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Anterior Compartment Symdrome

Anterior Compartment Symdrome is a condition in which swelling within the anterior compartment of the lower leg jeopardizes the viability of muscles, nerves and arteries that serve the foot. In severe cases, emergency surgery is necessary to relieve the swelling and pressure.

Causes of Anterior Compartment Symdrome

During exercise which involves repetitive dorsi- and plantarflexion of the foot (moving the foot up and down), such as running, swelling can occur in the muscles of the anterior compartment due to increased blood flow. This can create an increased pressure in the compartment. If the fascia surrounding the compartment does not stretch enough (remember, the bony walls of the compartment don't give), the increased pressure will compress the artery and nerve, thereby causing pain or numbness or tingling in the distribution of that nerve.

Symptoms of Anterior Compartment Symdrome

Pain induced only by athletic activity and often at a specific point in the workout
Pain and tightness in the shin, located along the outside (lateral) edge of the shin bone
Decreased sensation on the top of the foot in the area above the second toe (the big toe is toe #1)
Weakness may be noted on toe extension and dorsiflexion of the foot

Treatment of Anterior Compartment Symdrome

If you have been experiencing symptoms of anterior compartment syndrome your first approach to treatment should be to stretch the anterior muscles of your shin. This can be done kneeling on the ground with your toes pointing behind you and the top surface of your foot flat on the ground. Then you can 'sit' down on your heels and lean your body backwards over your feet. You should feel the front of your shins stretching.

Massage is also a useful approach to treatment because if the muscles are chronically tight they will be more prone to swelling.

When chronic cases do not respond to conservative care, fasciotomy is the treatment of choice. This is a surgical procedure where an incision is made along the length of the affected compartment through the fascia to release the pressure. Properly execute surgery has a success rate of close to 90%. Prior to surgery, a patient would have to meet certain diagnostic criteria whereby pressure measurements are taken at rest and during activity to insure that the procedure is warranted.

Modified 3-14-04
Information compiled from the National Institutes of Health

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