Thursday, September 15, 2011

An answer

I finally met with an Orthopaedic Specialists about my leg pain earlier this week.  The pain came back after six weeks off of running.  It was so bad I could barley walk.  I was told that I have Chronic exertional compartment syndrome


Definition


By Mayo Clinic staff


Chronic exertional compartment syndrome is an uncommon, exercise-induced neuromuscular condition that causes pain, swelling and sometimes even disability in affected muscles of your legs or arms.


Anyone can develop chronic exertional compartment syndrome, but it's more common in athletes who participate in sports that involve repetitive movements, such as running, fast walking, biking and swimming. Chronic exertional compartment syndrome is sometimes called chronic compartment syndrome or exercise-induced compartment syndrome.


Conservative treatments typically don't help with chronic exertional compartment syndrome. However, surgery is usually successful, allowing you — whether you're a recreational or serious athlete — to return to your sport.



Symptoms


By Mayo Clinic staff


The pain and other symptoms associated with chronic exertional compartment syndrome may be characterized by:


Aching, burning or cramping pain in the affected limb — usually the lower leg, but sometimes the thigh, upper arm, forearm or hand

Tightness in the affected limb

Numbness or tingling in the affected limb

Weakness of the affected limb

Foot drop, in severe cases, if nerves in your legs are affected

Occasionally, swelling or bulging as a result of a muscle hernia

Pain due to chronic exertional compartment syndrome typically follows this pattern:

Begins soon after you start exercising the affected limb

Progressively worsens as long as you exercise

Stops 15 to 30 minutes after the affected limb comes to rest

Over time, may begin to persist longer after exercise, possibly lingering for a day or two

Taking a complete break from exercise may relieve your symptoms, but usually only temporarily. Once you take up running again, for instance, those familiar symptoms usually come back.



Causes


By Mayo Clinic staff



Chronic exertional compartment syndrome

Your arms and legs have several groupings, or compartments, of muscles, blood vessels and nerves. Each of these compartments is encased by a thick layer of connective tissue called fascia (FASH-ee-uh), which supports the compartments and holds the tissues within each compartment in place. The fascia is inelastic, which means it has little ability to stretch.


In chronic exertional compartment syndrome, exercise or even repetitive muscle contraction causes the tissue pressure within a compartment to increase to an abnormally high level. But because the fascia can't stretch, the tissues in that compartment aren't able to expand sufficiently under the increased pressure. Imagine shaking up a soda bottle but leaving the cap on — an enormous amount of pressure builds up.



As the pressure builds up within one of your muscle compartments, with no outlet for release, nerves and blood vessels are compressed. Blood flow may then decrease, causing tissues to get inadequate amounts of oxygen-rich blood, a condition known as ischemia (is-KE-me-uh). Nerves and muscles may sustain damage.


Experts aren't sure why exercise or muscle contraction creates this excessive pressure in some people, leading to chronic exertional compartment syndrome. Some experts suggest that biomechanics — how you move, such as landing styles when you jog — may have a role. Other causes may include having enlarged muscles, an especially thick or inelastic fascia, or high pressure within your veins (venous hypertension).




Patrick wants me to get a second opionion.  I've stopped running, and I've been walking much less than I normally do.  I'm starting to have much less pain.  But, Patrick concern is when I want to walk, bike ride, hike, will this be an issue?  So, I'll be going back to the Doctor to get some answers, and find out if surgery would be a good idea to keep me pain free and active as I get older.