Materiały źródłowe

• #1 Compartment Syndrome: What It Is, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/15315-compartment-syndrome

  You cant prevent acute compartment syndrome because it happens suddenly after an injury, or as a complication you cant predict. Going to the emergency room as soon as you think you have acute compartment syndrome is the only way to prevent severe complications. […] Avoiding putting too much stress on your muscles is the best way to prevent chronic compartment syndrome. Follow these tips to reduce your risk: […] Avoid overtraining dont play through pain if your muscles hurt during or after physical activity. […] Stretch and warm up before working out. Cool down and stretch after intense activity. […] Build your endurance gradually dont suddenly ramp up the intensity of your workouts. […] Mix up your workouts. Try to avoid doing the same workout, in the same way, every time you train. […] Try to avoid exercising on hard, rigid surfaces like concrete or tile floors.

• #2 Our knowledge of orthopaedics. Your best health.

  https://orthoinfo.aaos.org/en/diseases–conditions/compartment-syndrome/

  Chronic compartment syndrome, also known as exertional compartment syndrome, is usually not a medical emergency. It is most often caused by athletic exertion and is reversible with rest. […] The pain and swelling of chronic compartment syndrome is caused by exercise. People who participate in activities with repetitive motions, such as running or marching, are more likely to develop chronic compartment syndrome. This is usually relieved by discontinuing the exercise, and is usually not dangerous. […] Nonsurgical treatment. Physical therapy, orthotics (inserts for shoes), and anti-inflammatory medicines may be of limited benefit in relieving symptoms and generally do not allow return to full activity. […] Your symptoms may subside if you avoid the activity that caused the condition. […] Cross-training with low-impact activities may be an option.

• #3 Chronic Exertional Compartment Syndrome – Journal of Urgent Care Medicine

  https://www.jucm.com/chronic-exertional-compartment-syndrome/

  Chronic exertional compartment syndrome (CECS), which often masquerades as shin splints, is one example of a running-related injury that results from repetitive microtrauma. […] Once CECS is diagnosed, the treatment most likely to return a patient to his or her former level of physical fitness is surgery. […] Abrupt changes in a training regimen often lead to injuries such as CECS. When increasing training volume or training intensity, patients should be counseled to gradually increase the volume or intensity (typically a 10% increase per week is advised). […] Although surgery is the most effective treatment for CECS, cessation of the inciting physical activity would also lead to lessening or disappearance of a patient’s symptoms. […] In patients who present with symptoms of CECS, proper diagnosis requires measurement of compartment pressures both before and during exercise. If these measurements confirm the diagnosis, a patient should be referred to an orthopedic surgeon for a fasciotomy approximately 40 miles will reduce the number of injuries. […] It is advisable to run no more than 4 or 5 days per week, with one long run (13+ miles) taking place only once every 14 days.

• #4 Conservative treatment of anterior chronic exertional compartment syndrome in the military, with a mid-term follow-up | BMJ Open Sport & Exercise Medicine

  https://bmjopensem.bmj.com/content/5/1/e000532

  Objectives To assess the outcome of conservative treatment for chronic exertional compartment syndrome (CECS) as it relates to the reduction in surgical fasciotomy and return to active duty in a military population. […] A conservative treatment programme for anterior CECS was able to return 65 % of patients to active duty, without surgery. […] In the military, treatment for anterior chronic exertional compartment syndrome may be initiated with a special conservative approach before fasciotomy. […] The conservative treatment programme should at least contain gait retraining of running and marching, in shoes and boots. […] The number of surgical procedures can be reduced significantly; however, surgery is still indicated when conservative treatment is not effective. […] It is reasonable and perhaps safer and more cost-effective to follow a protocol in which surgery for exercise-related leg pain is offered only after optimal conservative treatment has been attempted.

• #5 Our knowledge of orthopaedics. Your best health.

  https://orthoinfo.aaos.org/en/diseases–conditions/compartment-syndrome/

  Some athletes have symptoms that are worse on certain surfaces (concrete vs. running track, or artificial turf vs. grass). Symptoms may be relieved by switching surfaces. […] Changing from heel strike to toe running may modify symptoms depending on the compartments involved. […] Surgical treatment. If conservative measures fail, surgery may be an option. Similar to the surgery for acute compartment syndrome, the operation is designed to open the fascia so there is more room for the muscles to swell. […] Usually, the skin incision for chronic compartment syndrome is shorter than the incision for acute compartment syndrome. Also, this surgery is typically an elective procedure, not an emergency. […] Surgery for chronic exertional compartment syndrome of the leg produces excellent results in the anterior and lateral compartments, and less predictable results when the posterior compartments are involved. An accurate diagnosis is key to achieving a significant benefit from surgery.

• #6 Compartment Syndrome • Harmony Chiropractic

  https://harmonychiro.com/compartment-syndrome/

  Chronic exertional compartment syndrome normally has options to decrease its occurrence. […] Compression is not a good thing in compartment syndrome so compression tights and Ace wraps need to be loosened. […] Elevation of the extremity up to the level of the heart can increase drainage and decrease swelling. […] Activity modification is often needed with decreased distance or intensity. […] Alternatively, one may need to work on their pacing. […] For those that want to retain their aerobic conditioning, cycling can often be substituted for running. […] In some cases, it might be necessary to avoid the offending activities. […] Decreasing stride length may also be an option. […] Some individuals who have mild symptoms tend to benefit from massage therapy. […] Massage therapy can also be beneficial to some who have declined surgery.

• #7 Chronic Exertional Compartment Syndrome (CECS) – Sports Clinic NQ

  https://sportsclinicnq.com.au/chronic-exertional-compartment-syndrome-cecs/

  Weight loss: When you gain weight the muscle has to work harder and there is potentially more mass in the compartment which increases pressure. Keeping weight as low as is appropriate is often helpful. Some athletes experience symptoms only after returning to running after a layoff and any increases in weight during this layoff may be a factor in increasing compartment pressure resulting in pain. […] Flexibility training: If a muscle group is tight, the muscles that pull in the opposite direction have to work harder than normal. […] Running modifications: As mentioned earlier some athletes experience symptoms only after returning to running after a layoff. A subtle change in running technique can be a cause of this. Feeling relaxed during the run may help as it can make changes to foot strike position.

• #8 Chronic Exertional Compartment Syndrome (CECS) – Sports Clinic NQ

  https://sportsclinicnq.com.au/chronic-exertional-compartment-syndrome-cecs/

  Training modifications: It is important to effectively train around the injury without provoking symptoms. Swimming, cycling and a variety of gym based machines can be used in place of running. Interval runs of short duration and high speed are often less symptom provoking than longer steady state runs. Using short interval runs in place of longer runs can keep you running without bringing on symptoms. […] Soft tissue treatments: Including massage may be useful to decrease the degree of muscle swelling. […] Biomechanical assessment and correction: Assessment and correction of your biomechanics may potentially be very useful. […] Surgery: Surgery to cut the sleeve of connective tissue surrounding the compartment is necessary in some cases, as this enables the muscle to expand during exercise without increasing pressure.

• #9 CHRONIC EXERTIONAL COMPARTMENT SYNDROME | Sports Medicine Today

  https://www.sportsmedtoday.com/chronic-exertional-compartment-syndrome-va-34.htm

  Chronic exertional compartment syndrome (CECS) is one cause of exercise-related lower leg pain. […] Changing the way an athlete runs can prevent some types of CECS. For athletes with very flat feet, arch supports may also help prevent CECS. Creatine use may increase the risk of developing CECS, and discontinuing this over-the-counter supplement may prevent the development of CECS symptoms.

• #10 Nonsurgical Treatment for Chronic Compartment Syndrome | NYU Langone Health

  https://nyulangone.org/conditions/compartment-syndrome/treatments/nonsurgical-treatment-for-chronic-compartment-syndrome

  If chronic compartment syndrome is causing pain, weakness, numbness, or tightness in your muscles during or after exercise, your NYU Langone doctor may recommend avoiding high-impact exercise and using custom orthotic shoe inserts to relieve stress during physical activity. […] Avoiding the activity that causes symptoms can relieve pain and tenderness and prevent compartment syndrome from worsening. […] NYU Langone doctors advise wearing shoes that have ample arch support and a cushioned sole when exercising. […] Over time, this uneven alignment may lead to increased pressure on certain muscle groups and increase the risk of chronic compartment syndrome. […] For those with chronic compartment syndrome, an orthotic shoe insert may redistribute weight across the foot in a way that allows you to continue running or participate in other high-impact activities without muscle pain.

• #11 Compartment Syndrome – Georgia Foot and Ankle

  http://www.georgiafootandankle.com/document_disorders.cfm?id=159

  Chronic exertional compartment syndrome may be treated conservatively by modifying the type, duration and frequency of the sports activity that causes the pain. […] The condition is often successfully treated by altering the surfaces the individual runs on and the shoes they run in. […] In addition, CECS sometimes responds to altering the function of the muscles of the lower leg with in-shoe custom supports such as functional foot orthotics. […] If all conservative measures do not resolve the pain from CECS adequately, the podiatrist may refer the patient to an orthopedic surgeon for possible surgical release of the sheath surrounding the muscle compartment. […] In general, most patients who have surgical release of the muscle compartment sheath are able to resume unrestricted exercise within a few months of the procedure. […] Many notable athletes have had the compartment release surgical procedure performed and have returned to training without pain or limitations.

• #12

  https://journals.lww.com/acsm-csmr/fulltext/2023/06000/the_pressure_is_rising__evaluation_and_treatment.6.aspx

  Chronic exertional compartment syndrome is a condition that typically affects athletic/active individuals. Initial care commonly involves conservative treatment, such as physical therapy, modifications of patient’s exercise technique, foot orthoses, and various procedures over a period of 3 to 6 months. […] Nonsurgical measures are the foundation for initial treatments for those with CECS and encompass modifying the triggering physical activity (i.e., gait retraining, rest, orthotics, anti-inflammatory medications, stretching/strengthening protocols, and therapeutic modalities, such as transcutaneous electrical stimulation, ultrasound, and massage). […] While gait retraining, which addresses one of the underlying causes of CECS in the anterior compartment of the lower leg, has demonstrated promise in its ability to reduce the need for surgical intervention, more generic physical therapy protocols have not proven so beneficial.

• #13

  https://journals.lww.com/acsm-csmr/fulltext/2023/06000/the_pressure_is_rising__evaluation_and_treatment.6.aspx

  The ultimate treatment for CECS involves reducing the ICP for the subject and there is no medication that has been shown to accomplish this. However, medications can be useful in controlling pain prior to any intervention being performed. […] Procedural interventions have become increasingly popular in patients who are hoping to avoid the risks associated with more aggressive surgical options. […] If conservative treatment fails, or if the patient has opted for more aggressive intervention, there are multiple surgical fasciotomies available, including but not limited to open, single-incision, percutaneous, and endoscopy-assisted compartment fasciotomy. […] Nonoperative treatment protocols remain the first line of interventions over 3 to 6 months given the inconsistent success rate, recovery time, and return to activity rate of surgical intervention.

• #14 Compartment Syndrome – Dr. Henry Backe

  https://henrybackemd.com/compartment-syndrome/

  Chronic compartment syndrome causes pain or cramping during exercise. This pain subsides when activity stops. It most often occurs in the leg. […] Nonsurgical treatment. Physical therapy, orthotics (inserts for shoes), and anti-inflammatory medicines are sometimes suggested. They have had questionable results for relieving symptoms. […] Your symptoms may subside if you avoid the activity that caused the condition. Cross-training with low-impact activities may be an option. Some athletes have symptoms that are worse on certain surfaces (concrete vs. running track, or artificial turf vs. grass). Symptoms may be relieved by switching surfaces. […] Surgical treatment. If conservative measures fail, surgery may be an option. Similar to the surgery for acute compartment syndrome, the operation is designed to open the fascia so that there is more room for the muscles to swell.

• #15 Emerging Treatment for Compartment Syndrome – Sports Medicine Review

  https://www.sportsmedreview.com/blog/emerging-treatment-compartment-syndrome/

  Chronic exertional compartment syndrome (CECS) is an underdiagnosed condition that causes lower and upper extremity pain in certain at-risk populations. […] Nonoperative management of CECS is more commonly described in the literature, and consists of cessation of activities, altering foot-strike pattern, physical therapy, taping, and injections of botulinum toxin A. […] Initial management is almost always nonsurgical. This normally consists of rest, avoidance of the aggravating activity, NSAIDs and possibly anesthetic or corticosteroid injections. […] Currently, based on these limited studies, Botulinum toxin is a safe and cost-effective alternative to fasciotomy for the treatment of CECS. […] In summary, chronic exertional compartment syndrome (CECS) is often seen in sports medicine clinics due to the population affected. Providers should be comfortable with the nonoperative treatment options. Botulinum toxin A has shown positive results in multiple small studies and may be an option, but further research is needed in this area. The ultrasound guided fasciotomy has been proposed as an additional treatment option for CECS and initial reports have shown positive results and a quicker recovery time when compared to traditional open fasciotomy.

• #16 Registry Development and Non-Surgical Treatment Options for Chronic Exertional Compartment Syndrome — MIRROR | Musculoskeletal Injury Rehabilitation Research for Operational Readiness

  https://mirrorusuhs.org/mirror-projects/project5

  Chronic exertional compartment syndrome (CECS) is a debilitating disorder affecting mostly an active population. […] Gait retraining is an attractive alternative to fasciotomy. […] Military sports medicine clinics at Fort Belvoir Community Hospital (FBCH) and USU have been utilizing BoNT-A injections for the non-surgical treatment of CECS. […] The purpose of this grant application is to create a registry across all MTFs for CECS to compare diagnostic and therapeutic data. We will simultaneously assess the effectiveness of non-surgical treatments options for chronic exertional compartment syndrome as well as test the use of xylocaine injections to predict success for non-surgical or surgical options at selected sites. […] Finally, this study would determine if xylocaine injections could predict who will benefit from BoNT-A injections or fasciotomy.

• #17

  https://link.springer.com/article/10.1007/s40279-022-01729-5

  The natural course of CECS was shown to cause persistent symptoms over time. […] Traditionally, management of CECS starts with conservative measures. Gait retraining and botulinum injections may have positive outcomes. […] If conservative interventions fail or if a patient experiences severe symptoms, surgical treatment is considered. […] However, a clear treatment algorithm and clinical guideline are not available, whereas presentation of treatment outcomes in the scientific literature is far from standardized. […] The aim of this Delphi study was to establish consensus on practical issues guiding diagnosis and treatment of CECS in civilian and military patient populations. […] The panel agreed that gait retraining and cessation of provoking activities are valuable components of a conservative treatment program.

• #18

  https://link.springer.com/article/10.1007/s40279-022-01729-5

  The panel agreed that a fasciotomy of the anterior compartment can be performed safely and effectively using the entrance of a single small incision. […] Consensus was reached on the statement that a standardized institutional rehabilitation protocol should be used postoperatively. […] The panel members could not agree on the type of restrictions in such a protocol. […] The outcome of this Delphi analysis on CECS may serve as a platform to initiate simple guidelines for clinical practice.

• #19 Chronic exertional compartment syndrome – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/chronic-exertional-compartment-syndrome/

  Chronic exertional compartment syndrome may respond to nonsurgical treatment and activity modification. […] Options to treat chronic exertional compartment syndrome include both nonsurgical and surgical methods. However, nonsurgical measures are typically successful only if you stop or greatly reduce the activity that caused the condition. […] Your doctor may initially recommend pain medications, physical therapy, athletic shoe inserts (orthotics), massage or a break from exercise. Changing how you land on your feet when you jog or run also might be helpful. However, nonsurgical options typically don’t provide lasting benefit for true chronic exertional compartment syndrome. […] A surgical procedure called fasciotomy is the most effective treatment of chronic exertional compartment syndrome. It involves cutting open the inflexible tissue encasing each of the affected muscle compartments. This relieves the pressure.

• #20 Guide | Physical Therapy Guide to Compartment Syndrome | Choose PT

  https://www.choosept.com/guide/physical-therapy-guide-compartment-syndrome

  Chronic compartment syndrome is common among young athletes. The condition develops slowly over time. It can be associated with exercise training errors or limited space within the compartment itself. […] Physical therapists can help to identify the factors that may lead to chronic compartment syndrome and help people successfully manage their condition. […] Chronic compartment syndrome is often called „exertional” compartment syndrome. Exercise that involves repeated movements, such as walking, running, biking, swimming, playing tennis, or jumping typically cause CCS. Too much exercise, without time to recover, causes the tissues of the leg to be overworked. Development of CCS can be influenced by: Poor body control during movement, Poor footwear, Training on surfaces that are hard or uneven, Too much training.

• #21 Compartment Syndrome • Harmony Chiropractic

  https://harmonychiro.com/compartment-syndrome/

  Manual therapy and treatments like Graston Technique can also be beneficial. […] Compartment syndrome has been linked with abnormal foot biomechanics like overpronation so custom foot orthotics can be of benefit. […] Changing to softer training surfaces can also be helpful. […] Corrective exercises can be helpful as improved range of motion and muscle strengthening can be beneficial.

• #22 Chronic Compartment Syndrome? –help– 32 y/o male – Triathlon Forum – Slowtwitch Forum

  https://forum.slowtwitch.com/t/chronic-compartment-syndrome-help-32-y-o-male/686716

  Chronic exertional compartment syndrome (CESC) typically (90% of the time) is related to anterior and lateral compartments which cause lateral shin pain. […] Unfortunately no treatment, aside from fasciotomy has been shown to be very beneficial. […] While it is certainly possible that you have CECS if your pain is in you calves the odds are it is something else. That being said, it is worth getting tested (exertional compartment pressure testing) if your symptoms are limiting your running to that degree. […] If massage therapy helps, it would seems built up fatigue, stress and low level injury (that was likely ignored) is to blame. […] Try regular stretching post run and observing your fatigue and stress levels.

• #23 Conservative treatment of anterior chronic exertional compartment syndrome in the military, with a mid-term follow-up | BMJ Open Sport & Exercise Medicine

  https://bmjopensem.bmj.com/content/5/1/e000532

  It appears that comprehensive conservative treatment for anterior CECS should be at least a 6-week programme and should include gait retraining of running and, in a military setting, retraining of marching and running while in boots. […] In conclusion, for patients with anterior CECS in the military population, initiating care with a comprehensive conservative treatment protocol can have a two-third return to duty rate while avoiding surgery and reduce the total number of fasciotomies required.

• #24 Compartment Syndrome | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/compartment-syndrome.html

  Chronic compartment syndrome is a less serious condition that many athletes develop due to repetitive movements in exercise. […] In most cases, our specialists can treat chronic compartment syndrome with nonsurgical methods, including some lifestyle modifications. You may need one or more options such as: […] Temporarily discontinue the activity causing pain to let your muscles rest. […] Change the type of surface you exercise on to lower the impact to your muscles. You can also modify your activities to reduce impact. […] Our physical therapy specialists can teach you exercises and stretches using the proper form to improve your flexibility and strength. […] Wear well-fitting shoes or orthotics (shoe inserts) to properly support your feet and leg muscles. […] Take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen to reduce pain and swelling. […] In rare cases, chronic compartment syndrome may require surgery. Our experts modify the procedure we use to treat acute compartment syndrome, a fasciotomy, by using a smaller incision.

• #25 Compartment syndrome

  https://www.nhs.uk/conditions/compartment-syndrome/

  Treatment is often not needed for compartment syndrome that develops gradually. […] To help relieve your symptoms you can: avoid the activity that caused them if you run, switching to a low-impact exercise, such as cycling, may help […] use anti-inflammatory painkillers to reduce the pain and discomfort […] have physiotherapy […] use inserts (orthotics) in your shoes if you start running again. […] If your symptoms do not improve after trying these things, surgery may be an option. The operation is similar to the one used to treat acute compartment syndrome.

• #26 Chronic exertional compartment syndrome – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/chronic-exertional-compartment-syndrome/

  To help relieve the pain of chronic exertional compartment syndrome, try the following: Use orthotics or wear better athletic shoes. Limit your physical activities to those that don’t cause pain, especially focusing on low-impact activities such as cycling or an elliptical trainer. For example, if running bothers your legs, try swimming. Or try running on softer surfaces. […] Stretch the painful limb after exercise.

• #27 Chronic exertional compartment syndrome – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/chronic-exertional-compartment-syndrome/

  To help relieve the pain of chronic exertional compartment syndrome, try the following: Use orthotics or wear better athletic shoes. Limit your physical activities to those that dont cause pain, especially focusing on low-impact activities such as cycling or an elliptical trainer. For example, if running bothers your legs, try swimming. Or try running on softer surfaces. […] If you have recurring unusual pain, swelling, weakness, loss of sensation or soreness while exercising or participating in sports activities, talk to your doctor.

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