Health: Bilateral Chronic Exertional Compartment Syndrome

I’ve always played sports. I played basketball in grade school. I did track and field (sprinting and throwing) and baseball (both softball and fast pitch) from grade school through high school. I was a national-level wrestler. In my grown-up life, I played women’s full-contact football, I raced motorcycles, and now I play roller derby.

I’m pretty healthy- I mean, overall pretty healthy; however, I have a couple of issues with my body. One issue is bilateral chronic exertional compartment syndrome. CECS occurs  when your muscles are too big for the compartments they are in, and when they swell in the fascia during exercise, there is a huge amount nerve pressure causing burning, excruciating pain and drop foot (when you can’t really lift your toes).

For years I thought that I had shin splints because, well, whenever you talk about having lower leg issues, folks tend to tell you it’s just shin splints. CECS is a condition that  General Practitioners don’t seem to know much about. It took me researching my symptoms on the internet, and telling my doctor that I needed the testing done. My GP referred me to a Sports Physician, and he suspected it right away. Unfortunately, just discussing the symptoms isn’t enough to diagnose CECS.

I was sent to a radiologist to get an arterial doppler ultrasound performed on my legs to rule out any blood flow issues first. They went from groin (awkward!) to toes listing to the blood circulating through my legs. Thankfully that test went well, and everything is good in my pipes. The test to come would not prove as pain-free as the doppler.

In order to confirm CECS, you need to find the compartment pressure measurements both before, and after exercise, in all compartments. The super unfortunate part about that is that the pressure needs to be taken internally, in each compartment, twice. Freezing is injected into three (or four, depending on the approach of the physician) spots on each leg. Then, a pressure gauge is inserted into the skin, and through the fascia of each compartment. The resting pressure is recorded, then you exercise until you experience the worst symptoms you can handle. Then, the gauge is reinserted into each compartment and the measurements are recorded again.

My Sports Physician took my pressures, and they ranged from 20-47 resting, and 38-85 after exercise. He informed me that 60 is typically the magic number needed before requiring a fasciotomy. Also, a large number gap between the resting pressure and the post-exercise pressure measurements could be cause enough for alarm that a fasciotomy would be required. So, now I wait for a referral to a surgeon.

While I’m not looking forward to another surgery, I am happy that I finally know what’s wrong with my legs, and that I might be able to play roller derby without pain sometime soon!

2 Comments Add yours

  1. Sounds like while others get grief over it, you have no choice but to skip leg day.

    Like

    1. Chandelle says:

      In roller derby, every day is leg day!

      Like

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