Anterior Compartment Syndrome
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Transcript Anterior Compartment Syndrome
Anterior Compartment
Syndrome
By Marie and Molly
History
20 year old female soccer player
Midfield Position
During one of the last practice sessions of
the season was kicked in the shin by
another player
Athlete was not wearing shin guards
Signs and Symptoms
Pt. c/o pn w/passive plantar flexion
Pn along ant. Aspect of lower leg
Palpation reveals hardness and tension
w/soft tissue
Shiny or pallor skin
Distal pulse diminished
Numbness and tingling radiating to toes
Diagnosis
Pt. has Anterior Compartment Syndrome
What is it?
– There are 4 compartments in the lower leg
– Each compartment holds fascia and muscle
– Pressure becomes too great and there is no
room for expansion
– Vascular structures and neural structures can
be damaged
– Anterior compartment most commonly injured
Treatment
Surgery must be performed
A fasciotomy is performed to release
pressure in the compartment
95% success rate
Treatment
Muscles invloved
– Tibiallis Ant.
– Ext. digitorum lungus
– Ext. hallicus lungus
Surgery
injection
Close up of cross
section
Fascial release
Cut distally
Release of peroneal
nerve
Surgery Cont.
Treatment Post Op
Must be place on crutches w/non-weight
bearing for 7-10 days
Friction massage by incision for soft-tissue
mobility
Gait training
NSAIDS
Goals for Post-Op
Full ROM
Biking/Swimming 2-4 weeks
– Swimming when wound heals
Jogging at 4-6 weeks
Sports participation 6-8 weeks
– Athlete should be able to run 2-3 miles pn
free before returning to play
Modalities
Milk Massage
Myofascial release
– Release scar tissue
Ice Bag/slush bucket
Heat
– Start 3rd week
Week 1
Non-weight bearing
Check wound dressing daily
Week 2
Partial weight-bearing
– 2 point gait
Isometric exercises
– Inversion
– Eversion
– Planter flexion
– Dorsiflexion
Toe Exercises
– Towel rolls
Week 2 cont.
Alphabet
Weight-scale exercise
Stretching
– Gastroc stretch
– Soleus stretch
– Achilles stretch
– Dorsiflex stretch
Week 3/4
Arm Bike/Elliptical
Gait training
POOL
– Single leg stance
– Grapevine
– Step ups
– Gastro/soleus stretch
– Heel raises
Week 3/4 Cont.
Ankle Walking
Double knee bend
Seated knee extension
Team core work-out
Week 5/6
Underwater treadmill
BAPS board
– Two legs
Closed kinetic chain
– 4 Lunges
– Squats both legs
– Leg presses
Week 5/6
– Terminal knee ext.
– Heel raises
Lower leg and foot stretches
Rubber Tubing
– Inversion/eversion
– Plantar/dorsiflexion
Week 7/8
Warm up walking on treadmill
Stair climber
Treadmill jogging ½ mile to 1 mile
Lower leg stretches
BAPS board
– One leg
4 Lunges w/tubing
Leg press
– More weight
Week 7/8 cont.
Heel raises
Tubing exercises w/increase resistances
Lunges w/tubing
Week 9/10
Running on the field
Swimming
Box jumping
Dot drills
Long/short passing
Ball Juggling
Backwards running w/ball kicking
Z-lines w/ball
Corner Kick drills
Week 9/10
During last week they must pass
functional tests before moving to
functional exercises
Must be pain free
Functional exercise
– Scrimmage
Practice
Return to play w/shin guards
Athlete may participate in:
– Upper Extremity Weight Lifting
– Practice drills as tolerated w/lower ext.
– Any upper extremity drills
– Core work outs
Considerations
Watch for:
– Increase swelling
– Increase pain
– Numbness or tingling
If any apply, modify the rehab
Everything is as tolerated
– May need to continue rehab longer than
expected