Anterior Compartment Syndrome

What is Anterior compartment syndrome?

Anterior compartment syndromes arise when a muscle becomes too big for the sheath that surrounds it causing pain. The big muscle on the outside of the shin is called the tibialis anterior. The and is surrounded by a sheath.

The main purpose of the muscle is in moving the foot upwards and outwards (dorsi flexion and eversion). A great deal of stress can be placed on this muscle throughout the running gait cycle.

This is called the anterior compartment of the lower leg. Compartment syndromes can be acute or chronic.

Symptoms of acute anterior compartment syndrome

• A sharp pain in the muscle on the outside of the lower leg, usually the result of a direct blow.
• Weakness when trying to pull the foot upwards against resistance which may result in foot drop or a slapping gait.
• Swelling and tenderness over the tibialis anterior muscle.
• Pain when the foot and toes are bent downwards.

It will likely be cause by:

• An impact which causes bleeding within the compartment and therefore swelling.
• A muscle tear which also causes bleeding.
• Over use injury which also causes swelling.

Treatment

What can the athlete do?

• Rest, but try to exercise your upper body or cycle if it is not painful.
• Apply ice or cold therapy and compression for 20 minutes at a time.
• See a sports injury professional who can advise on rehabilitation.

What can a sports injury specialist or doctor do?

• Prescribe anti-inflammatory medication e.g. ibuprofen.
• Correct any biomechanical disfunction with orthotic devices.
• Operate. They could make a small cut or two in the muscle sheath to allow the muscle to expand out.

Symptoms of Chronic Compartment Syndrome

• Pain which increases during exercise which eventually makes running impossible.
• Pain goes after a short rest but comes back again during exercise.
• Difficulty in lifting the toes and foot up.
• Pain when pulling the toes and foot downwards.

Causes include:

• Over use and over developing the muscle through training.
• At rest the blood vessels are not at capacity. During exercise these blood vessels fill up much more and expand putting pressure on the sheath.
• The sheath becomes inelastic and unable to expand.

Treatment

What can the athlete do?

• Rest until there is no pain.
• Apply sports massage techniques to increase the elasticity of the muscle sheath.
• Apply heat and use a heat retainer.
• See a sports injury specialist.

What can a sports injury specialist or doctor do?

• Prescribe diuretics and anti-inflammatory medication.
• Analyse your training methods, running gait and types of shoe to determine any contributory factors.
• Use sports massage techniques to stretch the muscle sheath.
• Operate. They could make a small cut or two in the muscle sheath to allow the muscle to expand out.