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#1 Compartment Syndrome and Fasciaotomy02-28-2012, 05:21 PM
About two years ago I was sent on a pre-deployment training TDY to Hurlburt Field, Fl. AFSOC (Special Operations Command) is headquartered there, and the unit I was with, while not Special Ops, still physically trained towards that level. Towards the end of my trip I was experiencing severe pains in my shins, making it hard to walk.
Fast forward almost two years I'm diagnosed with Compartment Syndrome. Basically the Fascia, a layer of tissues that connect and surround your muscles, in my legs have been injured and they now restrict proper pressure release in my legs. When I exert the muscles pressure builds up within them, but isn't released properly. That is what was causing my pain, and pretty much has made it impossible for me to run at the levels I needed to given Air Force standards.
*Warning, some nasty pics.
The process of diagnoses was hardly easy. It was originally just diagnosed as shin splints, and they gave me clearance to not do any timed running or walking for 3 months. Over the next 9 months I took things easy, never really pushing myself that hard, but when I did run I could feel the pain, just not as severe as it initially was. Last summer I was thrown into a pretty hard physical training program that had me doing extended running 4 times a week. Within short order this brought the symptoms back, and I was again diagnosed with Shin Splints, and given 2 months off. At the end of the period, my leadership through me into an even harder work out regimen, and within a month I was back to where I was. The beginning of December I went back to December and told the docs that I'm not buying the shin splint excuse and we needed to find out what was really wrong. I was again put on a 3 month profile, and sent to some orthopedic specialists. They didn't really want to commit to a diagnosis, and assigned me to a month of physical therapy to strengthen some muscles in my legs that were weak, hoping that would alleviate the stresses on the muscles in my lower legs. Didn't do much. I'm beginning to worry about now, because when I'm on a medical profile due to a specific issue for a year, I'm sent to a medical evaluation board, and I was getting pretty close to that 1 year point.
So after the failure of physical therapy the Ortho's decided to test for Compartment Syndrome, which we conducted yesterday. They started out by using an ultrasound machine on my legs, examining where my arteries were, and marking points of entry. I was then given locals in three spots on each leg, two in the calf, one on the inner ankle. They then took tests with me rested, shoving a giant fucking needle into each marked location, attached to an electrical sensor that measured the pressure in those muscles. 4 of the 6 readings where pretty high, before I even did anything physical. After the initial test they put me on a treadmill, cranked up the incline and speed, and had me run till the pain was close to unbearable. They then immediately tested me again, and verified that pressure levels had risen (which is normal). After 5 minutes of resting they test it again (18th penetration with these giant needles btw), and a normal person should be showing signs of the pressure beginning to lower. On me the pressure was still building. This pretty much confirmed that I have the Syndrome.
So there is bad news with that, but good news comes of it. The only way to fix it is through surgery by doing a Fasciaotomy. They cut my legs open, and cut open the fascia. They'll then stretch it out a bit, and allow it to reheal, which should allow the pressure to build and alleviate normally. Since they'll be doing both legs, it'll be a real pain in the ass, but the good news is that 9/10 times it's a permanent fix. That other time scar tissue can sometimes form that will replicate the issue and they'll have to go back in and clean it up. So after receiving this surgery, I'll pretty much be good to go, not having to worry about severe pains when I run anymore, and getting to dodge that Med Board.
So, Compartment Syndrome is generally caused by an injury to those muscles in your lower legs. Mine was from being thrown into a Spec Ops physical training regimen when I wasn't even close to being up to that standard.
The symptoms were pretty clear cut. When running I would feel "pressue" building up in my lower legs, just below the muscles in my shin, but right above my ankles. This would progress towards pain, though as I was running it wasn't to bad. The worse of it was after I stopped. That pressure would begin to increase, and the pain grew so intense I could barely even walk. This could last up to 15 minutes after I stopped running. Continually stressing my legs out like that would lead to an ever present pain that would affect me when I did things like climb stairs, or even just flex my ankle. It would take a couple weeks of no serious physical activity with my legs to make that pain go away. I would also have bulges form on my legs, mid way up, on the outside of the legs. This was just those pockets of increased pressure having nowhere to go. My muscles in my lower legs would also be extremely tight. The calf muscles are generally pretty easy to stretch, but the anterior compartment muscles are kind of impossible to target with good stretches, so for two years you could really just compair those muscles to iron. They were rock hard at all times.
If your experiencing symptoms like those when you run, bring it up with your doctor. As with my case, it was easy to misdiagnose as something like shin splints, which never gets to fixing the root cause.
In hockey, it means you have to sit in the penalty box for five minutes.
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