Compartment Presure Testing

Your doctor or physiotherapist has diagnosed a probable exertional compartment syndrome and is requesting some pressure measurements in your leg muscles after you exercise to help confirm this diagnosis. This may happen in the fronts of your shin, the calf region or in both places.

This procedure involves injecting some local anaesthetic into the affected area of your leg so that the pressure monitoring needle can be inserted without pain. After the anaesthetic you will either hop for 1-2 minutes, or move your foot up and down, depending on where the problem is, to build up the muscle pressure. The pressure monitoring needle will then be inserted and the pressure is measured over the next 10 minutes.

What are the risks of this procedure?

We have done 3 to 4 hundred of these tests with very few problems. There is however a potential risk that one of the needles may touch a nerve or artery in your leg and cause some bleeding in your shin muscle. If this was severe it may require an urgent operation to release the bleeding, but this has not been necessary in any of our previous tests.

In preparation for the pressure test:

• Try to continue to exercise, within the limits of your pain, as this makes the test more accurate for your condition
• Bring someone with you to drive, as there is a chance that your foot may be numb, and you cannot drive home

After the test:

• You should not plan to exercise for at least 3 days, or until your leg has fully recovered.
• You should avoid baths or spas for 2 days until the needle holes fully heal; you may have a shower with no problems.
• You shouldn’t drive on the day of the test, and not until you are sure your leg is fully recovered – usually the next day.
• There may be a mild ache when the anaesthetic wears off, and this usually responds to elevation of the leg, ice packs, and simple pain relief such as Panadeine or Voltaren– this is not unusual.

Warning:

But if you should experience increasing pain increasing swelling increasing throbbing increasing numbness this may be a sign of bleeding into the muscle.  This is an emergency and you should contact the clinic or seek an assessment from your local hospital emergency department immediately.  You should explain to them that you have had a compartment pressure test and that there is a chance you may have bleeding in the muscle (ie acute compartment syndrome).  This is fortunately very rare and has never been a problem in the past.  It is however important to get it checked by a Doctor to exclude an acute compartment syndrome where a prolonged increase in pressure can damage muscle.