Soleus and/or Deep Posterior Compartment Syndrome

Sounds like you have real mess going on down there!!

I was going to say get checked out for a possible stress fracture, but then you dropped that into the last sentence or two of your paragraph.

You have already had compartment syndrome and went through the surgery to release that tissue.  This means that the tissue down there is probably not very "happy".  In addition, when ever we have a surgery, myofascial lines are changed and that affects the way that tissue pulls when ever we do anything and move.  This is call tensegrity - think about a spider web and how if you give a gentle pull on one side, it will affect the whole web with a pull towards that side.

Have you had anyone do specific soft tissue work?  I am not talking the little rub a dub crap they do at a spa or even the 5-10min. of soft tissue nonsense that a lot of physical therapists do.  I am talking real, "clinical" work.  Like something an active release therapist might do or a neuromuscular therapist.  Scar tissue (from training stress, overuse, surgeries) will lay itself down like a thick web, all matted up and in a variety of drections, and prevent proper soft tissue movement and lead to ischemic tissue, trigger points and myofascial pain and dysfunction.  Have a hands on manual therapist go in and work on that scar tissue to break it up and then have you perform some stretching, eccentric exercises, and then ultimately exercises which re-integrate you back to regular functional movement and re-groove patterns can do wonders for re-aligning the tissue into a parallel order and allowing it to function properly.

It is a shame you are in GA, because this is the main type of work I do (almost exclusively for athletes) and since you have been through all the doctors and ruled out many things, we could be pretty aggressive in trying to restore function.

Patrick Ward, MS, CSCS, LMT

Great post.

Pelvic position is critical and ASTYM (same as graston except physical therapists do it) or Graston  are both great for breaking up scar tissue and if it is really matted down, they will work better than someone using their hands and doing ART.

Patrick Ward, MS, CSCS, LMT

This is the exact thing that I was thinking.  Its a whole lot less invasive than surgery.  Active Release Therapy (ART), Myofascial Trigger Point Specialist, Kenesis Myofascial Integration (KMI) and different specialties that might be able to help. 

Good luck

J Otten & Katherine91,

Sorry, I did not really monitor my post after the first 6 weeks or so. I came back upon it as I was looking for posts regarding stress fractures. I can provide a brief update here (more details via PM if anyone is interested). I had surgery in May 2009 for release of the posterior and deept posterior compartments and release of the soleus. I can say that this surgery was a 100% success for me. the surgeon ended up finding a rupture of the soleus due to the tight fascias. Recovery was pretty quick from this which I attribute to 1) skill of the surgeon (this one was way better that my fasciotomoies of the lateral compartments) and 2) fitness which I had maintained through cycling. I walked out of the hospital the next day without crutches even though both legs were cut (granted I was high as a kite on  Vicodin but still...). Within 3 weeks of the actual surgery, I was biking around 3-4 hours per week.  Istarted stairclimbers and ellipticals within a month and was back to track racing (bike velodrome) within 6 weeks. Within 8 weeks I began running again. Now the only downside (which is due entirely to my own eagerness/stupidity) is that since I had plenty of cardio fitness (due to biking) and sufficient leg strength (from strength training / elliptical, etc), I was easily able to outperform my own legs since they were not used to the impact of running. Thusly, I now have a stress fracture in one of my tibias. Even though its disappointing to be down again, I know this will heal and I'll be back running. I had worked up to comfortably running 10K distances before the wheels started falling off at Thanksgiving. So all in all, my course of treatment was exactly what was needed for my condition. It is often very, very difficult to determine the source of the problem / injury, particularly in the lower leg. I really had to work to find the right surgeon and to educate myself on all possible sources of the problem to get it right. Very frustrating I know, but patience and diligence will pay off. Granted there are plenty of risks associated with something as invasive as a fasciotomy but it comes down to "how bad do you want to be able to run again" which is what my surgeon asked me before cutting.