Acute Compartment Syndrome is a medical emergency!

The Stanley Cup Playoffs of the NHL consist of notoriously fast play, great saves, and of course big hits. These big hits keep the excitement level at a maximum, but being on the receiving end of a 200+ pound professional hockey player’s check can create significant injury for those players involved. This was highlighted last week in game 4 of the Western Conference Finals when Nashville Predators center, Ryan Johansen, was checked by Ducks defenseman, Josh Manson. Johansen slowly skated off the ice, grimacing in pain. It was recently announced by the team that this “lower body injury” was diagnosed as compartment syndrome and required emergency surgery only hours after the injury.


Acute Compartment Syndrome


Compartment syndrome occurs when pressures within the compartments of the leg increase. The lower extremities are created by walls of thick tissue, called fascia, which help to contain the muscles, nerves, and blood vessels. Two types of compartment syndrome injuries exist; chronic exertional compartment syndrome and acute compartment syndrome.


With chronic exertional compartment syndrome, the pressures in the legs increase with repetitive use of muscles, such as in running and cycling. This type of compartment syndrome is usually not an emergency, but with increased pressure, you can experience temporary or permanent damage.  Patients usually complain of numbness and tingling during the activity that is relieved with rest. Treatment usually requires decreasing activities that induce symptoms and rarely require surgical intervention.


The second type of compartment syndrome is acute in nature and usually caused by fractures or crush injuries, as was the case with Ryan Johansen.  After an injury occurs, bleeding directly into the compartment or muscle swelling can cause increased compartmental pressure due to the lack of flexibility of the fascial walls. This type of compartment syndrome is a medical emergency and may require emergency fasciotomy, or opening of the compartments to allow for the return of blood flow to the legs and reduce the possible death of tissue.


With proper evaluation and treatment, long-term complications can be avoided. Ryan Johansen was transported directly to the hospital from the area following worsening symptoms that left him unable to walk out of the locker room. He was in the operating room within 2 hours. He is expected to make a full recovering within the next few weeks according to team reports.


If you are experiencing chronic pain during or after exercising, see a specialist at Kansas City Foot and Ankle.  If you incur an injury and develop extreme pain, go to an emergency room right away, as you may be experiencing acute compartment syndrome and will need help right away.