Compartment Syndrome


I've started to see a physio who reckons I've got chronic compartment syndrome. He's started to massage my shins but has said if they dont respond then it'll be surgery.

Anyone know how effective massage is? If it doesnt work will I be able to get the op done on the NHS or had i better start saving?




  • Ooh nasty and painful that CW.

    Mild CS responds well to massage combined with resting from the aggravating activity, but depends on the severity of your condition.

    Serious cases of it can result in functional impairment and even death (kidney failure) image

    No idea whether you can get op on nhs - ask your GP?

  • Hi CW,

    In my experience most exercise induced leg pain which is confirmed as chronic compartment syndrome requires surgery for the best results regarding returning to pain free running.  Has this been formally diagnosed with dynamic intra-compartment pressure testing?

    Where are you based in the UK?

  • Hi

    Siance - dont think I fancy kidney failure!

    SDoB -  so far I havent had pressure testing - going to wait and see how they respond to massage I guess. BTW I'm in the Milton Keynes area

  • Sorry CW I dont know your part of the world very well - but if it ever gets to that stage I know the specialist to see in London.  He definately takes private referrals but unsure about this on the NHS.

    Wish you all the best


  • Hi SDoB,

    I've been suffering from what my physio and podiatrist suspect is compartment syndrome for the last year or so now. Sports massage and rest haven't helped much and am pinning last hopes on new orthotics - the problem is in my left leg only, which is shorter than my right and I seem to put undue pressure through the muscle on the outside of my shin.

    If the orthotics don't work am considering that having the compartment pressure test might be worth investigating - could you let me know the name of the specialsit you mention in London?


  • Hi Andyquattro

    Apologies for the delay in response

    Specialist is Dr Nat Padhiar at the London Independant Hospital, Stepney Green.


  • ((Colonel))

    Nothing else helpful to contribute but just to acknowledge CS is nasty and you've got my sympathy.  I'm quite injury prone and have had any number of things but (touch wood) so far manages to avoid CS.  Hope things get better for you.

  • CW

    Surgery sounds pretty drastic - maybe a second opinion wouldn't hurt? Prior to anything drastic get your physio to tape it up (either shave your leg first or make sure they put some protective gauze round it first) and see if that helps to ease it but you do need to maybe watch what you do as even walking/driving might be continuing to add stress.

  • Thanks all,

     off to the physio next week so will see what happens. It hasnt really got any better when I've tried a gentle jog. My internet research (I know it needs a pinch of salt) suggests that surgery is the only real cure - BUT - it needs to be diagnosed with pressure testing first.


  • I have also been advised that I will probably need the operation, but will have to have the test to confirm the diagnosis. 

    The op is available on the nhs, however my local Hospital Trust do not have the equipment to perform the test and I am struggling to find an nhs hospital that does. 

    I have been quoted £500 with consultant fees and the test to have it done privately at a Sports Injury Clinic.

     Does anyone know of a Hospital that might be able to provide the test on the nhs?  My consultant has not been able to give me any information on this.  I live near Reading.

  • I had this problem a few years ago, affected one leg more than the other. Went to sports physio got massage and ultrasound and instructed on one basic stretch. I religiousltydid this stretch 3 times a day and managed to control the symptoms and allowed me to train for marathons, so would recommend that rather than surgery, but you need to be committed to doing the stretching. Interestingly I have tried (and failed) to change my running style to land more on my forefoot as I a land on my heels, when I do this the anterior muscle pain goes away!
  • I have had this issue for near on 3 years, Thought it was Shin Splints went to a sports physio and she said it was chronic CS. She said no amount of rest, massage, physio was going to cure it.  In between that I have had knee operation which meant 3 months of no Running or Netball. As soon as I went back it was back.

    Anyway finally got my GP to refer me to my consultant which happens to be my knee surgeon and is an Army Doctor. Whilst in for another knee op last september the rest of the people on the list were CS people having ops. All of them were army peeps.

    Anyway finally got an appointment last week with my consultants registrar who said they have never come across a civvie with CS before and that there is no testing at my local hospital (frimley Park) and that all army people come straight from the medical centre after testing. They are going to write to the army centre to see if they will do the compression test for me and then my surgeon can operate.

    Guv23 - Did you find anywhere else to do the test? if the army won't test I will be in the same position as you and near enough in the same area.

    Good luck to anyone who has this, it is the most painful, soul destroying injury ever. Even doing aerobics brings the pain on. I am so fed up with it and I just want to be pain free. I have been picked for a very good netball team and the training is causing me problems and I hate it and as soon as it is fixed il be a very happy bunny.

    If you think you may have it get it sorted, see a sports physio and then get your gp to refer you and just chase it. No amount of massage, straping, resting is going to get rid of it.

  • one of the guys who works with me had serious CS many years ago in both legs - at the time he was a quick competitive triathlete (sub 2:15 classic) but in the end had to resort to surgery (his scars are impressive!) and packed in triathlon and took up kitesurfing as it was too painful to run after surgery, partly due to tissue scarring....

    as time has gone by, the problem has eased and he's been running again for a little while and finally managed to get racing again at a duathlon in December (came 13th!). he doesn't want to get into too much running again but is happy to be back doing something competitive

  • Just in case anyones interested, I've seen a consultant who has referred me to phsio. I've got until Oct, and if its not better then its chopping time!

    Really impressed with the physio, looked at other muscle groups in my legs to see if they're contributing, so I've got a set of exercises and stretches, will have to see how things go.

  • Weird, just got an email to say this had been posted in.

    Im having my deep posteriors released tomorrow!! to say im nervous is an understatement! I have had this pain for near on 4 years and do you know what in the last few months its not as painful as it was lol but im still getting some pain.

    Anyhow since my last post 3 posts up, i saw my consultant who sent me for a bone scan, when the results came back he agreed that there was enough evidence on the scan and with my description of the pain, he was more then satisfied to operate without the pressure test, which I would of had to pay for and also the muscle compartment its in the pressure test is not always accurate.

    So role on next year when hopefully i can start running races again! Im also looking at traithlons as well as I have been doing a lot cycling/spinning and swimming since this problem.

    Anyone know what sort of time frame after the op i will be back on my feet and possibly running/jogging again? Ive been doing what I can to be extra fit before the op so hopefully its wont take me much to get back into it again.  

  • Hey

    Just got to this from a google search -been a member on here for ages but have only just found out about CS.  Had chronic pain in my calves for ever - been running for 20 years - just assumed that it was bad running style, not enough stretching etc - but now thinking of getting this investigated - consultant-wise.  I always put it down to scar tissue from cramps I had when I was a teenager.

     ninab100 - did the surgery go OK (fingers crossed)? 

     Can anyone else give more info? I've found this and a couple of other bits:

    I've googled a couple of people - the guy mentioned above at the London Nat Padhiar comes up as doing pressure tests for this.

    Any advice gratefully received...

  • Hey Chris

    I had surgery last year and although the pain got a lot less I was still having pains in the outer shin area when I started running again!! So in August this year I had the anterior compartments released and so far so good. I have done some running and gone back to Netball, even done some body combact and step classes which I couldnt do before. I am really happy with the results so far.

    After care is so imporatant, I ended up going private for physio as the NHS one I had was useless!! I also massaged the scars as soon as the scar started healing and they are nice and soft now hopefully the color will fade soon as not looking very attractive in a netball skirt!!!

    Anterior was alot quicker to recover from then the Deep posterior. The bruising on the Deep posterior was immense! I was still on crutches after 3 weeks. The Anterior ones I was walking on within a day and the bruising was nowhere near as bad. (I have lovely pics if you wish to see!!)

    Good luck, I hope you get it sorted out, any other advise you need just let me know image


  • Nina

    Thanks!  Glad to hear it's helped and you're managing stuff again.

    I've got an appointment with a consultant for next week - with this chap in London.  I'll keep posting as to how it's going and whether this is the issue - I could just be reading too many internet articles about it!

    3 weeks on crutches sounds... a bit tricky... image


  • I was diagnosed with compartment syndrome a couple of years ago, although no where near as bad as you two seem to have had it.  As soon as I was diagnosed by a local physio I booked into a consultant at the local private hospital (lucky to have private health insurance). 

    My problem was relatively mild and I was at first prescribed orthotics and to try a different type of trainer.  Neither of these worked and in fact caused me more problems with my knees.  I read about it on the net and found an article (sorry but cannot remember where) that advised trying a different running style.

    It took my a few weeks of short slow runs but I started running more upright with my hips further forward.  Virtually immediately, it relieved the pressure and I was able to run as normal again.  If I am racing, I can sometimes fall back into my old style and get slight pain, but this goes after a couple of days.

    As for the massaging I can recommend a golf ball to get between the bone and muscle.  It is also better if you can get the other half to do it as it can hurt and often other people will be harder than you can do it yourself.

    Good luck

  • Thanks for the info Martin - I've used a baseball(!) for massage for a while, and worked on my running style so I'm more of a forefoot striker.  It's helped a bit. 

     I think catching it early and gettign it investigted is the right thing - really glad it worked for you.  Looking back I've had this for quite a while - but it's only become an issue as I've started to move up to marathons and take things a little more seriously.

  • Hi, only just seen this.  I had the ACS op about 15 years ago, following pressure tests.  The consultant was Mr Padhiar and I think that at that time I was something of a guinea pig (he was doing his thesis I think).  Op was successful though follow up was a patchy to say the least - as suggested in previous posts, massage the scar tissue as soon as it appears.  The op was on the NHS at the Royal Free (I think it was) in Whitechapel.

     Prognosis was generally good but as with any traumatic intervention the law of unintended consequences can apply.  Easing the front has meant shins generally work fine (bar effects of scar tissue - two three inch incisions each shin) but calves can sometimes feel the strain.

     Following the op I successfully completed very intensive training and only recently had to slow down, following the time it took to diagnose the need for arthroscopy on my knee (extremely successful, again on NHS).

  • Thanks Chris - good to know it was successful.  Will keep posting.
  • Hi

    So I saw a specialist - it turns out that my chronic calf pain is not CCS - it's more likely actually related to back problems and a couple of issues with discs in the L area of my back.  It's called radicular pain, which is similar to sciatica.

     Upshot is that I've been prescribed a course of physio to strengthen my back muscles, so they can hopefully take some of the load off my spine and stop or reduce the nerve impingement.

     So, hopefully there is some solution, although the physio has cautioned that I might not get back to a full training programme. 

    thanks for the advice in the previous posts.


  • Good to know there are people who recover from this... I'm feeling a little terrified at the moment! I've had chronic CS in both legs for the last 6 months, starting with shin splints, which has developed into this. Haven't been able to run this entire time, used to be able to use the cross trainer instead, but even that is now giving me pain within a few minutes.

    Only just realised that this is what my condition is, should be getting tested next week and hopefully will be making progress from there (after several poor diagnoses, including a Vitamin D deficiency and RSI in my legs!), but am petrified about the prospect of surgery (I keep hoping that this time has just been a dream, that I'll wake up tomorrow and trot out an 8-miler... instead I get tight and bruised legs from 15 slow minutes on the bikes..!).

    One, because I'm in the middle of a really important and intensive work year, so I can't really afford time out and can't afford to let my work suffer -  how have people dealt with this; there must be weeks you can't do anything in? Two, because of the prospect something might go wrong - presumably everyone on this forum gets a buzz from sport - how do you cope with the prospect of not being able to do it? Three, recovery from surgery sounds awful - I know it sounds crazy, but the idea of not being able to do ANY exercise for three weeks is terrifying. Also, do most people have surgery on both legs; and if so, can you still use crutches?! 

     But the longer I don't get surgery for, the worse it seems to be getting.. the sane person in me knows that I have to just sit at home and stop aggravating my legs, but somehow, I feel like an alchoholic staring at a bottle of vodka the entire time!

     Any advice/tips would be so helpful. Apologies if this seems quite rambly - I think it's only just hit me that my CS is not going to get better with massage and stretching, so am having a bit of a meltdown!

    Thanks image

  • Hi Shrimpy

    I'm the one who thought he had CS and then didn't - got this back problem with nerve impingement giving me leg pain, mainly in my calves.  I wanted to say something reassuring about your situation.

    I've run most every week of my adult life (not quite every, but lots more than not).  I'm not running now, and am OK with it.  A bit of swimming a bit of weights in the gym (very low weights, lots of reps, a bit like running), and this physio. 

    I love my running and look at this as a temporary hitch, something to get through before I come back an even better runner.  It's an excuse to NOT spend my time running and get in the stretching and cross traiining that I never quite get around to when I'm clocking the miles. But I do miss the miles - although it's good to be in less pain all the time.

    I don't deny it's tough - my physio has said that Marathons might be beyond me from now on (a major blow as I've set myself a specific marathon target).  So, I'm thinking "I might be able to, he's not said definately not" and if not then I might change goals and start doing short distance triathlons.

    From what I read about CS before I got my diagnosis, most people recover, and if you are young, then there's every chance.  Keep your chin up, you'll work something out.

    Good luck, I've got my fingers crossed.


  • Thanks Chris for the support, much much appreciated! Will let you know how this thing progresses...will put my "positive thinking" hat on! Best of luck for you too - start with the 10Ks and see where it goes!
  • Does anyone know where the nearest place to Newcastle is for compartment testing? My condition is leaving me absolutely devastated as I can only walk or stand for about ten mins before my symptoms start to kick in. I can barely make the journey to work, I cant go to clubs, bars or even shopping round town, and Im not even walking up and down stairs so I have no form of exercise.

     My symptoms start of with an ache, then my leg becomes tighter, then when its really severe it weakens to the point where I can barely stand as it spreads up my whole leg. When my sysmptoms are bad my injured foot  feels colder than my other, although this is purely internal. Ive not responded to physio (massage and accupuncture).

     Ive had a trapped nerve and stress fracture ruled out. My condition started when I did a 62 mile walk and before that I ran a marathon, and since then Ive been completely crippled ever since.

     Does anyone know how much the testing costs private, and if I take a trip to London will I actually be able to walk after the pressure testing? My consultant said that the compartments I seem to be pointing to as the cause of my pain is a very unusual combination. I dont think he can treat me as he wants to refer me to someone in Leicester but then Im in for NHS waiting lists.

     Also when youve gone private how long has it taken from test result to getting your operation?

  • Can't believe I started this nearly 4 years ago!

    Had the op just under a week ago, and it's been better that I thought. Bruised and painful, but I'm walking without any crutches.

    Pretty pleased,but haven't really hadmuch adviceon post-op recovery. Anyone who's had the surgery got any advice on exercises I can try and when I'd be OK to try running?



  • You suregon should advise. Sooner the better, get gently running by 2 weeks for sure, you don't want the compartments to scar up tight.

  • Thanks, surgeon didn't say much at the time. Two weeks is up next week so will have a go then I guess.

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