Abnormally pumped right forearm, compartment syndrome??

Andy B wrote:I tweaked a finger tendon back in October, but have been back climbing at 100%. I recently finished a round of serious training regime with the Rock Prodigy system. I should be on the power/endurance stage. I'm thinking all that campusing is not friendly to my arms.

This.

Was the tendon on your left hand by chance?

You got injured, then jumped into a training regimen. I can't blame you since I did the same with my shoulder.

Even if you're not aware of it (your body/mind are very good at hiding this), you can over/under train limbs because of current or recent injuries. It wasn't until I finished a full hangboarding cycle that I realized that my right arm (uninjured shoulder) was always more pumped than the left after a hangboarding session. Turns out it should have been, it was doing all the work.

It's entirely possible there's something else going on and you have a rare yet deadly syndome, but I'll place my bets with slightly more common and explanatory maladies.

Optimistic wrote: Definitely one of those. I just think, as Mark said, that it's important to be really circumspect when you're not able to examine the patient. Also, I try always to keep in mind that while of course you've got to make decisions and act on them, it's essential to stay open to that little voice trying to tell you that your understanding of the patient is wrong.

Well Optimistic, I understand what you are saying, and I agree with you. I do appreciate the advice, and I will consider it before future posts.

Since I helped derail the thread I'll try to offer some value.

IF you have another episode, and IF rest, ice and elevation don't help and the pain is getting steadily worse, common sense suggests that seeing a real Emergency Physician in person might be worthwhile.

I do agree with Paul B on one thing- you aren't likely to benefit from a fasciotomy or even having your compartment pressures measured at this point.

On the other hand, if this kept happening to me, I'd first think about any supplements I might be taking (e.g. creatine) or weird diet that might screw up my electrolytes. If that didn't explain things, I'd experiment so I had a really good handle on what set off the episodes.

Brendan may be on to something- unbalanced strength certainly could be causing the uneven pump.

The ONLY way to tell if you have an exertional compartment syndrome is for a physician to measure your intracompartmental pressure when you're having symptoms. I have seen a few cases of this in bodybuilders, Marines, and athletes. Waiting for pulselessness, paralysis, pain out of proportion, paresthesia, poikilothermia, and pallor to show up may be unreliable and if present may be late findings. An exertional compartment syndrome manifests symptoms only during the exacerbating activity and goes away at rest usually unless the compartment swells so much that damage is done. This hyperlink gives better information on compartment syndromes: patient.co.uk/doctor/compar… . To rule in an exertional compartment syndrome, you have to rule out other causes of symptoms and perform intracompartmental pressures before and after the exercise.

Is it on the radial side of your arm where most of the pressure and pain is? Or is it your entire forearm?

There is a condition called DeQuervains Tenosynovitis, or first compartment syndrome, where the radial (lateral) side of your forearm becomes inflamed and develops a subacute compartment syndrome. Sort of just causes pain and pressure, but not the whole tissue death and destruction thing (sorry, Paul)

Look up the 'Finkelstein' test and do it on yourself. Pretty unfortunate name, if you ask me.

On second thought, what does your pee look like? Does it hurt to touch? Are you just recently getting back into the gym after a hiatus?

Could be rhabdomyolysis. If you have dark 'tea colored' urine, or decreased urine output, I would go be seen to at least get some blood-work.

Here's a case report of exertional compartment syndrome in a competitive rower.
hindawi.com/journals/crior/…

Andy, if you do end up having this (kind of a long shot, but who knows...) you should definitely write up a case report on yourself.

Wow, this topic took some weird turns.

Anyway, thanks for the positive feedback... I'll ignore the others.

I'm going to continue regular icing and no climbing (which sucks). I'll keep posted if further action is needed.

There are a number of case reports of exertional compartment syndrome in the forearm. Here's another link: rheumatology.oxfordjournals… . If your symptoms return with exertion, you need to be seen by your primary care manager first to rule out other possible causes of your symptoms and for an orthopedic referral to measure your intracompartmental pressures before and after exercise.

Andy B wrote:Wow, this topic took some weird turns. Anyway, thanks for the positive feedback... I'll ignore the others. I'm going to continue regular icing and no climbing (which sucks). I'll keep posted if further action is needed.

Why no climbing? If you are feeling better again it might be helpful to pinpoint the factors causing trouble.

Mark E Dixon wrote: Why no climbing? If you are feeling better again it might be helpful to pinpoint the factors causing trouble.

I've been climbing a lot recently, and just finished a cycle of hangboarding/campus. I'm hoping its just a muscle sprain. Hope some time off will help.

Ill give it several days and climb again. Good idea on pin pointing the issue. Some part of me thinks its from pinching as hard as possible in the gym. I got outside last weekend and didn't have the abnormal swelling.