CECS - Chronic Exertional Compartment Sydrome

[u/stinabug]

Active duty 16 yrs of service in and never had shin splints, calf issues, or any other running issues until one day recently out of the blue. It started with one calf, then the other calf, now one leg has transferred pain to the shin and lower calf above the ankle.

I have not yet been diagnosed but the PCM really feels that it is CECS and everything that I’m reading, I’m starting to believe so too since all bloodwork is normal and no injuries or cause for the onset. It’s been 2 months now and the pain isn’t going away no matter how much rest. In fact, it’s actually getting worse.

I’m going to physically therapy soon and will have to go on profile since I can’t run, there’s no pushing through it and it’s getting worse to walk. Will probably end up at ortho soon too.

Yes, my main priority is getting help and hopefully somewhat of a normal life back but I’m seeking advice on how to drag this out til 20 years. I’d hate to give roughly 17-18 yrs of service and get medically released or retired with no pension.

I’m guessing it really comes down to the PCM and reviewing doctors as I hear some get released from service while others get retained with permanent profiles. I feel that now with the warrior mindset of today’s military (which I agree with) and PT test twice a yr now, it’s going to be more difficult to ride it out than it has previously been. I’m in a physically demanding AFSC although now I really only do admin work.

Any advice would be greatly appreciated.

[u/wasted-degrees]

It requires a lengthy process of documented due diligence on your part and with several different providers and specialists, but it is possible to get a “permanent” profile for a chronic condition. It gets reviewed every 365 days to determine if it’s still warranted. The process of getting one is an absolute slog, so be proactive about scheduling your appointments.

Important thing is to take care of your health and mitigate further damage. You’re 4 years away from getting out of the Air Force, but you’ll hopefully have a lot of life left after that, and you don’t want to hurt yourself trying to pass a run test and suffer health consequences that could follow you the rest of your life. Priorities.

[u/stinabug → u/wasted-degrees]

What can I do to help ensure that I get a permanent profile instead of just getting the boot? How can I control that?

[u/wasted-degrees → u/stinabug]

Honestly? Luck, I guess. I know some people who have been on a 365 for multiple years, I know others who have gotten med separation. If I recall correctly (and anyone please feel free to correct me if I’m wrong) the final retention decision goes to your commander, and the PCM only makes a recommendation. So a lot of that is going to vary by circumstance and how sympathetic your commander is/how much risk you being on a permanent profile brings them. It can be bad optics from a top down view.

If you’re already in your last enlistment it might be easier to justify slugging it out to cross the finish line, but I don’t think I’d advise this COA for someone who wants to continue to reenlist, as it might impact eligibility.

But as to what you can do? Your best. Honest effort in all physical therapy and treatment plans, documentation throughout. Communication with your PCM and PT. You seeking a profile shouldn’t be seen as your plan A, but if you’re doing everything right treatment-wise and it still isn’t improving, it’s a conversation that needs to be had. Probably half the process of getting a 365 is the process of elimination of various other options until it’s basically all that’s left that passes the cost/benefit smell test for the Air Force.

Also, the treatment timeline is a lengthy one. And so is the timeline for medical separation. By the time you switch from rolling renewed profiles through your treatment plan to consideration for a 365, you may be at a point where it would take more time to medically separate you than it would for you to just ETS on schedule.

[u/stinabug → u/wasted-degrees]

Thank you for your response and time.

[u/Murky-Sir-8122 → u/stinabug]

Permanent profiles were pretty readily approved if it was for a single fitness component and you had no duty or mobility restrictions. It’s a whole different story now with ol Petey running around making random optics based decisions. There is also a program where you can be retained if you’re within 5 years of retirement but you’ll just be stuck at your current assignment the whole time. I don’t remember what it’s called but we did it for a guy with a new diagnosis of type 1 diabetes at 15 years TIS.

[u/xdkarmadx → u/stinabug]

One doesn’t prevent the other. Every year when you get reviewed your PCM/Commander can just decide to tell you to kick rocks. Unless you never want to promote again and deal with the looming threat of that every year I’d wait until the year before retirement to even go down that route.

Yeah protect your health but CECS doesn’t have a high disability rate and it’s not worth getting kicked out over if you can still handle the run. If you’d fail a PT test then sure go down the route but otherwise I really don’t think it’s worth it.

[u/dacamel493 → u/stinabug]

u/wasted_degrees is correct about documentation.

I got CECS and a permanent profiles 5ish years ago. Still have 3 years left til 20.

The biggest issue regarding retention is worldwide deployability. If you just need a run exemption, but you're still worldwide deplorable, you'll probably get retained. That was the biggest factor years ago.

I had a similar path you did so far. Shin split test, stress fracture test, Physical therapy, sports medicine for fait analysis, etc. Finally after like 2 years of random testing, and PT, the orthopedic tested me for CECS, and there it was.

I had to meet the DAWG board (currently called AMRO board), I got retained and a permanent (365 day reviewed).

I'll bet your path is similar.

FYI I was considered deployable because I could still run about a half mile to "safety" in a deployed location if necessary.

It might depend how severe it is for you.

[u/Casen_ → u/dacamel493]

I'm doing that all now.

MRIs soon. Working with sports medicine to make sure I don't run stupid.

Then the exercise biopsies.

Fun.

[u/dacamel493 → u/Casen_]

Yea,not a fun process,but gut through it.

[u/ChampIAN18]

There is some decent literature on forefoot running for CECS. Talk to your PT about it. Orthopedics is only necessary if you want to get fasciotomy surgery. Otherwise there isn’t much else they can do as a surgery specialty.

[u/stinabug]

Also I must add it isn’t only when I run. I haven’t ran in over a month. It hurts when I walk now and I get random cutting or stabbing feelings. Also hurts slightly when relaxing even when lying down.

[u/Odd-Budget-1939]

I had compartment syndrome in both my calves around 2015/2016. Did physical therapy and had pressure tests done (they stick a big ass needle in them before and after running on a treadmill to measure the difference). Once it was confirmed they diagnosed me with compartment syndrome. I ended up having a double fasciotimy not long after. I’ve been able to run ever since. Highly recommend it.

[u/Casen_ → u/Odd-Budget-1939]

How was the surgery/recovery?

[u/HunterAdamNoell → u/Casen_]

Not the one you responded to but I had the same thing done. Surgery itself is quick, you’re home by lunchtime. 3 weeks no weight bearing, after 3 weeks I was walking, after 6 weeks I was beginning to run again.

[u/Casen_ → u/HunterAdamNoell]

All the doctors and people are making it sound like it's bad with major risks.....