Chronic compartment syndrome



The forearm muscles are divided into three groups (muscle compartments) of powerful, partially unyielding, muscle membranes (fascias); a front, an outer and a rear muscle compartment. Each muscle group has its own blood and nerve supply.

Cause: The muscles can increase so quickly following intensive training of the forearm that the muscle membranes surrounding the muscles cannot keep up, causing the pressure in the muscle compartment to increase. The pressure can in some cases increase so greatly that impingement of blood vessels and nerves can occur. In other cases, chronic muscle compartment syndrome can arise due to development of scar tissue in the muscle (following previous muscle ruptures).

Symptoms: With chronic compartment syndrome there is slowly insetting pain in the muscles after a few minutes activity. There is a sensation that the muscle is “tightened” and becomes hard, which is accompanied by discomfort. If the activity is stopped the discomfort diminishes, but returns after a short period of resuming the sports activity once again. There is often sensory disturbance in the fingers.

Examination: The diagnosis is made on the basis of the characteristic history and possibly with a pressure measurement in the muscle compartment.

Treatment: With chronic muscle compartment syndrome the treatment primarily comprises relief and slowly increasing training intensity and possibly rheumatic medicine (NSAID). If there is scar tissue in the muscle, ultrasound guided injection of corticosteroid around the scar tissue formation can be attempted. In cases where there is a lack of progress a surgical splitting of the muscle membranes can be performed, which is usually a minor procedure with good results (article).

Rehabilitation: INSTRUCTION

Rehabilitation: Rehabilitation is dependant upon which muscle group has been affected. Once the pain has diminished, the sports activity can generally be slowly resumed according to the principles mentioned under rehabilitation, general.

Complications: In cases of lack of progress with relief and slow rehabilitation, an ultrasound scan should be performed before possible surgery to rule out complications from an earlier muscle rupture.