Please help! Compartment Syndrome

BTILC

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Hi,
I used to get pain in my tibialis anterior when I went running. It only occurred after say a mile or so. I went to different physios and I was told it was a muscle strain. It healed over time and I didn’t have anymore issues with it. It was always slightly sore the day after a run but so is my left so I’m presuming that’s just DOMS. However, one time when I ran for about 6 mile at a high intensity the pain came back and it brought me to a complete stop. I couldn’t run and barely walk. It was fine the day after. I went for an MRI the day after it and it came back clear. Would this have shown in the MRI the day after if I had compartment syndrome? I’m worried that I have it.
 

mace

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First of all take a deep breath and relax even though it is frustrating. Shin splints are fairly common. Lucky for you here is a solution:
Don’t get fouled by the title, the exercises will help strengthening your lower leg muscles. Additionally do banded tibialis raises:
3 sets of 1 minutes.
Always work within a pain free range.

Also, have a look at the sole of your shoes. If some of the tread is gone that means you have covered way more mileage in those shoes than the midsole of the shoe is designed. Running shoes should be changed around every 400 miles. Changing shoes is still cheaper than physio.

Further, make sure you are not heel striking. Video your running and work on form:

 

JWJ

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For Compartment Syndrome, to use an MRI to diagnose or investigate, you really need to do two MRIs in the same few hours, i.e one MRI before exercise, do exercise to exacerbate your symptoms to the point when you're experiencing it the same as you would when you have to stop, and then an immediate MRI post-exercise.

However, with CECS - you'll know there is a problem to say the least, you'll atleast suspect you have shin splints from the persistent exercise-induced pain. If you're concerned its CECS for whatever reason, your gold standard test is to get compartment pressure monitoring, or the double MRI like I outlined however I advise against you trying to diagnose yourself and just seek the opinion of professionals
 

JWJ

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Would this have shown in the MRI the day after if I had compartment syndrome? I’m worried that I have it.
To better respond to what you asked - its possible that there would be some edema apparent on the MRI, but one classic sign of CECS is that symptoms (and therefore any edema) resolve after halting exercise, so its very possible if not likely that if you did have CECS, a late MRI like that would not be concerning or too helpful to spot it.
 

mace

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Oh and obviously rest it! Last week when I tried running for 3 days in a row I had pain in my shins as well. I had to walk home. Doing some tibialis raises, stretching and not running for 4 days made the trick. No pain this week and I have had 3 run sessions with a rest day in between. Also got new shoes as I released I already did over 600 kms in them, better safe than sorry.
 

BTILC

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Thankyou all for the help, I bought new insoles and got some orthotics to help with recovery. This was months ago and I’ve not had any symptoms since but I haven’t been on any long runs since due to other issues. If I was to get a pressure tests for CECS how would I go about it?
 

JWJ

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Thankyou all for the help, I bought new insoles and got some orthotics to help with recovery. This was months ago and I’ve not had any symptoms since but I haven’t been on any long runs since due to other issues. If I was to get a pressure tests for CECS how would I go about it?
I'd just go and see what your local Physios think, and if they can't suggest anything go and see your GP.
 

mace

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Thankyou all for the help, I bought new insoles and got some orthotics to help with recovery. This was months ago and I’ve not had any symptoms since but I haven’t been on any long runs since due to other issues. If I was to get a pressure tests for CECS how would I go about it?
That’s great, still, consider doing the above Knee Ability Zero programming. It saves knees and shins. ;)
 

BTILC

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I'd just go and see what your local Physios think, and if they can't suggest anything go and see your GP.
Will do I’ll speak to my GP. Is there anyway of getting the test done privately do you know?
 

mace

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Yeah that’s the only issue. But then if it does come back clear then that shouldn’t affect my medical should it?
I don’t know sorry, it’s still something they are going to ask about and request proof of from your GP
 

BTILC

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I don’t know sorry, it’s still something they are going to ask about and request proof of from your GP
Yeah true, to be fair I’d rather take the risk and know where I stand injury wise even if it means my medical takes a bit longer. If it turns out to be compartment syndrome I’m guessing I wouldn’t pass the medical anyway.
 

mace

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Yeah true, to be fair I’d rather take the risk and know where I stand injury wise even if it means my medical takes a bit longer. If it turns out to be compartment syndrome I’m guessing I wouldn’t pass the medical anyway.
So you are still experiencing problems with it?
 

JWJ

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Yeah true, to be fair I’d rather take the risk and know where I stand injury wise even if it means my medical takes a bit longer. If it turns out to be compartment syndrome I’m guessing I wouldn’t pass the medical anyway.
CECS is not a permanent bar to entry. Unresolved CECS is.

Take it from me, if its CECS, you won't be able to get through CTC - I have some personal experience with that.
 

BTILC

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So you are still experiencing problems with it?
I haven’t been able to run a long distance in a while due to other minor injuries so I don’t really know. But the last 6 miler I did I had to come to a complete stop with the sudden pain.
 

BTILC

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CECS is not a permanent bar to entry. Unresolved CECS is.

Take it from me, if its CECS, you won't be able to get through CTC - I have some personal experience with that.
Thankyou for the reply, would you advise to get it tested to see if I do have it? It could just be a case of a weak muscle from when/if I sprained the muscle ages ago.
 

mace

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I haven’t been able to run a long distance in a while due to other minor injuries so I don’t really know. But the last 6 miler I did I had to come to a complete stop with the sudden pain.
Start with very short distances couple times a week and gradually build up your mileages back. Increase your weekly mileage by 10%.
 

BTILC

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I’ve been referred by my GP to the muscular skeletal team. Going to push them for a CECS test.
 

stumpylegs

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Go to BMI The London independent hospital, get the pressure test done by David goodier. It’s done privately off your record. If it’s is compartment syndrome, then get a fasciotomy by him, I have compartment syndrome and he’s operated on a lot of guys going into the military
 
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