I guess it’s a good sign that I rarely think or talk about compartment syndrome anymore. What used to dominate my running life is now relegated to the occasional ache in my mostly-faded scars. Holly brought me back recently, though, asking a question about my symptoms before surgery on my very first post. I wrote her a reply there, then realized it probably warranted a post of its own. So for Holly:
Now that I’ve had quite a few years of living with Compartment Syndrome, training with other athletes with CS and coaching high school girls with CS, all I can conclude is that the biggest challenge with CS is diagnosis. I didn’t have pain, I had horrible fullness, drop foot and a burning sensation. Some days, I could go 30 minutes without pain. Some days I couldn’t make it 5. Another friend had the weakness sensation that you describe and an inexplicable drop in performance, but no pain. Another had excruciating pain. And the lack of hardness could simply mean that your anterior and lateral compartments (easy to palpate) are not affected, but your superior and deep calf compartments could be…the point is, it’s really hard to diagnose CS unless you have the puncture test.
I will tell you that the first time I got aggressive about handling my symptoms, I balked after a spinal puncture was suggested as my next diagnostic step. The surgeon with whom I was working didn’t feel that he had enough of a definitive diagnosis and I had already undergone a nerve conduction study, EMG and Stryker test, all of which are extremely painful. The risks of that procedure outweighed the benefits for me at the time, I stopped running for a while and got another year out of my calf. My second surgeon was much more aggressive, had seen more CS and helped me make the good choice to go through with the fasciotomy even though I didn’t have the classic clinical symptom of pain. My recovery took a long time and my surgery side still bothers me, but now over two years out from surgery, I’ve had a full return to sport.
Hindsight being what it is, I wish I’d advocated for myself more starting in high school and certainly by college. I had a lot of non-specific lower leg pain that prevented me from performing at a level consistent with my fitness and talent and spent many years in chronic discomfort. Surgery was difficult for me; I didn’t handle the anesthesia well, I developed a blood clot and my recovery was long. That said, I’m exceedingly happy with the results and if I were to develop symptoms in my right leg, I wouldn’t hesitate to do it again.
Hope this helps…