Compartment Syndrome

Corkie to Compartment Syndrome

How the wrong treatment of a simple “corkie” can lead to a much more serious problem- Compartment Syndrome

A simple hit to the leg is often referred to as a ‘corkie’ or a contusion. The standard treatment of RICE (rest, ice, compression, elevation) and no HARM (heat, alcohol, running, massage) should always be followed for the first 3 days.

If heat is applied early after the injury then increased bleeding can occur around the area of the injury causing increased swelling and pain. If this occurs in areas where the body has difficulty coping with the extra fluid,  then the pressure can increase and a condition called compartment syndrome can develop. This is characterised by extreme pain, possible loss of sensation and a very swollen and distended area. The simple ‘corkie’ can turn into an extreme medical situation requiring immediate urgent attention and sometimes even surgery to relieve the pressure (decompression).

There is also the possibility of chronic compartment syndrome where pressure can gradually build up in an area with exercise.  Over time this can be quite painful and debilitating. Whilst this sometimes requires surgery to help long term, often treatment consisting of stretching and deep massage can help alleviate this condition.

I recently heard of a young footballer who had a “corkie” on the outside of his lower shin. In a time-span of just over 12 hours, he had intense pain, loss of sensation in his foot and he required emergency decompressive surgery to release the pressure in his leg. He subsequently lost some of the muscles in his lower leg and will have permanent muscle weakness in the area.  Where did his treatment go wrong? Heat and massage to “rub it out” contributed to an increase in bleeding in the area.

This example shows the importance of following the simple rules of early injury management – RICE and no HARM. As with all cases of unusual and worsening conditions, seeing a Doctor is always suggested with examples like this.

by Mark Nagel, Physiotherapist Adelaide Crows Sports Medicine Clinic