Chronic Exertional Compartment Syndrome

Ever since high school soccer season started this spring, Hadrian has been having excruciating pain in her lower legs. I kept listening to her compaints, and kept thinking hhhmmmm. Ok, Hadrian. I took her seriously, but at the same time, I am thinking these are some really weird symptoms you are having! I was hoping her legs might just heal on their own. You know, one of those miracle cures where it just suddenly all feels better! The sports trainer at school has been working with her. She has been getting stretched, and pulled, and massaged, and taped and iced all through the day at school. All by our young, amazingly cute, sports trainer. It has been making me wonder if she wasn't somehow enjoying this pain!? : )

But, watching her play soccer has just about been too much for me. Grayson was playing Parkview (biggest game of our season!) and Hadrian played so hard - all the while dying!! I could tell every single minute of the game was pure torture because her legs were hurting so very badly, but she played right through the pain. And, she played amazingly well. What a girl! I love her for being such a trooper!!

Well, we had an appointment scheduled yesterday with the sports doctor. The PA first came in and checked her out, and he said he had seen this problem only once before in a girl who had sickle cell anemia. And, since Hadrian doesn't have sickle cell anemia, he wasn't sure if he was correct with his diagnosis, so he went to get the real doctor.

Well, Dr. Traub agreed with the PA, but he wanted to test Hadrian. She had to run until the pain started (which took all of 2 minutes), and then he checked her again. He said her legs were so swollen on the inside after two minutes of running that there was no doubt in his mind that she has the dreaded compartment syndrome. Usually, making this diagnosis is very difficult. It usually takes test after test after test, and they usually stick needles with measuring instruments in your legs to check the pressure in the compartments. But, Hadrian didn't need any of the tests! The reason this is so hard to diagnose is because the legs look perfectly normal on the outside but they swell on the inside. But, it is good we got a definitive diagnosis immediately so we know what we are dealing with here.

Since this is such an uncommon condition, let me explain. Muscles are enclosed within a tight tissue called a fascia. Normally, the fascia has enough extra room to allow the muscle to function without a problem. With Hadrian, her fascia is too tight, and it constricts the muscle during activity. This stops the blood flow to the muscle. The lack of blood flow causes ischemia which is the same phenomenon as a heart attack. So, just as a heart attack causes chest pain, this lack of blood flow in the legs causes severe leg pain.

So, Hadrian has to completely rest her legs for six weeks while taking anti-inflammatories. We will see if this helps. If not, we move on to surgery which is called a fasciotomy. Dr. Traub thinks he has performed two of these in his entire 14 year career. Seriously?!

Well, there is never a dull moment around our house. Always something happening, or in this case, not happening. No soccer for six weeks?! What will we do?!