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Compartment Pressure Syndrome in forearms

12:39:57 PM
Just wondering if anyone else out there has been unlucky enough to be
diagnosised with Compartment Pressure Syndrome in the forearms. I have been lead to believe by 3 experts that
it can be common umongst climbers, kayakers and maybe trades people who use their forearm muscles.

The surgeon I saw was pretty much trying to talk me out of surgery. Been dealing with
this pain in my mid-forearm on both arms for over a year, still hasn't gone away.
Pretty much at my wits end now, would just love to climb once more.
All thoughts and experiences would be greatly appreciated..

12:50:16 PM
If you are looking for some climber specific information about this, the book "One move too many" has a small section on compartment syndrome. I can dig it out if you want.

12:52:59 PM
That would be great if it is not to much hassle.....cheers.
2:03:58 PM
I was nearly convinced I had this in my calves after persistent problems a few years ago.

On consulting with an osteopath they were unable to rule this out although conceded it wasn't their speciality.

Fortunately I kept researching before seeing a surgeon. Eventually it transpired that a magnesium deficiency was the cause. Compartmental Syndrome is major surgery to rectify, be very sure that's the problem before taking on the cure.

2:17:56 PM
Dug the book out. Unfortunately, while it is covered, there's not heaps in it about this (2.5 pages with one of those being pictures). Summary of what's there:
Symptoms: Pain like your forearm is going to pop like you're really, really pumped but way too early in workout. Can last for extended periods.

Cause: Muscle fascia hasn't stretched to accommodate muscle growth, causes constriction and lack of blow flow. Lowered removal of lactic so burn can last days. Highly trained athletes can also experience this when infection disease has compromised immune system.

Diagnosis: Difficult. Intercompartmental pressure measurement must be taken while preforming the sport specific stress. To do this a small catheter is placed inside the muscle (with local) and the pressures measured before and after climbing. If pressure reaches a certain point and does not return to normal within a given amount of time, the diagnosis is proven.

[ Picture of pressure testing showing catheter in arm hooked up to display ]

Recommended therapy: Stress reduction, Stretching, Antiphlogistic drugs, massages and lymphatic system drainage, in severe cases, surgical procedure.

[ Photo of the author's forearms, one after compartment syndrome and surgery to repair it, the other never having had the problem. Visible bulge where muscle has been released through the fascia ]

4:42:54 PM
Thanks heaps aj,

I had a test done which confirmed the diagnosis. However, the way you have described the test is not entirely the same the way the doctor did my test and the ostepath I saw also was curious as to the method used to test the pressures. Which of course left me even more baffled, needless to say I am seeing another specialist surgeon for another opinion before jumping right into surgery. Plus I plan on seeing an OT and doing quite a bit of deep tissue massage to see if that helps for some time.
I definately agree with gfdonc,
"be very sure that's the problem before taking on the cure." good advice.

I guess my only real main concern is if this will get worse, I have read that the increased pressures can cause temporary or even permanent nerve damage. Not really what I need.

cheers all

6:09:07 PM
Apart from rest what have you tried to alleviate the symptoms?

Sarah Gara
9:17:28 PM
If it's anything like Anterior compartment syndrome in your legs the only thing that will cure it is either surgery to cut the fascia that holds the compartment and the muscle in place allowing the muscle to continue to grow. or loosing muscle and allowing the muscle to refit into the compartment it was supposed to fit in originally -before you got too strong and muscly. (i can't spell that word)

Anecdotally - my bro had Ant comp syndrome operated on earlier this year after 2years of pain and being unable to run and he is now back to full strength and no longer has a fat face - (he put on loads of weight not being able to run!)

The way they diagnose it (again I only know the legs0 is by inserting needles into the muscle and measuring the pressure at during exercise.

I hope for your sake it's not compartment pressure syndrome... good luck man x

8:44:30 AM
I have had extensive physio (lots of stretching and tai chi) and have had quortisone infusion patches on the effected area. This was when I thought it was RSI. Now that I believe it maybe CPS I have only really had some deep tissue therapy, the diagnosis was only made about 3 months ago. The MRI that I had showed no evidence of tendon sheath damage or any other abnormalities which is why my sports physician has lent towards CPS.

Once I am 100% convinced it is CPS than I guess I will see if other treatments work first, failing them I am booked in at the end of the month to see another specialist for a second opinion. This surgeon might not tell me that he needs to open up my forearm just to cut the fascia like the first surgeon I saw told me....

I may even get the test done again, this time not have needles inserted near my elbow to get the pressure reading, which is what puzzled the first surgeon I saw. hmmmmm.

I seriously hope it isn't CPS as well even though I am mentally prepared for the final diagnosis....thanks for the good luck wishes...cheers

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