Compartment syndrome refers to a medical condition that causes increased pressure in a muscle compartment. The pressure accumulation can lead to little blood flowing to the muscles and even permanent damage to those muscles. Luckily, there are different treatment options to assist in managing this condition, and physical therapy is one of them. A physiotherapist can give you the care you require to fight this condition. This blog explains everything you should know about compartment syndrome and how physical therapy can help.

An Overview of Compartment Syndrome

Our limbs (legs and arms) are sectioned into compartments containing different blood vessels, nerves, and muscles. These compartments are separated by fascia. Fascia is a thick, non-stretching tissue that looks like a sheet.

Our bodies can handle slight alterations in the amount of pressure in these compartments. Body tissues may, for example, swell a little after you have worked out extensively or sustained a slight injury. However, should excessive swelling happen in a compartment because of severe chronic overuse or acute injury, pressure accumulates within the affected compartment since the fascia will not stretch to accommodate rising volume.

Rarely, this condition may reach a level at which the body cannot handle it, leading to the restriction of blood supply to the affected compartment. Should the condition persist, it can lead to an injury to the nerve and muscle tissue. It is crucial to alleviate the pressure promptly to avoid irreversible damage.

Generally, there are two types of compartment syndrome, depending on the symptoms and cause. These are chronic and acute compartment syndromes.

Acute Compartment Syndrome (ACS)

ACS can occur as soon as a few hours after a serious injury and is a medical emergency. If not treated for even some hours, permanent tissue damage could occur. This condition most usually occurs in the forearm and lower leg. Generally, ACS results from a severe injury, including the following:

  • Injury from a highly restrictive bandage, splint, or cast
  • Crush injuries, for example, work-site injuries or motor vehicle collisions.
  • A direct blow or hit to the leg, for example, because of a fall from a high place, like falling off a ladder or a roof
  • Broken bones (bone fractures)
  • Sports injuries
  • Complications following surgery
  • Severe muscle contusions
  • Prolonged pressure on a leg and arm after staying still for several hours.

The most prevalent symptoms and signs of acute compartment syndrome include the following:

  • Significant pain or being unable to bear weight through the affected limb.
  • Severe pain whenever the affected region is touched
  • Severe pain accompanied by expansion of the affected muscle
  • Limb discoloration
  • Sensing the limb being full or tight (from the rise in pressure and swelling)
  • Change in sensation (numbness, burning, tingling)
  • Severe pain within the affected limb that might be disproportionate to the general response to a given injury

ACS Diagnosis

Acute syndrome must be detected and treated promptly. If you are showing symptoms of the ACS condition after a serious injury, you should visit the ER immediately for assessment by a medical professional. The doctor will objectively measure pressure levels in the affected compartment. If need be, they will perform surgery to relieve pressure in that compartment through a procedure known as fasciotomy. 

During this surgery, the doctor incises the skin and the fascia to draw out the swelling and alleviate the compartment pressure. If you undergo this surgical procedure, you must remain admitted for some time to ensure the pressure becomes normal again and the surgical site heals properly. After the fasciotomy procedure, you will need physiotherapy to help restore the affected limb’s function, strength, and motion.

Chronic Compartment Syndrome (CCS)

CCS is also usually known as exertional compartment syndrome. Its general cause is exercise involving repetitive movements, like jumping, biking, running, or walking. Often, excessive exercise results in the leg tissues being overworked without enough recovery period.

External factors like poor body control during movement, too-firm or uneven training surfaces, excessive training, or poor footwear may influence CCS development. Also, there have been instances where excessive use of steroids has been connected to chronic compartment syndrome.

The signs of chronic compartment syndrome may be the same as those of acute compartment syndrome. However, they are usually less serious and do not result from an acute injury due to trauma. The symptoms might include the following:

  • Tingling or numbness in the affected limb
  • Pain when you stretch the impacted limb
  • Mild swelling
  • Cramping and pain in the affected limb that often decrease with rest and worsen with activity
  • Weakness

CCS usually improves and heals on its own if you rest the impacted muscle compartment and avoid overusing it in the future. However, if it does not improve, you should see a doctor for further direction.

CCS Diagnosis

Since the CCS symptoms are the same as those of several other medical conditions, a physician should first rule out other potential diagnoses, like shin splints, stress fractures, tendinitis, or other inflammation-related conditions. The exam might include your doctor using diagnostic imaging, like MRI, X-rays, or ultrasounds, to evaluate the tissues within the painful region.

If your physician suspects CCS, they will likely conduct a test known as the compartment pressure measurement. This test solely applies in instances where the doctor strongly suspects CCS. They will conduct it at their office. In performing this test, the doctor will measure the pressure levels in the affected compartment during, after, and before exercise.

The compartment pressure measurement test aims to reproduce CCS signs as they arise during real-life activities. If your doctor diagnoses CCS, they will create a treatment plan to manage symptoms and prevent pressure accumulation. If your CCS is milder, the treatment options your doctor may recommend include the following:

  • Altering your exercise routine. You may need to attempt various lower-impact exercises. Some individuals with compartment syndrome change to cross-training. This entails mixing up what exercises you perform rather than doing the same exercise every time. You may also need to change your exercise area; for example, start running on a softer track rather than concrete.
  • Medications. Anti-inflammatory drugs such as acetaminophen or over-the-counter NSAIDs lower inflammation and alleviate pain. Do not take these drugs for over ten days in a row without speaking to your physician.
  • Orthotics. Orthotics refer to shoe inserts that support your legs and feet. They may assist individuals with compartment syndrome in their legs. Your physician will inform you what kind of orthotics will be most helpful.

The doctor will also likely refer you to a physiotherapist, who will assist you in increasing flexibility and strength in your impacted muscles. The physical therapist will also show you how to modify your exercises to stop or prevent pressure and stress buildup. If the case is more severe, your doctor will likely refer you to the relevant surgeon to see whether you will need to undergo a fasciotomy.

Compartment Syndrome Risk Factors

Anybody can develop ACS since it occurs after unexpected injuries. On the other hand, athletes and individuals with physically demanding jobs are highly likely to overwork or overtrain their muscles, which may lead to the development of chronic compartment syndrome. Also, individuals with blood-related disorders such as hemophilia might be at a higher risk of developing CCS.

When to Seek Help

Only a physician can diagnose compartment syndrome. However, do not ignore symptoms such as swelling or muscle pain. Visit the ER if you believe there is a chance that you may have ACS.

Visit a physician if you feel swelling or pain after exercise, particularly if it occurs often. CCS is not a life-threatening emergency, although it is still a serious issue.

People often think that experiencing agonizing pain after working out is okay. However, this could not be further from the truth. You should not be in extreme pain after being active or working out. There is a difference between feeling sore for one or two days after extensive work and being unable to do your duties without feeling severe pain.

Visit a medical provider if you feel sore and worried about something. Even if you do not have CCS, you may have another issue or injury causing the soreness.

Physiotherapy for Compartment Syndrome

If your physician has diagnosed you with either type of compartment syndrome, a physiotherapist can play a significant role in treating it, whether it needs surgery. The physiotherapist will work closely with you to tailor a treatment plan contingent on your specific condition and personal goals. They may recommend the following:

  • Muscle strengthening

Core and hip weakness can impact the movement of your lower body. It can also lead to imbalanced forces throughout the muscle groups in your lower leg, which might lead to compartment syndrome. Strengthening the core (pelvis, lower back, and abdominal muscles) is crucial. A stronger midsection enables greater body stability since the legs and arms perform varying motions.

If you are an athlete who participates in endurance sports activities, having a stronger core is crucial to stabilizing the knee and hip joints when doing repetitive leg movements. Your physiotherapist can establish which muscles have weakened and recommend specific exercises for targeting these areas.

  • Exercises to improve range of motion

Ankle, foot, or knee movement restrictions may cause increased strain in the muscles found in your lower leg compartments. Stretching exercises can assist in restoring motion in the compartments and minimizing extreme muscle tension.

  • Modalities

Your physiotherapist might incorporate modalities like iontophoresis, ultrasound, cold therapy, or moist heat into your rehab program. These techniques can assist you in improving tissue flexibility and mobility and promote recovery. Your physiotherapist will inform you of the objective of every modality before proceeding.

  • Manual therapy

Many physios have undergone training in hands-on (manual) therapy. This involves a physio utilizing their hands to manipulate and move joints and muscles to enhance strength and motion. Manual therapy can target regions that are more challenging to treat yourself.

  • Education.

Your physical therapy plan will also include education regarding safely returning to your prior activities, especially if your compartment syndrome necessitated a fasciotomy procedure. Your physiotherapist might recommend the following:

  • Modifying your place of work to minimize the risk of injury
  • Mastering different strategies for healing and maintaining good health, like giving your joints and muscles enough rest time
  • Pacing your activities
  • Avoiding particular activities altogether
  • Choosing an exercise terrain and surface that is more appropriate
  • Wearing footwear that is more appropriate

How Physiotherapy Can Help Before and Following Surgery

If your compartment syndrome case requires surgery (be it because of a chronic condition or acute injury), postoperative physiotherapy will be crucial to successful healing. Your physiotherapist will communicate with your doctor about the complexity of your surgical procedure, anticipated timelines for recovery, and how you are progressing with rehab. As your healthcare team, your medical providers will create a recovery plan that ensures your body has ample time to recover while incorporating techniques to restore your range of motion, strength, function, and mobility.

The Type of Physiotherapist You Need

All physiotherapists have the clinical experience and education to treat various injuries or conditions. You might need to consider going to a physiotherapist who:

  • Has experience dealing with patients with musculoskeletal or orthopedic injuries
  • Is certified by the board or has completed a sports or orthopedic physiotherapy residency. These specialists have advanced skills, experience, and knowledge that apply to athletes.

Recovery Period

If you have ACS, you should start feeling better after you have healed from a fasciotomy procedure. Many patients need rest for approximately one month before they use the affected muscles. Your physician will inform you when it is safe to begin making movements again and the period you must wait before you can resume physical chores and activities.

Managing CCS might take longer, particularly in the beginning. It may take several months to establish a combination of exercise modifications and treatments that alleviates the symptoms. The symptoms should resolve slowly as you look for techniques to avoid exerting excessive pressure on the impacted muscles.

Complications of Compartment Syndrome

Compartment syndrome can lead to severe complications. If the pressure within a muscle compartment becomes too high, your tissues will not get sufficient nutrients, oxygen, and fresh blood. This can result in necrosis (tissue death), which leads to permanent damage.

ACS can be fatal if it is not treated immediately. Visit the ER if you suspect you have ACS.

What to Expect If You Have Compartment Syndrome

Compartment syndrome can be very painful. However, your signs and symptoms should resolve when you begin to manage them. ACS usually does not recur once it is treated through the fasciotomy procedure. However, it is essential to have a doctor diagnose and address it promptly. The risk of irreversible damage rises the longer you wait without treating ACS.

CCS might recur, particularly if you unexpectedly increase your level of activity. Ask your physician what activities are okay to engage in while healing. It could take a maximum of 12 months before safely returning to intense physical activities.

Compartment Syndrome Prevention

You cannot prevent ACS because it occurs suddenly following an injury or an unpredictable complication. Visiting the ER immediately when you suspect you have ACS is the sole way of preventing severe complications. Inform your physician if you are wearing a splint or cast that you feel is too tight, particularly if you have taken pain relievers and that body area still swells or hurts. Your doctor can adjust the immobilization device to avert the compartment syndrome condition.

Avoiding stressing your muscles too much is the ideal way of preventing CCS. Consider these tips for reducing your risk of developing CCS:

  • Mix up your workouts. Avoid engaging in the same exercise, in the same way, each time you train
  • Build your endurance slowly. Do not suddenly increase the intensity of your workouts
  • Warm up and stretch before you work out. Stretch and cool down after intense physical activity
  • Avoid overtraining. Do not continue to exercise if you have hurting muscles after or during physical activity
  • Avoid exercising on hard, stiff surfaces such as tile floors or concrete

Find an Expert Physical Therapist Near Me

Compartment syndrome can restrict your everyday activities. If you suspect you have developed the condition, you want to move quickly and address it to regain your life as you know it. Luckily, different treatment options, including physical therapy, are available to assist in treating compartment syndrome. Physiotherapy will help strengthen your muscles and improve your range of motion, alleviating the symptoms of the disease. You need to work with a physical therapist who is an expert in both types of compartment syndromes to obtain the best possible outcome.

At Suarez Physical Therapy, we offer personalized compartment syndrome treatment plans to our patients. We aim to enhance our clients’ quality of life by effectively relieving related symptoms. We will guide you to your recovery through comprehensive physical therapy treatments. If you seek physiotherapy for your condition in Las Vegas, NV, we can give you all the care you require to fight this condition. Call us today at 702-368-6778 to schedule an appointment and start your journey to functional restoration and pain relief.