Most of us are familiar with the term “shin splints,” which refers to an achy, tender or sore feeling along the front of your leg that develops as you exercise. But the next time you jump to self-diagnose the pesky but non-emergent condition, it may pay off to take a closer look at your symptoms.

Shin splints can be confused with chronic compartment syndrome, also known as exertional compartment syndrome. Like shin splints, compartment syndrome is exercise-induced, but it differs by causing pain deep in muscles that can routinely prevent you from participating in a chosen sport or activity.

What is compartment syndrome?

The American Academy of Orthopedic Surgeons describes compartment syndrome as causing swelling or bleeding within a compartment in the body. The AAOS notes that because our connective tissue, known as fascia, doesn’t stretch, the condition increases pressure on capillaries, nerves and muscles in the compartment. While compartment syndrome most commonly affects the lower leg, it can also affect the thighs, arms, hands, feet and buttocks.

If you’re suffering from compartment syndrome, you may experience:

Additionally, pain and issues caused by compartment syndrome might follow a pattern, such as starting after a specific time, distance or intensity of your workout, progressively worsening as you exercise, and lessening or stopping completely once your workout ends.

You have a higher risk of developing compartment syndrome if you’re under 30 years old, overtrain your workout frequency or intensity, and participate in a sport involving repetitive impact.

“People who participate in activities such as running or marching are more likely to develop compartment syndrome,” says Dr. Thurman Alvey, sports medicine specialist at Forté Sports Medicine and Orthopedics.

Taking the lead in better understanding compartment syndrome

While the cause of compartment syndrome isn’t fully understood, Alvey is designing a research project to better understand why physicians appear to be treating more cases today than they did 10 years ago.

“It would seem that overtraining, poor flexibility, gait mechanics and growth cycles all play a role,” says Alvey. “Ultimately, none of those issues create tight fascia, but they definitely contribute.”

Examination and treatment

To diagnose compartment syndrome most accurately, Alvey uses a comprehensive testing process designed to reproduce the symptoms and when and how they happen.

“Most occur when running, so we utilize a treadmill-based test,” says Alvey. “If it is from biking, then a similar protocol is used with a stationary bike. Testing is taken into consideration on an individual basis.”

With a diagnosis, Alvey can implement a treatment plan to resolve pain, but typically surgery is the answer to release the compartments.

The team at Forté is standing by to provide an exam and a customized treatment plan so you can start feeling better, faster. Request an appointment online or call 317.817.1200.

Locating the source of nerve and muscle problems can be complicated. Fortunately, the team at Forté Sports Medicine and Orthopedics uses tools that make narrowing down and pinpointing the cause easier, getting you back to your active life faster.

Forté uses a two-part process known as electrodiagnostic testing or EDX to help detect an injury or disorder of a nerve or muscle and the connections between them.

The first portion of the test is a Nerve Conduction Study or NCS, in which medical staff place electrodes over specific sites on your arms and legs and then apply small electric impulses.

During the second portion of the test, Electromyography or EMG, a tiny pin electrode is used to measure electrical activity in the muscle.

Together, these tests help physicians diagnose or rule out muscle and nerve disorders and determine the best treatment for relieving your symptoms.

When to consider electrodiagnostic testing

Your physician may consider electrodiagnostic testing if you’ve experienced muscle pain or cramping, tingling, numbness, or weakness with no apparent cause. It’s often used to help diagnose:

What to expect before, during and after testing

Once you’re referred for electrodiagnostic testing, the experience will be individualized. The time commitment varies per patient, typically ranging between 30 and 60 minutes from start to finish.

There are no restrictions relative to activities before testing, but there are some things to consider. You should wear loose-fitting and stretchy clothes to your appointment. Additionally, you should stop using creams or lotions on your arms or legs approximately 12 hours before testing.

Both parts of the testing process are typically tolerated without needing pain medication.

“The impulses delivered at the NCS electrode sites will feel like a tingling sensation, last less than one second and immediately go away with no lasting effects,” says Dr. Michael Del Busto, a rehabilitation and sports medicine physician at Forté specializing in minimally invasive procedures.

“While there may be some pain or discomfort from the pin electrode used during the second portion of the test, we can control the settings as we go,” says Del Busto. “Following testing, some muscle soreness is to be expected, but it will go away within two to three days.”

You can resume normal activities immediately following testing. Results are typically sent to your physician’s office within 24 hours and will help determine the next steps in your care.

Ready to take the next step? The team at Forté is specially trained to offer electrodiagnostic testing. If you suffer from nerve or muscle problems and are interested in finding out whether EDX is right for you, request an appointment online or call

Shockwave Therapy for Tendon Pain

Overuse or sudden stress on a tendon can cause pain and swelling that interferes with your daily life. It’s common for the pain to worsen as you move, which can restrict your ability to participate in activities you enjoy, from sports to hobbies such as gardening.

Unfortunately, tendon pain can also be complicated to resolve. It doesn’t always respond to traditional treatment options, such as physical therapy, oral medications and modifications to physical activity.

When other options fail, your physician may suggest shockwave therapy, also known as extracorporeal shockwave therapy or ESWT, to help heal your injury. Shockwave therapy transmits low-energy sound waves to the tendon or soft tissue that’s causing you pain.

“It works by desensitizing the tendon and helping it remodel and heal,” says Dr. Michael Del Busto, a rehabilitation and sports medicine physician at Forté specializing in shockwave therapy and other minimally invasive procedures. “The hope is that patients will experience a long-term benefit.”

Benefit: Helps heal nagging injuries

One of the biggest draws to shockwave therapy is its ability to help heal chronic, nagging injuries.

As shockwaves pass through the skin, they increase blood flow to the injured area. This speeds up the body’s natural healing process and is often helpful in resolving issues that patients have been dealing with for weeks, months or even years.

Benefit: Non-surgical procedure with little-to-no downtime

Additional benefits of shockwave therapy include being an outpatient procedure with minimal downtime. While healing from surgery can take weeks, the non-invasive nature of shockwave therapy means patients can return to work immediately, as long as they don’t engage in strenuous activities or high-impact exercise for the first 48 hours after the procedure.

“You’re a good candidate for shockwave therapy if you need to take the next step in treatment but want to avoid something invasive and don’t want any downtime for your sport or lifestyle,” says Del Busto.

What to expect from your treatments

Shockwave therapy typically takes about 5-10 minutes per treatment, with an average of three treatment sessions each scheduled a week apart. A physician will put ultrasound gel on the injured area and then use a hand-held device, like an ultrasound wand, over the gel.

“Most people experience mild pain or discomfort during the procedure, which we can help manage by changing the device settings,” says Del Busto. “Even if patients have some discomfort during treatment, they often walk away feeling better.”

Following the procedure, patients may experience mild side effects, such as pain, redness, bruising, swelling and numbness in the affected area. These issues typically resolve within a week and can be managed with over-the-counter painkillers such as acetaminophen.

Watch below to learn more from Drs. Matthew Negaard and Michael Del Busto about shockwave therapy

Is shockwave therapy right for you?

The team at Forté is specially trained to offer shockwave therapy as a non-surgical option for safely treating your tendon pain. To learn more about shockwave therapy and decide whether it’s right for you, request an appointment online or call 317.817.1200.


Our Forté Fast Orthopedic urgent care clinic in our Greenwood location will be closed on Thursday, February 29th.

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