Anterior compartment syndrome
What is it?
Your muscles are surrounded by a protective sheath, which forms a closed space called a compartment. The anterior compartment of the lower leg contains your tibialis anterior - the big muscle on the outside of your shin.
Compartment syndrome happens when your muscle swells. The muscle is confined by the compartment it's in, so doesn't have much room to expand. The pressure in your muscle increases causing symptoms of compartment syndrome.
Symptoms
The main symptoms of anterior compartment syndrome are discomfort and an aching, cramp-like pain in your lower leg. This is bought on by exercise. The symptoms usually start after about 10-30 minutes of exercise. You may also have a tight feeling in your leg. The symptoms usually go away slowly once you have stopped exercising.
Acute anterior compartment syndrome can develop after a serious injury to your leg. This is a medical emergency. If it isn't treated, the muscles and nerves in your leg could die because of a lack of oxygen. Symptoms of acute anterior compartment syndrome are:
- pain in your leg, which is worse than expected
- severe pain when you move your leg
- swelling of your leg
- pale skin on your leg, which is usually patchy
- pain when your toes are moved
Causes
Anterior compartment syndrome is caused when muscles in your legs swell. When you exercise, your muscles try to expand but aren't able to do so. This causes increased pressure, and therefore pain in your leg. Anterior compartment syndrome happens most often if you do a lot of running or cycling.
Acute compartment syndrome can develop after a severe leg injury. This can happen after a breaking a bone or an injury that involves your leg being crushed. The pressure on your muscle can be made worse if you have a tight splint, dressing or cast on your leg.
Treatment
You will need to rest your leg until the pain has gone. You may be given some exercises to do to strengthen your muscles. You may also need massage therapy. You may need to have surgery if other forms of treatment aren't successful.
If you have acute anterior compartment syndrome, anything that may be confining your leg, such as a splint or cast, will be removed. You will usually then need surgery to relieve the tension and pressure in your leg and give room for your muscle to swell. This is called a fasciotomy.
Do
- See your doctor as soon as possible if you have symptoms of acute anterior compartment syndrome.
- Try alternative exercises to running, for example swimming.
Don't
- Carry on running - you will need to rest your leg.
Peer reviewed by Alex Floyd, MCSP, Bupa Sports Medicine physiotherapist
Publication date: June 2009
