Wednesday Workout: Taming Compartment Syndrome (with Video and Mini Podcast)

BEND, Ore. — Two letters for better or for worse that we often associate with the negative sides of too much skiing are PT— as in physical therapist. Based in Bend, Dave Cieslowski is a licensed physical therapist and certified strength and conditioning coach. He has a core group of cross-country skiers who take his word on injury prevention and treatment — that group includes the U.S. Nordic Combined team.

One common overuse injury is compartment syndrome, or what specifically is called exertional compartment syndrome. Painful? Yes! If you don’t take my word for it, just read this post from former U.S. Ski Team member and distance skier Kris Freeman.

OK, it’s painful, but according to Cieslowski, it may be preventable and treatable in some cases without surgery.

Here are some basics: pain and/or numbness may develop when a muscle becomes swollen during exercise and the compartment containing the muscle does not expand. For skiers, this most often occurs in the lower leg where there are four muscle compartments — commonly, when compartment syndrome is suspected in a skier, symptoms are often evident in either the calf or shin area.

According to Cieslowski, the onset of compartment syndrome that specifically affects the shin is more likely in skiers who raise their toe up during the return phase (just after the leg push off) while skate skiing. That action, the toe raising, may eventually cause pain in the shin area.

Here’s a short podcast episode in which Cieslowski describes the reasons for the following exercises (press the play button below).

What You’ll need for exercise #1:

• 2 x 3 ft. resistance tubing
• A secure structure to anchor the resistance tubing
• Place one piece of tubing around the top of your hips, the other around one ankle
• Watch the video for more specific details about how to proceed

What You’ll need for exercise #2:

• 1 x 2 ft. resistance tubing, both loose ends knotted together to form a circle
• Step through tubing and position just above the knees
• Dumbbell and weights appropriate for a single leg step up onto an approximately foot high box
• Watch the video for more specific details about how to proceed

For both exercises, use caution and determine the proper number of sets to ensure you are fatiguing the appropriate muscles. You’ll note in the video that Cieslowski’s cycle rate is slow — that is on purpose. These are not meant to be high cycle rate exercises.