Exertional Compartment Syndrome

1. Switch Dr.'s

2. get a 2nd opinion (see #1)

3. Have you Google'd ECS? I've done research on it in school. Nasty stuff, get a handle on it if thats what you have. I don't remember anywhere that stated the test was unreliable.

4. Don't give up on running yet. Get whatever it is taken care of. Doesn't mean you're done running.

5. Good luck.

I think I have a similar issue - could you tell what RWOL means??!!  Thanks

Agree with Socks.  The test is reliable, but you have to find someone who can perform the test and has some knowledge of Chronic Exertional Compartment Syndrome.  The test is somewhat uncomfortable.  It requires 4 injections pre and post exercise (so 8 injections per leg).  The needle sticks measure the pressures in the 4 compartments of your lower leg.  If the pressures are elevated post exercise, the doc should talk to you about treatment options and surgery.  Also, ask your doc about popliteal artery entrapment.  The few runners I know that have failed CECS treatment all had popliteal artery entrapment.  I no longer recommend surgery until it has been ruled out.  Hope that helps.

BB

Give up running altogether????   I'd be running (no pun intended) to another doc.....

Matt Cazalas
Technical Writer

Network Cables

While the test is painful, if you've been suffering for a while and want to know what's wrong, it is the gold standard for diagnosing compartment syndrome. I'd been having pain in my feet that turned to numbness and severe muscle tightness in my legs. In Dec 07 I mentioned to my new PCP and began my exploration of the referral networks in the Boston area. For a while they thought I had Popliteal Artery Entrapment Syndrome, and wanted to do an angiogram to explore the arteries in my leg. But when they told me I might have to be admitted for 24 hours and wouldn't be able to drive for 2 days... I asked for a second opinion.

 I was diagnosed (via the barbaric pressure test) with chronic exertional compartment syndrome in all four compartments of both legs. As a warning, the test is painful. And as the local anesthesia begins to wear off, your calves will get very sore very quickly. I'd recommend getting a ride to the place of the test, as I had an extremely hard time driving right afterward.

 As of Jan 15 I am 3 1/2 weeks post op on the second leg. My orthopedist does them one at time. As he explained it, he needs to open the fascia as a first step to nearly every surgery he does, so releasing my compartments was a walk in the park. The most time-consuming part is stitching the incisions back up to reduce scarring. Even so, I have scars about 4-5 inches long on both sides of both legs.

 The surgery and recovery time are not as bad as you would think. I was in and out of the hospital both times in about 6 hours. They put you me a soft cast (fluffly gauze and ace bandage) with a splint when I got out of surgery.  I was non-weight bearing and on crutches for about 11 days with each leg, which was by far the most frustrating part. When I went back for my post op, they put me in a large aircast. My legs were each very sore for the first day or two, but I was out of the boot in about another 2-3 weeks. I am not walking essentially normally and will begin jogging over the next few days. There is not PT as part of the recovery, they only recommend flexing your foot as soon as you are out of the cast to make sure your ankle stays limber.

 The only minor complication I had was fairly significant swelling in the ankle of the first leg operated on. I had to go to the ER for an ultrasound because they were concerned I had a blood clot in my leg (esp since being on birth control increases your clotting factors). My ultrasound was clean and they told me that with any surgery, the lymphatic system is disrupted so the fluid in my leg wasn't draining properly.

 I am about to begin my return to the world of exercise. With not significant cardio activity for about three months, I am a bit daunted by getting back in shape. But I can already tell that my legs are looser than before, so I would say the surgery was definitely worth it!

 My doctor was fantastic at the surgery, but not spectacular at preparing me, or taking care of me through the scheduling aspect of it. Please let me know if you have any questions about what to expect!