Compartment syndrome, the ailment of runners

Compartment syndrome is a injury produced as a consequence of the increase in pressure inside the compartments of the fascia that involve the structures that form it, muscle, nerve and blood fibers. If the internal pressure is very high and sustained over time, the damage caused can be extremely serious. A structure without sustained nerve or circulatory irrigation could trigger a cell necrosis in tissue.

Types of compartment syndrome

According to the time of onset of the injury we will differentiate two types of compartment syndrome:

• Chronic compartment syndrome: the damages produced in the compartments are transitory and secondary to the increase in pressure supported during repetitive physical exercise for a certain time. It occurs with greater incidence in lower extremities. During sports, repetitive movements cause an increase in intracompartmental pressure that adds to the increased vascularity required by the muscle fiber during exercise. This triggers a compartment pressure increase that reverts when the exercise ceases. Frequent in runners, motorcyclists and climbers.
• Acute compartment syndrome: in this case the cause is usually traumatic and must be urgently treated for assuming a high compromise in the viability of the structures contained in the affected compartment.

Diagnosis

There are several conditioning factors that will influence the viability of this muscle group with an increase in intracompartmental pressure: the appearance acute or chronic, the symptom and his gravity and the time elapsed from the first signs. It is essential to carry out a comprehensive muscle group scan affected: muscle tone, mobility, sensitivity, strength ... If suspected, a pressure measurement should be made in the affected muscle compartments, which should be repeated some time later if the values ​​are not diagnostic. There is specific kit intended for intracompartmental measurement that all must have. It is important to keep this diagnosis in mind among the possible causes of limb pain in athletes and acute pain in traumatic. Clinically we will suspect it in the event of any increase in volume of a muscular anatomical area with pain on palpation and mobility. The subsequent appearance of the sensation of tingling or paresthesia is very frequent.

Treatment of compartment syndrome

If diagnosed acute compartment syndrome the treatment will be surgical. It will consist of carrying out fasciotomies or incisions on the fascia to relieve pressure inside. In case of chronic compartment syndrome Symptoms usually subside when exercise is stopped, so to confirm the diagnosis, the patient will undergo a stress test and we will measure the intracompartmental pressure. Surgical treatment will be chosen when the conservative measures they do not control the appearance of pain during exercise. Either way, it's a severe soft tissue involvement that can go unnoticed in case of chronicity. It is important to suspect it and rule it out. Of course, in the case of acute compartment syndrome we speak of a surgical emergency that must be addressed immediately by decompressing the compartment.

The internal structure of the muscle

muscle tissue is made up of specialized cells called myocytes or muscle fibers, which have the property of increasing or decreasing their length when stimulated by nerve impulses, this gives them the property of contracting and relaxing. The smallest functional unit of muscle is the muscle fiber or myocyte. The muscle fibers are grouped together forming a fascicle which, in turn, group together to form the complete muscle. The muscle is covered by a connective tissue membrane called fascia that provides protection and ability to deformity and slip. Sports Medicine Specialist