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Pain commonly disguised: Bruising, Shin Splints or Compartment Syndrome

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by: Peter Fuller (September 2014)
Do you have pain in your lower legs? Sometimes it feels like shin splints; other times more like a badly bruised muscle or deep bruising. Whatever it is, it seems like it is taking longer than it should to heal; and it is beginning to concern you.

You are dedicated and consistent. You try your best to pay attention to your body, eat right, get enough sleep and put in the time training so you can perform well. However, at this stage, you seem to be modifying cross training more often than doing prescribed workouts. You question whether to allow the pain to interrupt your intense training regimen and constantly evaluate whether you push through, train hard, and continue to place high load demands on your body. Do you need to take more active recovery days? Can you afford to take some time off from training and competition?

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Bruising is typically not alarming. People often get bruises when they bump into something or when something bumps into them. Bruises can occur in some people who exercise vigorously, such as athletes and weight lifters. These bruises result from microscopic tears in blood vessels under the skin. Often this can be alleviated with self-therapy and/or stretching and heal given enough recuperation time. It not, you may be thinking, perhaps it might be something more; like Shin Splints.

Shin splints are very common. Runners might get them after ramping up their workout intensity, or changing the surface they run on – like shifting from a dirt path to asphalt. Shin splints are also common in dancers.

Your shins throb and ache after your daily run or engaging in a quick sprint without any stretching or warm-up. For example: just sprinting to catch the bus. It could be shin splints.

They can be caused by:

  • Irritated and swollen muscles, often from overuse
  • Stress fractures, which are tiny breaks in the lower leg bones
  • Over pronation or ”flat feet” — when the impact of a step makes your foot’s arch collapse

What if adequate rest does not seem to give you what your body needs to heal?  Often people unsuccessfully attempt to resolve shin splints on their own.  You already tried arch supports, shoes that fit you properly, neoprene sleeve and anti-inflammatory pain killer/medicines.  They have had questionable results for relieving symptoms.  What is next?  It may also be you are suffering from something else altogether; Compartment syndrome.

Compartment syndrome is a painful condition that occurs when pressure within the muscles builds up inside an enclosed space in the body.  This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.

Compartment Syndrome
The dangerously high pressure in compartment syndrome impedes the flow of blood to and from the affected tissues.  Groups of organs or muscles are organized into areas called compartments.  Strong webs of connective tissue called fascia form the walls of these compartments.

Compartment syndrome develops when swelling or bleeding occurs within a compartment.  As a result, the fascia does not stretch or easily expand; this can cause increased pressure on the capillaries, nerves, and muscles in the compartment.  Blood flow to muscle and nerve cells is disrupted.  Without a steady supply of oxygen and nutrients, nerve and muscle cells can be damaged.

In acute compartment syndrome, unless the pressure is relieved quickly, permanent disability and tissue death may result.  This does not usually happen in chronic (exertional) compartment syndrome.

Go to an emergency room immediately if there is concern about “acute” compartment syndrome. This is a medical emergency.

Compartment syndrome (Exertional compartment syndrome) most often occurs in the anterior (front) compartment of the lower leg (calf).  It can also occur in other compartments in the leg, as well as in the arms, hands, feet, and buttocks.

Acute compartment syndrome can also occur after injuries without bone fractures, including: overly tight bandaging, prolonged compression of a limb during a period of unconsciousness, extremely vigorous exercise, especially eccentric movements (extension under pressure). Taking anabolic steroids can also contribute to developing compartment syndrome.

Your symptoms may subside if you avoid the activity that caused the condition.  Cross-training with low-impact (Range of Motion) activities may be an option.  Some athletes have symptoms that are worse on certain surfaces (concrete vs. running track, or artificial turf vs. grass).   Symptoms may be relieved by switching surfaces.

Do you push yourself hard in training?  Perhaps you know of someone struggling with pain.  Please do not let pain linger on for weeks, months, years, or decades.  If left alone, things do not typically get better; actually they tend to get progressively worse.  It is important to stay alert, pay attention to your body and invest in regular manual therapy.  It will help keep you moving well and your lymphatic system flowing optimally.

We hope you will consider giving Complete Health Fitness a call.  We would be happy to provide therapy to you and assist you.

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