L07 — February 2011 — Runner's Compartment Syndrome
Intro: It hurts when I run. That's what many orthopedic surgeons hear when runners and other athletes come into their offices. Sometimes people have obvious problems, such as strains or sprains. Other times these issues can be tricky to diagnose. The runner you're about to meet had symptoms he thought were no big deal. But he ended up having a condition that required an operation. More on compartment syndrome from Mayo Clinic.
A lot of cramping in the front part of my shins.
30-year-old Rudy Kovachevich first noticed those symptoms when he was running track and cross-country back in high school. He thought maybe it was shin splints.
My symptoms kind of progressed from there. It would get to the point where the muscles were so tight in the front that I'd have a hard time lifting my foot up when I was running. I would eventually have to stop in the middle of races.
Rudy had what's called compartment syndrome.
Compartments are basically groups of muscles that are together inside all our body parts. They're surrounded by a fascia, or a layer, sort of like skin.
Orthopedic surgeon Dr. Amy McIntosh says that layer acts like a rubber band, which usually expands when you use your muscles, like when you run. But sometimes, it's too tight. It doesn't expand. Pressures rise and can constrict nerves and blood supply which causes pain and tightness.
The only way to increase volume, to decrease the pressure, is to make a cut in the facial layer.
Surgery was the best option for Rudy.
This is the incision here.
But only after he tried other ways to manage it — physical therapy and cross training. You see, compartment syndrome takes some sleuthing to diagnose because it can mimic other issues like shin splints or stress fractures. To help make diagnosis easier, doctors at Mayo have developed a specialized MRI test that lets doctors see inside the leg.
Rudy had chronic compartment syndrome. It was only an issue when he was running. But it can also happen acutely or suddenly as a result of trauma or injury. In that case you need immediate surgical attention — to prevent permanent damage to muscles and nerves.
Rudy says compartment syndrome could have meant no more running. But surgery kept him on track.
Hasn't slowed me down.
For Medical Edge, I'm Vivien Williams.
The MRI test to diagnose compartment syndrome wasn't around when Rudy was running back in high school. He had to go through an older style of testing that's still used widely today — needle sticks in the muscles to measure pressure.
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