??Compartment syndrome

I experience numbness in my left foot while running. It starts after approx. 30 minutes in my big toe, if I carry on running the numbness travels down the left side of my foot and eventually up over my ankle, resulting in a completely numb foot. I also experience pain in my lower calf, which can last for a few days after a run where my foot went numb (the more numb the foot gets, the more painfull the calf is). The numbness goes away quickly after stopping running, however my big toe and sometimes my foot can feel heavy/dead for a few days. I've seen an orthapeadic surgeon, who referred me for nerve conduction tests, which came back negative. I have been prescribed orthotics (very pronoted feet) however when I run while wearing them I experience lots of pain in the inner arch of my foot, and cannot run for longr than 1 mile before having to stop - again this also results in a very sore calf/achilles region, which is painfull for a few days ater a run.

I think that I may have a deep posterior chronic compartment syndrone, any advice or alternative ideas would be gratefully accepted.

[JainMD]

Hi,
I think your symptoms are close and matching chronic compartment syndrome. Do you know why it happens?
Compartment syndrome is Increase in tissue pressure within a limited space, compromising circulation and function of the contents of the space. Acute compartment syndrome is a limb-threatening emergency. Chronic (or exercise-induced or exertional) compartment syndrome usually is a self-limited symptomatic disorder.
The elevated tissue pressure causes decreased perfusion, which can lead to necrosis of tissues and nerves within the enclosed space, with resulting ischemic contracture, paresis, numbness, or loss of the involved limb.
Depending on the amount of muscle death (rhabdomyolysis), myoglobinuria, acute tubular necrosis, hyperkalemia, and kidney failure can occur.
Do you have any symptoms suggestive of kidney failure like puffiness of eyes, decreased urine output?
Have you ever been investigated for electrolyte imbalance?
Local blood flow does not meet metabolic demand of tissues, leading to necrosis in compartment syndrome.
Has the compartment pressure being examined for you? If yes, then what was your compartment pressure?
Compartment pressure of 40 mm Hg or within 30 mm Hg of the diastolic pressure requires surgical compartment decompression.
Chronic compartment syndrome shows increased tissue pressure at rest and/or prolonged elevation of pressure after exercise.
You should be evaluated with basic metabolic panel, look for hyperkalemia from muscle death, serial creatine phosphokinase if the clinician suspects substantial muscle death. You should also examine urine for myoglobinuria and hematocrit to monitor blood loss into thigh.
Keep me posted with your thoughts.
Bye.