Shauna Musser appeared in five games this year after major surgery.

BATTLING ADVERSITY

Women's Soccer: Sophomore Musser Playing Through Rare Condition, Painful Rehabilitation

By: Brittany Perotti

Posted: 10/10/07

Throughout life, every person may face an obstacle standing in his or her way to success, and women's soccer player Shauna Musser is no exception. The road to playing the game has not been an easy one for her, as she found herself dealing with a relatively rare condition called chronic compartment syndrome, which doctors are still trying to understand.

Chronic compartment syndrome starts when athletes who are involved in weight-bearing activities experience an increase in their training regimens and are constantly on their feet. Because of this amount of time standing, athletes' blood starts to pool in their ankles and calves. If the body cannot get the blood circulating fast enough, pressure begins to build inside the four compartments, or group of muscles, of the lower leg, according to one of the team's trainers, Caitie Dann. This builds up the pressure inside the compartments.

"Occasionally there will be no pulse," Dann said.

Musser learned about the problem after straining her calf during preparation for her freshman season. She red-shirted the year and though she did not believe that the calf injury was the cause, it was soon after that her troubles began.

"It felt like there were weights around my calves,î she said. ìIt wasn't so bad the first semester - I mean it hurt - but the spring season was pretty tough. It got progressively worse."

Dann classified chronic compartment syndrome as a complex problem, though she could not specifically speak about Musser's situation due to patient confidentiality laws.

"It's a common uncommon, if that makes sense," she said.

In Musser's case, workout and rehab routines only aggravated her condition. Trainers originally thought that she had a muscle strain and treated it as such, putting heat on her legs - something she later discovered was one of the worst things she could do for her condition.

"We were doing five stadiums [running up and down the stadium stairs] every day," she said, explaining how the repetitive pounding of her legs against the concrete did more damage.

After a season of frustration and pain, Musser went back home to Arizona. She had done some research on the Internet and had called her club coach to see if he could look into the condition. Doctors there told her she might have chronic compartment syndrome based on the symptoms she had, but no tests were done. Instead of surgery, Musser tried taking a natural approach to healing. After playing one game that summer, she felt that everything was OK.

Yet, Musser's troubles reappeared once she returned for preseason in 2006. She was constantly using stationary bicycle and elliptical machines - she freely admitted she hated to use them - to try to get back into shape for the upcoming season because of the pain she had during running.

"We had a new trainer," she said. "I was supposed to tell her when I was in pain, but I didn't feel comfortable telling her."

So, Musser played until she could not walk during her preseason game, which did not take long.

"Within 15 minutes I had to get off [the field]," she said, recalling the moment when she realized she needed to do something if she wanted to play soccer again. "It was hard to lift my legs. I came off the field crying. I got in the last 10 minutes, and I couldn't play for five."

Musser had to face the truth: surgery was the only option to relieve the pressure inside her legs.

The procedure, called a fasciotomy, involves cutting the fascia, a thin layer of tissue connecting the muscle to the skin, to relieve pressure inside the compartment.

"It's like putting on nylons over a leg," Dann said. "The muscle would be the leg and the nylon would be the fascia."

With the fascia cut, muscles have

the ability to expand, reducing the pressure inside.

In order for Musser to have the surgery, she had to undergo tests to make sure that she had chronic compartment syndrome, which can be painful, as she explained the process that she went through. The memories of the long needles used to distribute anesthesia before pressure gauges were pushed into her muscles brought a grimace to her face as she spoke.

Musser went under the knife in early September 2006 in Connecticut, but her surgery took a little bit longer than expected. On the operating table, surgeons discovered that her fascia was twice as thick as the average person's. Surgeons explained to her that it was similar to "cutting through lettuce." Not only that, but her legs had five compartments instead of four. The procedure was same-day, and Musser, who had surgery on both legs, had to walk with crutches almost immediately.

"I took baby steps," she said. "It took me like 45 minutes to get from my car to my house."

Yet, as Musser soon learned, recovery from surgery can sometimes be a nightmare. She was told her recovery would take anywhere from six to 12 months, though doctors said it would be 12 months only if something rare happens - and in her case, it did.

"It went well for four months," she said "You think you're going to get better. Three to four months [after the surgery,] I started jogging again."

Then things started to go downhill.

"I ran for a week, and I started having problems with my ankle," she said, touching the top of her foot where it meets the leg to show where she had experienced pain. "I was doing all my rehab in pain. It was annoying because I got to see other people get better."

Musser stopped rehab and was eventually prescribed amitriptyline, a low form of an anti-depressant that is prescribed for diabetics with nerve damage, to ease the pain. She also tried to use an anti-inflammatory gel, and later a cream, that she rubbed on her ankle. But the drugs had an unwanted side effect, as Musser found herself struggling to do anything more than lie in bed.

"The drugs cloud your mind,"she said. "I couldn't get up until 11 or 12 in the morning. I was sluggish."

Then one day, something changed. Musser said it may have been the combination of the gel and the cream, but while at a friend's lacrosse match, she noticed a bumpy rash on her ankle.

"It was weird how it stopped hurting," she said. "When I touched my ankle, it felt like it was asleep. It kept getting better through the summer."

A year after her surgery, Musser was back on her feet, and back on the field.

"One Monday before preseason, the doctor said I needed to come back to get into shape," Musser said. "The nerve pain was gone."

Musser has appeared in several games this year, after missing her first two seasons due to the injury and surgery.

"She has very good ideas," said head coach Len Tsantiris. "She doesn't hold the ball. She plays quick. She's doing a lot better."

The condition is relatively rare, with only nine cases reported in the first 20 years after its discovery in 1956, according to the American Academy of Podiatric Sports Medicine. It is getting more attention, however, due to the extensive training that athletes go through today.

"I've heard of more people having it," Musser said, explaining that she knew of three former teammates who also had the condition. "I think they're more aware of the symptoms and they're testing people."

According to the Atlantic Coast Conference's Web site, chronic compartment syndrome is often mistaken for shin splints and is often found in runners. It can be found in amateur and experienced athletes in a range of sports, however, including biking, swimming, hockey and tennis, according to a CNN.com report.

David Castillo, a former center for Florida State University, was sidelined after surgery to cure compartment syndrome in 2005. Most recently, Oklahoma basketball player Tony Crocker was sidelined after sustaining an injury during practice on Aug. 29, which led to the development of compartment syndrome, according to The Oklahoman's Web site.

Its counterpart, acute compartment syndrome, is a medical emergency and occurs when the muscle detaches and all of the blood flows to that area in an attempt to heal the injury, building up enormous amounts of pressure, Dann said.

There are no known ways to prevent chronic compartment syndrome and athletes have to make a choice between surgery and ending their sports careers.

"I was super frustrated and down last semester," she said. "At some points, I questioned myself and was like, 'Why am I doing this?' But you have to remember the end product."

Despite the struggles, Musser said it was worth the pain in the end because she got something better in return.

"Everything's 100 percent better," she said with a smile. "It's a relief to play without pain. I forgot how much I love to play."

Contact Brittany Perotti at

Brittany.Perotti@UConn.edu.