K is over. Well, maybe that week, as I am pretty sure that right after the 5K is over, I will be limping home and crawling into bed.


  1. Yeah, I think you should get fitted for shoes. When I finally went and got fitted and a proper running store, they moved me UP a half-size and it made all the difference!! I go to Fleet Feet, though, not Georgetown Running Co, though I'm sure it doesn't matter.

  2. I have CECS and it sucks...mine went from just slightly numb feet and tight calves on my long runs to being completely benched after my last 5k. The 400 meter all out sprint put me over the edge! I am in PT...stretching and massaging daily! Hopingto avaoid the cut...but really missing my runners high! I am finally able to walk for 30 minutes.....I am seeing some hope! Anyway this really is a terrible injury...but if I can beat it I 'll have me life back! Good luck and please continue to share your story!

  3. I was a soccer player and before a game fell to the ground in pain, our trainer told me to take some meds and ice it, the opposing team trainer came over and diagnosed it as CS and said you should go the hospital. My trainer said no. After 6 months of crutches and a whole leg air cast to get swelling down, dr's scratching their heads, and physical therapist frustrated with me for not "progressing" in their therapy. I went to a specialist on my own. Chronic Compartment Syndrome. Did the pressure tests, confirmed it, and had to have the surgery, it was quick and easy. But, a year later, I had to have the surgery again, on the lateral muscle, now 4 years later I am having trouble with the deep posterial muscle and am afraid I will have a third surgery. I wasn't aware shoes make a difference. I am glad to find this I will be going to the local shoe store for some help! Thanks

  4. Matt,
    I noticed that this was posted a long time ago, so hopefully this is not a problem for you anymore. But I will comment anyway in the hopes that if you are still searching for an answer, this will help. I have dealt with CECS since 2004 and had surgery to correct it in 2005. It didn't work. I ran on and off for another 4 years hoping the problem would go away, and it never did. Finally I decided to completly change my running form. I started to run on the balls of my feet whenever my shins would begin to tighten up and it would aleviate the pain almost instantly. I alternated between running heal-toe and balls of the feet untill now i almost run exclusively on the balls of my feet. Granted this puts alot of stress on the calf muscels, but after 2 weeks they could handle it. Now I'm practically pain free and training for a half marathon. Hope this technique helps you, and good luck!

    P.S. I just tried these shoes called Newtons today and they made it even easier to runn on the balls of your feet. Try them out if the method seems too difficult for you!

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  6. I was an average runner (I'm in the Army) for 14 years (10-15 miles a week) and boosted my runs to about 30 miles a week over a month time frame. I developed CECS and it was the worst pain ever. I would collapse about 1 1/2 - 2 miles into a run and could not move my toes or feet, swollen ankles and feet all day with sever edema. You will know if you have CECS because the pain is very intense but goes away after about 10-15mins until the next time you run. I had a fasciotomy on both legs to make room for my large muscles. A year later I am back to running 2-5 miles every other day but now I feel the pain in the backs of my legs, not the anterior (you have 4 compartment in your leg). The muscles swell and my calves become very large. I will tell you that the pressure test to verify if you have CECS is very painful, I was screaming explisatives in the hospital and you have to be stuck 4 times before you run and 4 times after deep into the muscle. The chances of getting it again are high and you really need to do physical therapy after surgery. Part of the cause is genetics unfortunately. My father has large calves, as do I (I'm a woman). I have permanent numbness on my left foot from my toes to my calf because I continued to run on it and damaged the pareoneal nerve. If you believe you have it, DO NOT hesitate to see a doctor and please do not have your heart set on the fact that surgery will bring you back to your old running self. One leg is great, the other may need to have surgery again and still there are no guarantees. Good luck and go get it checked out, not something you want to fool around with. I bought shoes with a lot of shock absorbance which seems to help some, try the Asics Nimbus 12.

  7. I have played soccer my entire life. And have cs and Aldo had a fascia release. It comes and goes still when I run. More so when trying to run longer distances. Another recommendation that worked miracles after my surgery and during my collegiate soccer career was acupuncture. I recommend trying that before surgery. My dr said once you get surgery you will have to again and again. He said marathon runners base there surgeries around there marathons. Just another thing to consider along with great runner shoes.