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Compartment Syndrome

Compartment syndrome

Most of our muscles are divided into compartments surrounded by fascia which is not very giving (the silver skin for those who hunt). Compartment syndrome is a painful condition that occurs when pressure within the muscle compartment builds to dangerous levels.
This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.
Small nerve and muscle cells can die leading to permanent disability, weakness, and numbness.

Leg on left shows section of calf that would be swollen, and a cross section of the calf shows where the anterior compartment area of muscle is located.

Classic signs and symptoms

  1. Muscle pain and cramping
  2. Swelling of the affected limb
  3. Weakness and decreased range of motion in the affected limb
  4. Tingling, burning or numbness

Two types to consider:

Non-Traumatic/Exertional

  • The pain and swelling are caused by physical exertion. People who participate in activities with repetitive motions, such as running or marching, are more likely to develop non traumatic compartment syndrome.
  • This may be relieved by discontinuing the physical activity and rest. It is commonly mistaken as shin splints in the lower leg.
  • This may become a surgical emergency and require surgical treatment.

Traumatic 

  • Caused by a variety of things:
    • Broken bone
    • Badly bruised muscle
    • Crush type injuries
    • Anabolic steroid use
    • Constricting bandages or clothing
  • Traumatic compartment syndrome is considered a surgical emergency and requires surgical treatment.

Watch Outs:

  • A swollen, painful limb that does not improve with rest can be a sign of a significant emergency and should be treated in an emergency department.
  • Any numbness or weakness in the limb should mandate transport for professional medical evaluation.

Discussion Questions:

  • Your leg is swollen and sore after a long day of physical work.  What should you do?
  • Your crew member has been resting his swollen leg for a couple hours and now says it is tingling and cramping, what are your next steps?
     
Category
Firefighter Health and First Aid

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Date:  March 13, 2026
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The NWCG Leadership Committee is proud to announce the recipients of the 2024 Paul Gleason "Lead By Example" awards. Award categories include Initiative and Innovation, Mentoring and Teamwork, Motivation and Vision, as well as a Lifetime Achievement Award.

Congratulations to the awardees:

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NWCG is pleased to announce the new S-231, Engine Boss (Single Resource) course is now available on the Wildland Fire Learning Portal (WFLP). Developed through the Incident Performance and Training Modernization (IPTM) effort, this training supports individuals working towards Engine Boss, Single Resource (ENGB) incident qualifications. 

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NWCG is proud to celebrate 50 years of service to the wildland fire community. Beginning in 1976 with an interagency agreement between the Department of Interior and Department of Agriculture, NWCG has grown to include additional member agencies and is recognized as the standard-setting leader in wildland fire operations.

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NWCG is pleased to announce the new S-131, Firefighter Type 1 course is now available on the Wildland Fire Learning Portal (WFLP). Developed through the Incident Performance and Training Modernization (IPTM) effort, this course is a performance-based instructor-led training (ILT) that focuses on the application of situational awareness and decision making, building on the knowledge and concepts introduced in previous required courses. Using a threaded fictitious fire, each unit focuses on a performance-based activity in which students practice applying their decision-making and problem-solving skills.

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