It seems in my office the default diagnosis by many health care professionals and patients presenting with lower leg pain with exertion is shin splints. It’s an easy thing to fall back on as it’s a common problem, but certainly not the only problem that causes exertional lower leg pain.
I’ve had a special interest in exertional leg pain in runners and one problem I specialize in is exertional compartment syndrome. It’s an interesting problem that we still don’t have a definitive clear reason why it occurs — however, several theories exist.
Today on the podcast, we are going to cover exertional compartment syndrome with a colleague who also has a special interest in this problem, and is looking into some novel approaches to treating it.
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Links from this Episode:
— Peck E, Finnoff JT, Smith J, Curtiss H, Muir J, Hollman JH. Accuracy of palpation-guided and ultrasound-guided needle tip placement into the deep and superficial posterior leg compartments. Am J Sports Med. 2011 Sep;39(9):1968-74. doi: 10.1177/0363546511406235. Epub 2011 May 26. PMID: 21617254. https://pubmed.ncbi.nlm.nih.gov/21617254/
— Johnson SE, Finnoff JT, Amrami KK, Jelsing EJ. Radiological Prevalence of Popliteal Artery Entrapment in Individuals With Anterior Leg Compartment Chronic Exertional Compartment Syndrome. Clin J Sport Med. 2020 Sep 15. doi: 10.1097/JSM.0000000000000885. Epub ahead of print. PMID: 32941383. https://pubmed.ncbi.nlm.nih.gov/32941383/
— Reisner JH, Noble-Taylor KE, Cummings NM, Lachman N, Finnoff JT. Ultrasound-Guided Fasciotomies of the Deep and Superficial Posterior Leg Compartments for Chronic Exertional Compartment Syndrome: A Cadaveric Investigation. PM R. 2021 Aug;13(8):862-869. doi: 10.1002/pmrj.12477. Epub 2020 Dec 25. PMID: 32844578.
— Finnoff JT, Johnson W. Ultrasound-Guided Fasciotomy for Chronic Exertional Compartment Syndrome: A Case Report. Clin J Sport Med. 2020 Nov;30(6):e231-e233. doi: 10.1097/JSM.0000000000000777. PMID: 31688084. https://pubmed.ncbi.nlm.nih.gov/31688084/
— Lueders DR, Sellon JL, Smith J, Finnoff JT. Ultrasound-Guided Fasciotomy for Chronic Exertional Compartment Syndrome: A Cadaveric Investigation. PM R. 2017 Jul;9(7):683-690. doi: 10.1016/j.pmrj.2016.09.002. Epub 2016 Sep 14. PMID: 27639651. https://pubmed.ncbi.nlm.nih.gov/27639651/
— Finnoff JT, Rajasekaran S. Ultrasound-Guided, Percutaneous Needle Fascial Fenestration for the Treatment of Chronic Exertional Compartment Syndrome: A Case Report. PM R. 2016 Mar;8(3):286-90. doi: 10.1016/j.pmrj.2015.08.015. Epub 2015 Sep 4. PMID: 26344477. https://pubmed.ncbi.nlm.nih.gov/26344477/
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The Host of this Program:
Dr. Mark Halstead received his medical degree from the University of Wisconsin Medical School. He stayed at the University of Wisconsin for his pediatric residency, followed by a year as the chief resident. Following residency, he completed a pediatric and adult sports medicine fellowship at Vanderbilt University. He has been an elected member to the American Academy of Pediatrics (AAP) Council on Sports Medicine and Fitness and the Board of Directors of the American Medical Society for Sports Medicine (AMSSM). He has served as a team physician or medical consultant to numerous high schools, Vanderbilt University, Belmont University, Washington University, St. Louis Cardinals, St. Louis Blues, St. Louis Athletica, and St. Louis Rams. He serves and has served on many local, regional and national committees as an advisor for sports medicine and concussions. Dr. Halstead is a national recognized expert in sport-related concussions and pediatric sports medicine.
The Guest Featured Inside this Program
Jonathan Finnoff, DO, FACSM, FAMSSM, RMSK is the Chief Medical Officer for the United States Olympic and Paralympic Committee and a Professor in the Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science in Rochester, MN. Dr. Finnoff is board certified in Physical Medicine and Rehabilitation and Sports Medicine.
Dr. Finnoff has published over 100 articles in peer reviewed journals, authored multiple book chapters, and co-edited a book with Mark Harrast, MD, titled “Sports Medicine: Study Guide and Review for Boards”. He has been a faculty member or course director for numerous national and international conferences and previously served on the boards for the American Academy of Physical Medicine and Rehabilitation (AAPM&R) and the American Medical Society for Sports Medicine (AMSSM). Dr. Finnoff was a team physician for the United States Ski Team for nearly two decades and has provided medical coverage at the Olympics Games, Paralympic Games, World Cups, and World Championships. Dr. Finnoff’s clinical interests are broad and include multiple sports medicine topics including advanced diagnostic and interventional ultrasound and exertional leg pain.