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Chronic Exertional Compartment Syndrome: Case Study

Chronic Exertional Compartment Syndrome

   Chronic exertional compartment syndrome is a condition where exercise such as running causes numbness and tingling to the feet. It can be so severe and painful that the athlete cannot continue their exercises. Acute exertional compartment syndrome can be serious causing muscle necrosis (tissue death). This involves symptoms such as severe pain with lower leg swelling and muscle weakness that does not go away with a few minutes of rest. Go to the ER immediately, if you experience something similar to this. This patient is not an acute case but a stable chronic exertional compartment syndrome of the posterior compartment. It is a shame that I did not think to take pictures of the first week in which the feet were very pale or the skin was very white in color. Seeing such a big improvement in the second week, I had to make the patient stand and do 1 minute of calf raises to induce paleness in the skin. The normal capillary refill (return to pink skin) is after 10 seconds for the fingers or toes in general. Please read the disclaimer below and see a qualified healthcare professional for yourself. There is no certification for treating this condition in chiropractic school or with the instruments that I use so your local chiropractor may not know how to treat this.
   There are conditions in the arms & hands that I deal with in which some soft tissue such as a tight muscle or fascial restriction that impinges an artery or nerve. This patient happened to be a similar musculoskeletal related impingement for the legs based on the fast response, but it does not mean all cases of chronic exertional compartment syndrome can be treated in your case as compartment syndrome may not fully understood. The last picture seems to be an anomaly among the 10 pictures. I only remember being in a rush and skipping the picture after the calf raises. Overall, there is a general improvement in skin paleness immediately after 1 minute of calf raises which is very noticable & a general progression in improvement over the weeks which tells me that there must be a real change in circulation in the lower legs and feet.
 Compartment Syndrome: Before Treatment  Second Week: Before Treatment
 Compartment Syndrome: After Treatment  Second Week: After Treatment
 Compartment Syndrome: After Treatment  Second Week: After Treatment and After
 Calf Raises. A quick change in skin color.
 Compartment Syndrome: Before Treatment  Third Week: Before Treatment
 Compartment Syndrome: Before Treatment  Third Week: Before Treatment Immediately
 After Calf Raises
 Compartment Syndrome: Before Treatment  Third Week: Before Treatment, An
 Additional 10-20 Seconds After Calf Raises
 Before X-ray  Fourth Week: Before Treatment
 Before X-ray  Fourth Week: Before Treatment
 Immediately After Calf Raises. Very little
 change in skin color.
 Before X-ray  Fourth Week: Before Treatment, Another
 10-20 sec After Calf Raises. Quick return
 to normal skin color.
 Before X-ray  Fourth Week: After Treatment.
 Unfortunately, the picture taken seconds
 after lying down for a long period of time.

ChiroWorks Care Center
Anthony Tsai, D.C.
Chiropractor in San Jose, CA
Graston Technique Certified
FAKTR Certified

Disclaimer: The content in this blog is for informational purposes only and an opinion for specific individualized circumstances. It is not a prescription for therapy or diagnosis for you. All opinions expressed and any referenced articles are solely those of the particular author and do not necessarily represent the opinions of Anthony Tsai, Graston Technique®, its employees, providers or affiliates. Any opinions of the author on the site are or have been rendered based on scientific facts and/or anecdotal evidence, under certain conditions, and subject to certain assumptions, and may not and should not be used or relied upon for any other purpose, including but not limited to for use in or in connection with any legal proceeding. If there is any issue with the content or images on this blog, contact us an we will remove it immediately. Please refer to for more information.



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