Thread: Compartment Syndrome and Fasciaotomy

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  1. #1 Compartment Syndrome and Fasciaotomy 
    Zoomie djones520's Avatar
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    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.

    http://en.wikipedia.org/wiki/Compartment_syndrome
    *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 most sports, cold-cocking an opposing player repeatedly in the face with a series of gigantic Slovakian uppercuts would get you a multi-game suspension without pay.

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    Best Bounty Hunter in the Forums fettpett's Avatar
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    have you looked into massage at all? particularly Myofacial Release (deep tissue)? This type of work helps a lot with releasing the facial in the tissue. Something to look into http://www.massagetherapy.com/find/ check here to find a practitioner in your area
    "Should I keep back my opinions at such a time, through fear of giving offense, I should consider myself as guilty of treason towards my country, and of an act of disloyalty toward the Majesty of Heaven, which I revere above all earthly kings..." Patrick Henry
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  3. #3  
    Zoomie djones520's Avatar
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    That was a part of my physical therapy.
    In most sports, cold-cocking an opposing player repeatedly in the face with a series of gigantic Slovakian uppercuts would get you a multi-game suspension without pay.

    In hockey, it means you have to sit in the penalty box for five minutes.
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    Best Bounty Hunter in the Forums fettpett's Avatar
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    how much actual massage did they do? MFR is pretty specific modality, most people consider it "deep tissue" though it's not really. It works to release the fascia restrictions and may take a couple sessions but would be better than being cut up more which increases the risk of more damage to other fascia and muscles. If all the PT did was a typical swedish massage, it more than likely wasn't what your body needed. It's really up to you, but it might be worth checking out and try doing it a few time before your surgery to see if it does help.
    "Should I keep back my opinions at such a time, through fear of giving offense, I should consider myself as guilty of treason towards my country, and of an act of disloyalty toward the Majesty of Heaven, which I revere above all earthly kings..." Patrick Henry
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  5. #5  
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    Wow, Jones.

    Best of luck to you. You're young, you're tough, you're gonna make it.

    Thanks for the education.
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  6. #6  
    Grouchy Old Broad Kay's Avatar
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    Ouch that sounds painful.
    Im glad it will be reasonably easy to fix
    so it doesn't mess up your military career.
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  7. #7  
    Zoomie djones520's Avatar
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    Quote Originally Posted by Kay View Post
    Ouch that sounds painful.
    Im glad it will be reasonably easy to fix
    so it doesn't mess up your military career.
    Me to. I'm not exactly pumped about the idea of retiring just yet. I'd like to make E-6 before they did that to me at least.

    I'm hoping I'll just be off my feet for about 4 days afterwards, for my wifes sake more then anything else, she's got her hands full with two kids already. The doc told me for most people it's about two weeks before their fully recovered. The Air Force then gives me 42 days to build myself back up after that.
    In most sports, cold-cocking an opposing player repeatedly in the face with a series of gigantic Slovakian uppercuts would get you a multi-game suspension without pay.

    In hockey, it means you have to sit in the penalty box for five minutes.
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  8. #8  
    Zoomie djones520's Avatar
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    Quote Originally Posted by fettpett View Post
    how much actual massage did they do? MFR is pretty specific modality, most people consider it "deep tissue" though it's not really. It works to release the fascia restrictions and may take a couple sessions but would be better than being cut up more which increases the risk of more damage to other fascia and muscles. If all the PT did was a typical swedish massage, it more than likely wasn't what your body needed. It's really up to you, but it might be worth checking out and try doing it a few time before your surgery to see if it does help.
    8 sessions of PT. About 30 minutes of exercises, followed by 5 minutes of massage on each leg, every session. Conditions never improved. I've been living with this issue for 2 years now. A quick cut and sew up and it goes away, so I'm gonna take it.
    In most sports, cold-cocking an opposing player repeatedly in the face with a series of gigantic Slovakian uppercuts would get you a multi-game suspension without pay.

    In hockey, it means you have to sit in the penalty box for five minutes.
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  9. #9  
    Best Bounty Hunter in the Forums fettpett's Avatar
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    Quote Originally Posted by djones520 View Post
    8 sessions of PT. About 30 minutes of exercises, followed by 5 minutes of massage on each leg, every session. Conditions never improved. I've been living with this issue for 2 years now. A quick cut and sew up and it goes away, so I'm gonna take it.
    5 mins of massage is no where near enough. I'm just giving you something to consider. A couple 1 hour sessions and you may see a vast improvement. Also remember fascia is connected to everything in the body, and the actual problem may not be in the legs, but it's showing up there.

    PT's can't do much more than they are told to by the doctor and stick to a pretty strict regiment and wont deviate regardless of how the body responds. MT's on the other hand can do more and work areas that may not seem connected but are. Like there could be fascia restrictions or bindings in the glutes or feet that are causing the problem in the legs.

    just my advice and opinion, take it for what it's worth.
    "Should I keep back my opinions at such a time, through fear of giving offense, I should consider myself as guilty of treason towards my country, and of an act of disloyalty toward the Majesty of Heaven, which I revere above all earthly kings..." Patrick Henry
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  10. #10  
    LTC Member Odysseus's Avatar
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    Quote Originally Posted by djones520 View Post
    ...Since they'll be doing both legs, it'll be a real pain in the ass...
    If so, they're cutting in the wrong place.

    Seriously, I'm glad that you got the proper diagnosis, and it sounds like you will be getting some relief pretty soon.
    --Odysseus
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