Diagnosed with Compartment Syndrome - tests came back negative!

[nmarman]

Yeah NHS is unlikely to pay, results i have got over 1.5years have beengreat in people who had chronic conditions but no one has done any studies onthis as yet as therapy is so new. fficeffice" />>>

Get the right supplements, and rest! While heating in baths of Epson salts (magnesiumsulphate), 1kg: 1 bath, and 30 min soak. If you are near London I can helpotherwise check internet for shockwave practitioners you might even find shortwave therapy helpful.>>
Good luck

[tennislegs]

Nmarman,

''Yeah NHS is unlikely to pay, results i have got over 1.5years have beengreat in people who had chronic conditions but no one has done any studies onthis as yet as therapy is so new. fficeffice" />>>''

If this is so new, and there are no studies to support it's use with chronic conditions how do you justify using it and not using an evidence-based approrach to your clients?

pinkpussycat, I work for the military and see an awful lot of these symptoms in soldiers who do weighted, booted runs and fast marching. It sounds like no-one has ever really got a handle on your symptoms.

I would recommend seeing a podiatrist who specialises in biomechanics. If your feet are pronated (flat, but this nothing to do with arch height!!) and need correcting with some kind insole, it is unlikely that your symptoms will improve without this being addressed. You say that you wear your comfy insoles in your running shoes only - you should aim to be wearing them all the time if your symptoms are that severe. Otherwise you will be re-irritating and stressing structures during the times that you do not wear them. MTSS and tightness of the ITB on your lateral thigh are closely linked with pronated feet.

Once this is sorted, it's worth going back to a physio to ensure that the muscular balance of the lower limb gets corrected. Look at tightness in the gastroc and soleus muscles and also if there is an ankle equinus - sometimes a Grade V manip of this can ease posterior calf tightness and stiffness at the Superior Tib-Fib joint. Techniques such as periostial pecking with an acupuncture meedle can also help in some cases.

I hope this helps. Keep us updated.

Laura

[nmarman]

Shock wave therapy has lots of great data especially for tendon pain 60%-80% of people improve significantly at 6 month follow ups.

However hasn't had the time to produce enough double blinded trial to appease N.I.C.E the advisory group to the NHS.

Although they have deem this treatment as safe. meaning they wont pay for it yet they wont pay for it.

I know the Help the hero centers have the devices and are finding the of great use in quickening rehab times in soldiers - ask them

[pinkpussycat]

Also - I looked up Shock Wave Therapy and the Consultant I am under with the NHS has his own private practice and does this therapy! So, I will see what they say when they are supposed to be contacting me next week.

[nmarman]

if your ankle is so mobile I taken you where a support daily to stop re-aggravation. Orthotics change the way we load the feet. This change leads us to use different muscles so the large muscle may be because of the orthTics.

What side of leg is large tibial muscle?
What do you mean flex the foot? Curl foot or move ankle up/down?
What's your age and sex?

[pinkpussycat]

I don't wear an ankle support at all - as I thought the orthotics would control to pronation of my foot - but I am definitely going to look into getting some. Do you have them fitted or can you buy generic ones?

The large tibial muscle is on the outside of the leg at the front - on both legs. It appears when I pull my foot up towards my shin and is painful when I do this. It sometimes hurts when I drive as it constantly engages this muscle.

I'm female and 28 yrs old.

[physiobob]

What's your age and sex?

You can see this type of information at the top of the post. Everyone should read that yellow box (Brief Medical History Overview) before anything else as it is important to have that information ahead of making any comments. Sometimes is contains some really important information.

[pinkpussycat]

Hi physiobob

Should I get more orthotics from the NHS or should I buy the ones you can get from shops that are generic? They sell some called 'Super Feet' at Cotswolds Camping Shop where I live.

I am going to buy some new trainers on Thursday and I'm thinking when they see me running they will probably try and sell me motion control trainers for over pronation - should I not go with these? When I stand for long periods of time without my insoles in my legs ache like mad, so I think they have got so used to them now that without them I end up aching. But it has always crossed my mind that the NHS have given me the wrong ones - but this would be difficult to prove.

I am 5ft5 and weigh 9 stone - so definitely not over weight - although the strain on my legs feels like I weigh loads! When I run I am definitely not a quiet runner - there is lots of slapping of my foot and when I have seen physios in ths NHS, one of them mentioned that I don't have a very good push off motion when I walk. I tried walking differently for over a month - nothing changed. I think because I have been to see so many different people and they have mentioned so many different things that could be wrong from - pronating feet, collapsing ankles, tight hip flexors. I'm just confused about what approach to take. This is why this problem has gone on for so long - I've gone through all the exercises I have been prescribed by the physio, I stretch every day, I don't do anything vigorous anymore and yet my legs ache so much I feel like there is reduced blood flow

I have hypermobility and I can do everything on the Beighton Criteria - not sure whether this could be relevant? I suffer in my upper back because of this as I have a desk job.

Hope someone can fathom this all out

[pinkpussycat]

I have replied back to Leah after receiving a private message. Not been on here that long, but thought I would post a message as there have been some developments on my leg problem and wondered if anyone had any views....

Since having MRI which showed up compartment syndrome and compression tests coming up negative, I had EMG tests done which showed an overactive anterior tibialis and under active calf. Also had shock wave therapy on lower leg - no difference. Also had acupuncture - no difference. Still have constant aching, feeling like I need to stretch and tightening of calves on exercise and if I stand for any amount of time. Have now been referred for an angiogram as physio thinks it could be popliteal artery entrapment syndrome. Consultant says this is very rare and normally don't have any symptoms at rest. I still wear my orthotics as tried 2 months without and my calves went really tight.

Any views?

[pinkpussycat]

Thanks for your comments Laura and Marman. I initially started at the 'Mobility Centre' in the NHS and at the time I went to get some as I kept going over on my ankle. When I started wearing the orthotics I started to get more problems, which made me think it was them causing it. The pain progressed to the shin, then tightness in my calf then the inner part of then knee (it feels bruised all the time), now its at the thigh and hips. Over the past 4 years I have gone back to the NHS and had more and more insoles. Apparently, I have mobile flat feet - so my arch only disappears when I put weight on my feet, but only because my ankle collapses over it. I feel more stable in my trainers when I wear them, but I cannot help thinking that all these problems have been caused by the orthotics - is this possible? I once went to a private biomechanical specialist and he said the NHS orthotics aren't very good, as there is no shock absorption and I should get his - not sure whether this was a marketing ploy though. I did go through a period of 3 months about 1 year ago where I wore them all the time - there was no difference in my symptoms.

The large tibial muscle on the front of my leg only appears when I flex my foot - this appeared about 1 year ago - not sure whether this has developed because of my othotics changing the way I walk? No one I have seen can seem to explain this

The MRI scan showed up tightness in the gastrocnemius - that's why they thought it was compartment syndrome - can this indicate something else?

Thanks