self diagnosis - I have chronic compartment syndrome
 

Over the last few days I have had this weird ache in my left calf muscle. It feels almost like I pulled it or strained it or something, except that it does not hurt when I flex it. I tried to blow it off as just a little soreness or overdoing it since before experiencing this I went for a run last week for the first time in months and also experienced an episode a few days ago on my bike where I got some pretty nasty calf cramps (which I am pretty sure were caused by a combination of chilly temeratures and dehydration).

Anyway, after I realized that my calf did not hurt more when I flexed it I decided that this is not a typical strain or tear. Then I noticed that it was tender all in one place and slightly swollen, like I had a pocket of fluid or a cyst or something in it. So, long story short, I did some research on the computer last night and came across an article describing "Chronic Exertional Compartment Syndrome." It basically is a muscle group that gets swollen but is constrained by the fascia surrounding the muscle so it can't expand, resulting in pressure in the muscle. I guess it can get pretty nasty if the pressure gets too bad and may have to be drained. For now, I am hoping I can just take some regular aspirin (antiinflammatory) and keep it iced and elevated and it will go away. I will see my Doc if it gets worse.

Anyone else have any experience with this? I would be interested to hear other ideas about what caused it, how they treated it and if they have had reoccuring trouble.

I had the same sort of problem. Suddenly I was in constant cramp mode and it ached for days. Having gone through physical therapy before with a very well known sports med doc, I was hoping it wasn't tendonitis coming back. I started doing more stretching and strengthening the gastrocnemius muscle, which seems to be constantly weak on me, and it went away. Do lots of seated calf raises and step-ups, and it'll likely spring back if you're also stretching.

I thought I had that last fall after my left ankle/calf started to hurt during a running race. It turned out to be a stress fracture of my fibula.

Does the pain seem to be in the muscle alone? Or, could it possible be in the bone?

Note: stress fractures can take several weeks to show up on X-rays (mine was not visible 4 days after the accident, but 6 weeks later...well, Ray Charles could have read that X-ray :D).

It is definitely in the muscle. When I was researching last night I kept looking for a less serious excuse but then I read a couple articles on compartment syndrome that had "symptoms" sections that sounded like someone told me to write down exactly what I was feeling....and then plugged it into the article. Very discouraging. But, I am hoping it is mostly related to my jogging and that if I get it under control I can get back on the bike without a problem and without reoccurrence. I also hope I don't have to see a DR about it.....the best diagnosis and treatment involves sticking big long needles right into your muscle.:eek:

Yeah, but if you do have compartment syndrome, you definitely should see a doctor - it can be a serious problem.

Per Wikipedia:

"Acute compartment syndrome is a medical emergency requiring immediate surgical treatment".

and,

"Failure to relieve the pressure can result in necrosis of tissue in that compartment, since capillary perfusion will fall leading to increasing hypoxia of those tissues. If left untreated, acute compartment syndrome can lead to more severe conditions including rhabdomyolysis and kidney failure."

Don't f*ck around with this...see a doc ASAP.

I had chronic compartment syndrome in my left anterior tibialis. I got it through cross country skiing, not cycling, as I am a competitive ski racer. Chronic compartment syndrome is pretty different from acute compartment syndrome--it won't cause paralysis, for one, and its not NEARLY as scary. Because of some sort of stimulus (running, skiing, etc), your muscle is trying to swell beyond the fascia. However, when you stop, the pain should stop too. I had no pain when I was not skiing. If you muscle is still swollen and fluid-filled like you describe when you are not jogging, it is probably not compartment syndrome. However, the only way to tell is to get evaluated by a doctor. To do this, they poke a big needle into the muscle compartment that you think has compartment syndrome, measure the pressure in that compartment, and then have you do the activity that causes the pain. Then they measure the pressure again. If the pressure is over 30 (I don't know the units, sorry), that is chronic compartment syndrome. You then have two choices: don't ever do the activity that hurts the muscle, or get your fascia slit open so that the muscle can relax. I had the surgery, and I was walking in two days and biking in a week, although the shin muscle is supposed to be a quicker recovery than the calf muscle.

As a reference, when I skied, it felt like my shin was trying to explode, and was blocking my ability to control my left foot (and hence the ski). This was really painful, but in the sort of way that you couldn't ski through it. Didn't do great things for the ski season... I hear that runners get this far more often than skiers, so it is quite likely that running is what aggravated your calf if you do indeed have chronic compartment syndrome.

Get to a doctor! Good luck!

It is one of the main reasons I don't run anymore. It isn't an issue on the bike. But when running it is excrutiating and if I persist in running my feet will actually go asleep. Not good. It is only an issue with running for more than 15 minutes or so. If I sprint I feel fine.

Are you really? Who are you? :) I love to xc ski too. Did Pepsi/COLL/Mora/Birkie this year.

I would get to a doctor. If you can't feel the pulse behind the inside of your ankle on that side, or if you have decreased sensation, I would run to the doctor. Not trying to be alarmist, but if it is compartment syndrome, you face serious complications.

I understand that chronic and acute compartment syndrome are different. I am sure I have the chronic variety and am hoping that my running is what brought it on, as suggested. I have been resting and icing my calf and taking regular aspirin for the last couple days and it has seemed to help. I have almost no soreness right now and am looking forward to trying to get back on the bike in another couple days.

Assuming that running brought this on, is it going to be like tendonitis in the sense that now whenever I run I may get a reoccurence?...am I guaranteed a reoccurence if I run?.....or will it reoccur only if I overdo it?...

I appreciate everyone's concern and advice to see a doctor. I did not see a doctor but I did a lot of research on this and carefully monitored my condition and decided that the damage was not bad enough to need immediate attention. I agree that my research seems to indicate that acute compartment syndrome should be treated immediatly by a doctor. It is, as suggested, nothing to mess with. Even chronic compartment syndrome can be very serious if the pressure gets bad enough. I hope I am on the mend and do not have to experience the "jab a needle into your muscle" diagnosis or the "slice your muscle open" remedy. I will keep you guys updated if my condition changes and I have any good info to pass along.

I'm based out of Boston, so I raced the NENSA eastern cups last winter, along with the Jackson 30k and Craftsbury, and then spring series up in Presque Isle. I also competed at the world championships for ski-orienteering, which was quite the experience. I race bikes on teh side, though :p

I've battled chronic anterior compartment syndrome for about 20 years. Basic cause is tight hamstrings and gastrocs that overwork the muscles at the front of the shin. I don't remember the dorsi-flexion yada yada, but basically with each stride the effort needed to lift the toes back up is compounded by the tension in the calves and hamstrings. That causes the shin muscles to expand faster than the sheath that they are encased in can accomodate. That quickly cuts off the circulation to the shin muscles. Eventually, my shins go numb, feet go numb and have to stop.

Prevention. Stretch regularly. Run REAL slow during the first couple miles to allow the sheath to expand as the shin muscles expand. Once you've triggered an episode, its generally going to be hard to be able to run AT ALL for about an hour or so. I assume the same approach may be applied to posterior compartment syndrome.

When I finally had it diagnosed by an excellent sports medicine doctor many years ago, it was about a $1,500 procedure to slit the sheaths. As an amateur runner, I could hardly justify that. He said perhaps 30 to 40% of elite runners eventually have the procedure, but that seems high in my experience. But then again, I don't exactly hang with elite runners that much.:D

I to had all the symptoms of chronic compartment syndrome (self and doctor diagnosed). Turns out after several more doctor visits I had a Peroneal Nerve impingement (pinched). I wasted a 6 months trying to self medicate and R.I.C.E.. Only to have a surgery that almost instantly cured the problem. Stop wasting time , you could be riding, and see a doctor.

Cool man! :) I live vicariously through you guys. I have a friend who skis up there. Case is his name, although I think he's with Craftsbury.

compartment syndrome
 

Has anyone here gotten compartment syndrome after/when biking?

Of course compartment syndrome in the anterior compartment (tibialis anterior), but I do not think I've heard of it affecting the gastrocnemius. It seems much less likely. Too much soft tissue, not enough bone to compress the muscle against.

It all depends on your age, but something like DVT or an abscess seems a lot more likely to me (not likely, just more likely). You'd also want to rule out common running injuries, like a soleus or Achilles injury, though I'm almost sure you would have considered those.

Note the original thread here is 2 years old - IMO, new thread would have been appropriate, to keep future contributors from wasting time reading irrelevant posts. My $0.02, with all due respect.

I've got chronic compartment syndrome in all three compartments in my left leg amd the doctor suspects I have the same in my right leg (one for sure, 3 suspected) they are triggered by weight bearing activities and I had to stop running for this reaso. That was hard to give up after 10 years :( consequently triathlons came to an end as well.

Surgery is the only way to fix this, you can relieve the pain a little with stretches and exercises and whatnot but it will not go away. I decided not to go with surgery and now all I do is bike.