A compartment is like a pouch in which thereare muscles, nerves, and blood vessels are surrounded by a layer of fibrousconnective tissue. When the pressure inside the compartment increases due toaccumulation of fluid or external causes that can lead to impaired blood flow,tissue damage due to decreased oxygen supply.

Compartment syndrome typically happens in thelimbs usually in the lower leg or the forearm. Any increase of cellular orextracellular volume or a decrease of the volume capacity like with someexternal compression will lead to an increase of the pressure inside thecompartment this will compress the structures within and the first ones to feelthe effect of compression are the veins, as the pressure increases the arterieswill become compressed next and this obstructs the normal blood flow this cutsoff the oxygen supply and hypoxia develops which causes cells to startreleasing substances which cause capillaries to become leaky so fluid leaks outcausing extracellular edema that further increases inter compartment pressure.

The most common causes of compartment syndromeare: Bleeding inside the compartment this typically occurs with long bonefractures like the tibia and the forearm bones. In penetrating wounds andsurgical procedures that injure blood vessels. Other causes are swelling of thetissue after severe burns, intravenous drugs injection, and repetitive use ofthe injured muscles, or a vigorous muscle contraction like in seizures. Anylimb compression-like from a crush injury or an unsuitably placed cast can alsolead to compartment syndrome. 

Signs and symptoms of compartment syndromeare: Pain which is usually described as sharp and deep and worsens with passivestretching of the affected muscles, paraesthesia which is an abnormal sensationlike the feeling of pins and needles or numbness that can even progress to lossof sensation, pulselessness when compartment pressure is so high that it makesthe arteries collapse, pallor, and paralysis. The affected group of musclesappears stiff, firm, and feels hard like wood.

Some complications caused due to Compartmentsyndrome are: Necrosis which is the death of the tissue due to lack of oxygen,contractures. Another complication is rhabdomyolysis where muscles break down.

Surgical treatment of Compartment syndrome iscalled Fasciotomy where the fascia is cut open relieving the pressure andre-establishing normal blood flow, fascia can be left open for a few days untilthe cause of increased pressure is treated.

PHYSIOTHERAPY REHABILITATION OFCOMPARTMENT SYNDROME POST-SURGERY:

The primary aim of rehab is to regain theRange of motion and strength of the affected limb.

Post-surgery you may have numbness and painaround the incision and the aim of physiotherapy is to get you relief frompain, for this we use Cold therapy with a cold pack, & cryo-air.

Soft tissue massage.

Lymphatic drainage technique.

Passive mobilization of the affected joint.

Stretching exercises.

Strengthening exercises for an affected areasuch as for foot you can do- toe curl, picking marbles, toe squeeze, toe raise,dorsal/plantar flexion & inversion/eversion using a resistance band.

Cardiorespiratory training with stationarycycling, or trade mill, etc.

Combination machine therapy to prevent scartissue formation.

Super Inductive System to mobilize the joints.

High Intensity class 4 laser therapy fortissue healing.