Lateral Compartment Syndrome

A muscle compartment is a well-defined region that contains a group of muscles within a particular segment of the body.  The lower leg is divided into four compartments by a layer of separating fascia. This fascia is tough and inelastic and serves to hold the muscle, nerves and blood vessels together.

Muscle compartments of the lower leg

Fascial compartments of the lower leg

The lateral compartment, as the name suggests, is located on the outer side of the lower leg; it contains the two peroneus muscles (brevis and longus). These muscles effect eversion and bending of the foot.

Muscles of the lower leg

Any condition that leads to increased pressure within the closed compartment space compresses the local blood vessels, compromising the blood supply to the muscles and nerves within the compartment. If the rise in pressure is very rapid, it may lead to nerve and muscle tissue damage and if it is slow in progression (chronic), it gives rise to certain symptoms. This whole phenomenon is termed as Compartment Syndrome.

Cause:

An increase in pressure inside the fascial compartment may result from an increase in the compartment tissue substance; the non-resilient fascia does not accommodate the increase in size, thereby causing a build-up in pressure. This increase in compartment substance may occur due to:

  • Acute injury leading to pooling of blood and inflammatory fluid (Acute compartment syndrome)
  • Over-exertion of the muscles, leading to increased pressure inside the compartment (Chronic Exertional Compartment Syndrome); muscle hypertrophy (increase in muscle size due to exercise) may be a factor

Lateral compartment syndrome rarely occurs in isolation, and is usually seen when multiple compartments are involved. Scarring of the surrounding fascia, unconditioned hypertonic muscles and postural abnormalities increase the risk of developing compartment syndrome.

Symptoms:

  • There is pain and a feeling of pressure on the lateral side of lower leg.
  • Pain is usually severe and there may be associated tenderness and swelling.
  • The skin overlying the swollen leg appears pale, shiny and stretched.
  • Pain is aggravated by activity.
  • Numbness in the extremities, there may also be parasthesia (burning or tingling) due to nerve compression.

Diagnosis:

Diagnosis is usually carried out by combining presenting signs and symptoms with the results of other investigations. X-rays or CT scans help to reveal bone fractures and soft tissue injuries, as well as ruling out other conditions. A simple apparatus may be used to measure the pressure within the compartment.

Treatment:

Rest is the key to successful healing. However, if there is an injury and the condition is clearly acute, then immediate surgical intervention is required.

Surgical treatment includes making cuts in the surrounding fascia to decompress the tissues within the compartment. This procedure is termed fasciotomy. In severe cases, the wound may be left open for drainage. The closure is accomplished in a second surgical procedure about two to three days later.

Acute cases of lateral compartment syndrome may be treated by means of a fasciotomy

Fasciotomy for Lateral Compartment Syndrome (second from right)

A conservative approach is quite effective in chronic cases. The RICE regime works well. Avoid any activity that leads to pain and use painkillers, if required. Stretching exercises help loosen stiff muscles and should be carried out in the healing phase, but care should be taken not to stretch to a painful limit.

Massage of the affected leg and correction of any postural or biomechanical irregularities aids in healing.

Orthotics that will help to treat lateral compartment syndrome can be found below.




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THE KEY STEPS TO GETTING THE RIGHT SIZE DOCPODS:

FULL LENGTH INSOLES 

NON FULL LENGTH INSOLES 

1. Measure your existing shoe insole:

 1. Measure from your heel to ball of foot:


 

2. Then compare your measurements from above to match the product size charts below:
(you can trim to fit the insoles by approximately 1cm)


Docpods Regular Size Guide - for Slimline, 3 Quarter, Sports


  US UK EURO SLIMLINE 3 QUARTER  SPORTS 
Size  cm cm cm
Small  4-7  4-8  3-6.5  4-7.5  35-40 16  16.3  25.8
Medium  7-9   8-10  6-9  7-10  39-43  17.4 17.2  27.4
Large   9-13  10-14  8-12  9-13  42-47 19.3   18.2 29.4

Docpods Ultra Size Guide - for Ultra Soft

  XXS XS S M L XL
EURO  34  35.5-37.5  38-40  40.5-42  42.5-44  44.5-46.5
UK  2.5  3-4.5  5-6.5  7-8  8.5-9.5  10-12
US MENS  4-5  5.5-6  6.5-7.5  8-9  9.5-10.5  11-13.5
US WOMENS  3.5-5  5.5-7  7.5-9  9.5-10.5  11-12  13-14
LENGTH (cm) 23.2cm 24.9cm 26.2cm 28.8cm 30cm  31.2cm

Docpods Kids Size Guide - for Docpods Kids Fit only

  Size SPORTS  SLIMLINE
XXS 12-1  19.5cm 13cm 
XS 2-3 22.4cm  15.3cm 

Docpods Foot Pillow - Trim to Fit

  S L
US MENS  4.5 - 9  9 - 13
US WOMENS  6 - 10  10 - 14
LENGTH (cm) 26.5cm 29.2cm