Running Mechanics 6 Weeks Post Conservative Management Using Loadsols for an Active-Duty Female with Lower Leg Chronic Exertional Compartment Syndrome: A Case Study — MHSRS 2021

Velasco T, Peel S, Hulsopple C, Gornoski L, Goss D, Leggit J

Abstract submitted to Military Health System Research Symposium 2021

Chronic exertional compartment syndrome (CECS) predominantly affects highly active individuals’ lower legs, especially among military service members. The current treatment for CECS is a surgical fasciotomy of the involved lower leg compartment.  The post-surgical patient outcomes are mixed. Emerging non-surgical treatments with botulinum toxin A (BoNT-A) and gait retraining (GR) are alluring alternatives. BoNT-A may reduce compartment pressures and pain in individuals with CECS. The predominate muscle of the lower leg anterior compartment is the tibialis anterior. Using a forefoot strike pattern while running, the tibialis anterior decreases eccentric activity and anterior compartment pressure. Using gait retraining (GR) to alter foot strike patterns from rearfoot to forefoot running decreases ground reaction forces (GRF) and reduces leg pain. Published case series on these non-surgical interventions have promising results. When GR is offered as an intervention it is through supervised clinic visits or partial home-based training during a 6-week period.  These case series obtain kinetic data through instrumented treadmills, mainly in a male population. An alternative to using an instrumented treadmill are Loadsol sensors connected to a Bluetooth device and placed inside each shoe to assess kinetic data while running. The purpose of this case study was to observe foot strike patterns and review kinetic changes identified with Loadsol sensors in a female with bilateral lower extremity CECS after BoTN-A and home-based GR.