Compartment Syndrome

Four months ago I was rolling around in a wheelchair and now I am about to go spend 100+ days climbing, hiking, and cycling. I suppose I can see the confusion.

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Long story short: I had too much pressure in my calves. When my muscle would expand during exercise, there was no room for the nerves or blood flow to proceed so everything from my calf down would go numb and would lock up. I tried a bunch of things that didn’t help so I had to get surgery, I am now recovering.

But, if you care to know more I will explain what happened from start to finish. (sort of)

One year ago I was training for a half marathon. With only a couple of weeks until the race I was basically ready. I had been doing a lot of hill workouts and wasn’t very smart with letting my body rest (okay, I had procrastinated the whole starting to train thing so I was in quick training mode…). One day when I headed out on a run I hadn’t even gotten a mile from my house when my calves locked up. I didn’t even think I was going to be able to walk home. Eventually I made it back to my house and assumed it was some sort of shin splint injury. This continued to happen when I would exercise and my calves would swell and lock up. Eventually I decided I should see a professional who could tell me what was going on.

Needless to say I didn’t run the half marathon.

I went to see Dr. Amrine at Missoula Bone and Joint. He basically said that the description of what was going on sounded like compartment syndrome but that we should try a couple of other things before doing the pressure test (because the pressure test was going to suck). For the next two months I took a break from running all together and was advised to stay away the activities I was doing when the pain began. This was in February.

In April of 2015 I went back to see him and nothing had improved. I was still in horrible pain and we scheduled the pressure test. This was fairly unpleasant. Essentially, he stuck a very large needle into my each leg in two places and into two levels of the muscle. First near the surface, then into the deepest part of the compartment (the middle of my muscle) Also quick note: they are unable to numb the muscle so you feel every piece of the needle, lots of fun. After reading the pressure I then had to run on a treadmill until I felt the pain I would usually get and he re-stuck the needle into the same places before, checking the pressure again.

A normal pressure reading would be less than 15 and mine were 50 to 70+. They recommend surgery anywhere between 20 and 30, so yeah, I guess you could say that my legs were pretty bad. Chronic Exertional Compartment Syndrome it was, no question.

Chronic Exertional Compartment Syndrome is characterized by an exercise-induced pain that is relieved with rest.

We had to have the discussion as to whether we should perform the surgery or try to see if time and PT would help at all. I was about to leave for my internship in Portland, Oregon and there was no way I could start that in a wheelchair so I decided to wait. I again was advised not to run and to do light biking throughout the summer along with PT each week. (no hiking, not sure how I survived) When the summer came to an end I was still in just as much pain and we proceeded with the surgery.

I received a fasciotomy on both legs in which the surgeon, Dr. Jarrett, slit both sides of each calf into the fascia to release all the compartments. The idea is that this will create more space and relieve the pressure, which will hopefully allow me to return to normal exercise this year. While performing the surgery Dr. Jarrett said my nerves were unusual and if he wouldn’t have done the second slit, which many surgeons don’t, he would have cut the main nerve in my leg leaving my foot without any feeling. So, THANKS DR. JARRETT for keeping my leg alive.

This is where the wheelchair comes into play. I was in a wheelchair for three weeks and crutches for two at the beginning of my recovery. (thank you everyone – mom especially, who pushed me around campus and played taxi for me.) As far as the rest of my recovery, I have been moving at a faster rate than normal. Within a month I was biking and a month and half I was back to climbing. Two and a half months post-op I was able to get back on my feet and although it is still pretty tough to run I am slowly easing back into it.

I should be good to go in terms of hiking for my trip although I haven’t been able to summit any peaks since the summer of 2014. The main telling point will be six months post-op in terms of the success of the surgery. I am looking forward to testing out my new legs and cannot wait to get back to get back on the mountains.

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