The effect of ankle position on intracompartmental pressures of the leg

Tsintzas, Dionysios; Ghosh, Subhajit; Maffulli, Nicola; King, John B.; Padhiar, Nat

doi:10.3944/aott.2009.042

Cited by 18 publications

(13 citation statements)

References 18 publications

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“…In the early 2000s, field observations also indicated that free-technique evolutions led to enhanced ankle dorsiflexion. Tsintzas et al [31] have reported in patients with CECS a significant increase in pressure of the anterior compartment of the lower leg during ankle dorsiflexion. In runners, where the prevalence of CECS is increased, several studies demonstrated that changing the running style in athletes with CECS could prevent the occurrence of symptoms [32][33][34][35].…”

Section: Ski Technique Likely Influences the Cecs Prevalencementioning

confidence: 97%

Features of Chronic Exertional Compartmental Syndrome of the Leg in Elite Nordic Skiers

et al. 2020

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This study aimed to assess prevalence and incidence of chronic exertional compartmental syndrome as well as functional outcomes after surgery in elite Nordic skiers. An exhaustive list of 294 elite Nordic skiers from the French national teams between 1994 and 2014 was analyzed through their individual medical files in order to identify cases of chronic exertional compartmental syndrome. Eighteen athletes had confirmed diagnosis and performed a structured interview to identify factors associated with chronic exertional compartmental syndrome and surgery outcomes. The prevalence was 6.1% and the incidence 13 per 1000 skier-years. Biathletes had a higher prevalence than cross-country skiers (OR=0.40, p=0.08). Free-technique skiing and roller-skiing were the main conditions inducing symptoms. All injured athletes had bilateral surgery and 94% of them reported no more or sporadic leg pain after. Almost 90% resumed competition at the same or higher level than prior surgery. Compare to previous studies, the incidence rate of chronic exertional compartmental syndrome is higher in French elite Nordic skiers. The higher prevalence in biathletes and the trigger during free-technique skiing suggest a contribution of this technique to this disease. This study also confirmed that surgery was an efficient therapeutic solution without compromising athletes’ career.

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Section: Ski Technique Likely Influences the Cecs Prevalencementioning

confidence: 97%

Features of Chronic Exertional Compartmental Syndrome of the Leg in Elite Nordic Skiers

et al. 2020

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“…This leads to a marked increase in the eccentric activity of the anterior structures of the lower leg, in particular the tibialis anterior muscle. 32 The running technique concept that was used in the studies by Diebal et al 12 , 13 focused on a forefoot strike pattern (ie, landing on the ball of foot) by applying shorter strides and a significantly increased step rate (180 steps per minute or more). These adaptations reduce ground reaction impact forces by minimizing ground contact time and vertical displacement, but, more important, they shift the eccentric loading of the anterior compartment musculature of the leg to the posterior lower leg structures such as the Achilles tendon and the gastrocnemius-soleus muscle complex.…”

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confidence: 99%

The Effectiveness of a 6-Week Intervention Program Aimed at Modifying Running Style in Patients With Chronic Exertional Compartment Syndrome

Helmhout

Diebal²,

Kaaden

et al. 2015

Orthopaedic Journal of Sports Medicine

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Background:Previous studies have reported on the promising effects of changing running style in patients with chronic exertional compartment syndrome (CECS) using a 6-week training program aimed at adopting a forefoot strike technique. This study expands that work by comparing a 6-week in-house, center-based run training program with a less extensive, supervised, home-based run training program (50% home training).Hypothesis:An alteration in running technique will lead to improvements in CECS complaints and running performance, with the less supervised program producing less dramatic results.Study Design:Cohort study; Level of evidence, 3.Methods:Nineteen patients with CECS were prospectively enrolled. Postrunning intracompartmental pressure (ICP), run performance, and self-reported questionnaires were taken for all patients at baseline and after 6 weeks of running intervention. Questionnaires were also taken from 14 patients (7 center-based, 6 home-based) 4 months posttreatment.Results:Significant improvement between preintervention and postintervention rates was found for running distance (43%), ICP values (36%), and scores on the questionnaires Single Assessment Numeric Evaluation (SANE; 36%), Lower Leg Outcome Survey (LLOS; 18%), and Patient Specific Complaints (PSC; 60%). The mean posttreatment score on the Global Rating of Change (GROC) was between +4 and +5 (“somewhat better” to “moderately better”). In 14 participants (74%), no elevation of pain was reported posttreatment, compared with 3 participants (16%) at baseline; in all these cases, the running test was aborted because of a lack of cardiorespiratory fitness. Self-reported scores continued to improve 4 months after the end of the intervention program, with mean improvement rates of 48% (SANE), 26% (LLOS), and 81% (PSC). The mean GROC score improved to +6 points (“a great deal better”).Conclusion:In 19 patients diagnosed with CECS, a 6-week forefoot running intervention performed in both a center-based and home-based training setting led to decreased postrunning lower leg ICP values, improved running performances, and self-assessed leg condition. The influence of training group was not statistically significant. Overall, this is a promising finding, taking into consideration the significantly reduced investments in time and resources needed for the home-based program.

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“… 7 Local arteriolar pressure has been shown to decrease by 0.78 mmHg for every cm of ankle elevation above the right atrium. 8 …”

Section: Discussionmentioning

confidence: 99%

Bilateral compartment syndrome of the lower limbs after urological surgery in the lithotomy position: a clinical case

et al. 2019

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Acute compartment syndrome of the lower extremities after urological surgery in the lithotomy position is a rare but potentially devastating clinical and medicolegal problem. We report the case of a 67-year-old male who underwent laparoscopic prostatectomy surgery to treat cancer, spending 180 minutes in surgery. Postoperatively, the patient developed acute compartment syndrome of both legs, needing emergency bilateral four-compartment fasciotomies, with repeated returns to the operating room for second-look procedures. The patient also exhibited delayed wound closure. He regained full function within 6 months, returning to unimpaired baseline activity levels. This report aims to highlight the importance of preoperative awareness of this severe complication which, in conjunction with early recognition and immediate surgical management, may mitigate long-term adverse sequelae and improve postoperative outcomes.

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The effect of ankle position on intracompartmental pressures of the leg

Abstract: Dorsiflexion of the ankle increases ICP significantly in both anterior and deep posterior compartments. The results of this study may have clinical implications for the conservative management of both CECS and tibial fractures.

Cited by 18 publications

References 18 publications

Features of Chronic Exertional Compartmental Syndrome of the Leg in Elite Nordic Skiers

Features of Chronic Exertional Compartmental Syndrome of the Leg in Elite Nordic Skiers

The Effectiveness of a 6-Week Intervention Program Aimed at Modifying Running Style in Patients With Chronic Exertional Compartment Syndrome

Bilateral compartment syndrome of the lower limbs after urological surgery in the lithotomy position: a clinical case

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