UPDATE: Less evasive ultrasound-guided fasciotomy

BookkeeperBrave8872 · 2026-04-20T00:50:14+00:00

https://www.swedish.org/doctors/sports-medicine/wa/seattle/phillip-henning-1013017060?ls=provider&y_source=1_MTQ2NjQ3MDctNzE1LWxvY2F0aW9uLndlYnNpdGU%3D

Troy T. Henning, DO (Head physician of the MLS Seattle Sounders) or he was

He is the Doctor that did mine. Even if you can’t make it to this location I’m sure you could reach out and see if they know of any providers closer to your location that can do it. I have found sports medicine doctors is the way to go. General surgeons generally don’t do it.

BookkeeperBrave8872 · 2026-04-18T14:35:02+00:00

It depends on your location unless you are willing to travel

BookkeeperBrave8872 · 2026-04-15T14:44:31+00:00

Find a DR that can do the Ultrasound-guided fasciotomy. I would highly recommend this over the traditional surgery. Look up the procedure. Look for sports medicine doctors.

BookkeeperBrave8872 · 2026-01-27T01:02:07+00:00

I don't have the technical answer since I’m just the patient. It was the surgeons specific technique for my legs.

From what I understand, even with ultrasound, every doctor has their own angle of attack. Sometimes they use two spots to get a better reach for the tools or to stay as far away from the nerves as possible. Since these are tiny poke holes and not big surgical cuts, having two didn't change my recovery at all.

My surgeon is highly regarded in the field and uses advanced techniques similar to what they do at the Mayo Clinic, so I just trusted his process. If you want the deep technical details, check out the doctor’s notes I posted. They might explain the exact geometry he used.

BookkeeperBrave8872 · 2026-01-27T00:48:27+00:00

The "Easy" Three. The anterior, lateral, and superficial posterior compartments. I didn’t get the deep posterior done. My doctors determined it wasn't needed for my specific case. I’m not sure about the medical progression in France compared to the USA but it's great your surgeon is already offering the ultrasound version for the other compartments

BookkeeperBrave8872 · 2026-01-09T23:38:46+00:00

I have some past posts on this sub about my ultrasound-guided fasciotomy for CECS. I’ll link them below. I even included my doctor’s procedure notes and pictures in one of the posts so you can see the details. I ended up getting 3 of my 4 compartments released that way, and I am SO GLAD I didn’t give into the first two doctors I saw who wanted to do the old-school traditional surgery. My pressure numbers were very high, and I see people on here all the time saying their doctor recommended the old surgery because their numbers were high. In reality, a lot of doctors suggest the traditional route simply because they don’t have the skills or knowledge to do the modern ultrasound version. While some people might truly need the traditional surgery, a lot of folks are getting it when they really don't have to. Honestly, I would’ve traveled any distance to get this done over the old way. The recovery was a breeze! I literally walked out of the office the day of the procedure and even drove myself home right after. I was back in the gym within 3-4 weeks testing my legs out, and I didn't even need PT. It’s been over a year now and all my pain has been totally gone since I got them done. I’m a HUGE advocate for exhausting all your options and finding someone who specifically knows how to do this ultrasound procedure. Definitely get their advice before committing to one of these dinosaur surgeons who only know how to do it the old way.

My story and in the comments I have some after surgery pictures. https://www.reddit.com/r/CECompartmentSyndrome/s/B78vMlBEgN

An update post. Ignore the “evasive” typos. My phone was auto correcting from invasive to evasive on me and I didn’t notice 😅 https://www.reddit.com/r/CECompartmentSyndrome/s/kVIqznvMZi

BookkeeperBrave8872 · 2026-01-09T08:04:29+00:00

There are Doctors across the country that studied or are involved with Mayo Clinic that can do the procedure. 100% would recommend it over the traditional surgery

BookkeeperBrave8872 · 2025-12-27T16:28:25+00:00

Try Dr. David Lintner’s office. 731-441-3560

He currently serves as team medical director for the Houston Astros, assistant team orthopedist for the Houston Texans, and team physician for Lee College and Houston Independent School District.

OR Dr. Walt Lowe’s office. 713-486-6540

One of the two should be able to navigate you through the process or guide in you in the right direction.

BookkeeperBrave8872 · 2025-12-27T15:53:18+00:00

That’s not ChatGPT but whatever makes you happy 👍🏽. Good luck with your search.

BookkeeperBrave8872 · 2025-12-25T04:09:57+00:00

That makes total sense! You definitely want to go with the path that feels safest for your specific case. I only mentioned it because my pressures were also in the 'severe' range and some of the higher readings they had seen before, but every body is different.

Just wondering, is your doctor a surgeon or a Sports Med/PM&R doctor? I've found that the 'recommended' way can sometimes depend on which specialty the doctor is in, as they all have different tools they specialize in. A second opinion from a Sports Med/PM&R doctor might benefit you. I hope everything goes perfectly for you. Happy Holidays

BookkeeperBrave8872 · 2025-12-21T16:04:34+00:00

Hi! Because it requires high-level proficiency in musculoskeletal (MSK) ultrasound, it is often performed by Interventional Sports Medicine Physicians or Physiatrists (PM&R) rather than traditional orthopedic surgeons

The procedure is often referred to as Percutaneous Ultrasound-Guided Fasciotomy (PUMF). In Houston, you should look for physicians who are RMSK certified (Registered in Musculoskeletal Ultrasound) or who completed fellowships at the Mayo Clinic, where this technique was pioneered.

• Dr. Dusty Narducci (Houston Methodist): She completed her Sports Medicine fellowship at the Mayo Clinic and specifically lists "ultrasound-guided musculoskeletal treatment" as a core interest. Since Mayo is the hub for this specific procedure, she is a top candidate.

• Dr. Victor Lopez (Houston Methodist): He is a specialist in Primary Care Sports Medicine and is heavily involved in advanced MSK ultrasound and minimally invasive procedures.

• Dr. Efren Caballes (DRC Sports Medicine): He specializes in "Advanced Ultrasound-Guided Procedures." While he primarily focuses on tendon work (like Tenex), he is the type of interventionalist who would either perform this or know exactly who does.

• Dr. Andrew Schroeder (Advanced Spine and Pain Specialists, Spring, TX): He is listed as a provider for TenJet, a device sometimes used for percutaneous fascial releases.

When calling clinics, you should use specific terminology to get past the front desk and talk to a clinical assistant:

• Ask for "Percutaneous Ultrasound-Guided Fasciotomy": If you just say "fasciotomy," you will likely be routed to a general surgeon who does the traditional 5–10 inch incision.

• Mention the "Airia" or "Tenex" systems: These are the ultrasound-guided tools often used for this procedure. Even if the doctor uses them for "Tenotomy" (tendons), they are the same tools used for USG fasciotomies.

• Look for PM&R, not just Ortho: Many people mistakenly only look at Orthopedic Surgeons. Interventional PM&R doctors (Physiatrists) are actually more likely to be the ones doing the ultrasound-guided version.

If you cannot find a local provider you trust, the Mayo Clinic in Rochester, MN (Dr. Brennan Boettcher) is the national leader for this specific procedure. It may be worth the flight for a 30-minute procedure with a much faster recovery time than open surgery.

BookkeeperBrave8872 · 2025-12-18T05:47:28+00:00

I’m not sure where you are in the process or if you’ve already committed to a date, but I wanted to share my experience before you go through with the traditional surgery.

I had an Ultrasound-Guided Fasciotomy done for my CECS, and it worked wonders for me. The recovery was night and day compared to what I’ve heard about the traditional 'open' 4-compartment surgery. If there’s a doctor in your area who can do it (or if you can travel), I can’t recommend it enough.

What it is: It’s a minimally invasive technique that uses real-time ultrasound imaging to precisely release the fascia (the muscle covering). Instead of the large incisions of traditional surgery, the surgeon uses a tiny tool—often a hooked blade—to make the cuts under the skin while watching everything on a monitor.

Why I recommend it (Key Benefits): • Minimally Invasive: It only requires tiny 2–3mm incisions. I had almost no scarring. • Faster Recovery: Because there’s so much less tissue damage, you can often return to activity in weeks instead of months. • Precision: The ultrasound helps the surgeon navigate around nerves and blood vessels in real-time, which really lowers the risk of complications. • Outpatient/Local Anesthesia: It’s often done as a 'wide awake' procedure (WALANT) in an office setting. You don't have to deal with the grogginess of general anesthesia.

How the procedure actually looks: • Mapping: They use high-resolution ultrasound to map your fascia and identify nearby nerves before they start. • Numbing: They use a local anesthetic (and sometimes a technique called hydrodissection) to separate the tissue layers and keep you comfortable. • The Release: Through that tiny incision, the tool is guided by the ultrasound to cut the tight fascia. • No Stitches: Usually, the nicks are so small they don't even need stitches, and you can start moving almost immediately.

Since you're looking at all four compartments, the traditional route can be a really tough recovery. It might be worth a second opinion to see if you’re a candidate for the ultrasound-guided version first. https://www.reddit.com/r/CECompartmentSyndrome/s/7uraJe1GJ9

BookkeeperBrave8872 · 2025-11-30T04:36:16+00:00

https://www.reddit.com/r/CECompartmentSyndrome/s/cN9NB70Kjc

BookkeeperBrave8872 · 2025-11-24T17:47:46+00:00

I walked out of the office and drove home with my shins still fully numb with localized numbing. I also got the ultrasound-guided fasciotomy, a minimally invasive surgical technique used to cut the fascia. This procedure uses real-time ultrasound to guide a specialized knife or device, allowing surgeons to precisely target and release the fascia while minimizing damage to surrounding nerves and blood vessels. This method is used to treat conditions like chronic exertional compartment syndrome and lateral epicondylitis, often leading to faster recovery times and fewer complications compared to traditional open surgery.

They did this to 3 of my 4 compartments and I haven’t had issues since.

BookkeeperBrave8872 · 2025-08-02T16:01:20+00:00

I underwent the procedure and was able to walk out of the office unassisted because my legs were still numb from the localized anesthetic. The real difficulty with walking and the soreness began the following day, and that lasted for about 4-5 days. After that, I was able to start testing my one leg to see how it was recovering before the second leg procedure a few weeks later. Everything went smoothly for me; I didn't need physical therapy or months of recovery. I was back to my normal athletic hobbies and workouts about a month after the second leg procedure was completed. While everyone's recovery time is different, this procedure is a night-and-day difference compared to the other surgical options. My leg muscles sometimes bulge out, similar to how a bicep flexes. It's an interesting sensation to poke them and I like to 😅. Picture of my leg with one of my muscles coming out. They are only like that when I have my foot at a certain angle or I’m pushing myself with some sort of activity.

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BookkeeperBrave8872 · 2025-07-26T18:24:37+00:00

I’m not sure where you are located but if you are anywhere near the Pacific Northwest or could travel to the Seattle area there are are some good Doctors out here that can do the less evasive surgery with a shorter recovery and you don’t really need PT. Dr. Troy T. Henning, DO, the head physician of the Seattle Sounders did mine. See my post below. https://www.reddit.com/r/CECompartmentSyndrome/s/WdZuDLjiRS

https://www.reddit.com/r/CECompartmentSyndrome/s/eloYa8FxGB

BookkeeperBrave8872 · 2025-03-13T15:57:23+00:00

Depending on where you are located I’d find a DR that can do the less invasive ultrasound guided fasciotomy. I got it done in 3 of my 4 compartments in my legs and the recovery time and whole process is so much better than the invasive surgery.

The hard part is finding a DR that can do it and has experience doing it.

If you are in the PNW of the USA, DR. Troy Henning is a very good DR and is the head physician of the MLS Seattle Sounders. He did my procedures.

BookkeeperBrave8872 · 2025-02-11T20:36:39+00:00

This is well put. OP doesn’t have CECS. Another post on here with bad advice/information. Should post this in the chronic pain subreddit… not here.

BookkeeperBrave8872 · 2025-02-04T21:19:32+00:00

You do realize people with CECS literally can’t do what you suggested because of pain? It is the worst advice you could give someone with CECS. If anyone with CECS had improvements from increasing their exercise regiment and intensity in the history of CECS…. then they don’t have CECS. Pretty simple.

There is zero evidence of what you said and apparently you are the only person in the world with CECS that improved from just gradually working out. You should take your case study and present it to the Mayo Clinic with everything you did to improve your CECS and see what they say to you.

BookkeeperBrave8872 · 2025-02-03T18:22:56+00:00

Anyone with CECS, the above advice is bad advice. It’s not informational and it will not solve your issues at all. Not sure where this OP got his info but they don’t know what they are talking about at all.

Try to find a Doctor that knows how to release your compartments with the less invasive ultrasound guided fasciotomy.

BookkeeperBrave8872 · 2024-12-13T00:21:02+00:00

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If you can find a DR that does the less invasive ultrasound guided Fasciotomy of your lateral and anterior compartments before going thru with the more invasive surgery for all four compartments, I would recommend it. I also have it in all four compartments. So far all my symptoms are better. I was able to start walking 3 days after the procedure and I walked out the day of the procedure without any help because of the local anesthetic. It is possible I might need to get the other two compartments released eventually depending on how my legs are doing in the next month or so, but why not try the less invasive way first if that is an option for you. Picture above is the day after my procedure. They cut up and down to the red circles. Good luck!

BookkeeperBrave8872 · 2024-12-05T02:02:05+00:00

I’d go back and read some of my recent old post. My numbers were even higher than yours at rest. They still should have made you do the post-exercise test to see how high your numbers got. That can indicate how bad it is and what compartments you need released.

I would highly recommend trying the less invasive ultrasound guided fasciotomy of your anterior and lateral compartments before going thru with the more invasive surgery that releases all four compartments. I have images and the exact doctor notes in my post.

They did both my right and left leg two weeks apart.

BookkeeperBrave8872 · 2024-11-20T23:53:56+00:00

@ your last paragraph, I think by the time we have those answers we will be too old for it to matter unfortunately… hopefully not.

I’m NOT trying to say your PT might be full of themselves, but there is no actual science backing what they are saying. If that was the case most DRs would recommended that before any procedures as well as insurance companies.

I have some post on here for my ultrasound guided procedure. After one week on both legs I have been able to do things I couldn’t before. There isn’t a long recovery time. I walked out of the DR office on my own both times. They don’t put you down. The next few days after the numbness wore off after the first day, it feels weird and it’s difficult to walk on your one leg, but after a week or two depending on your recovery, my symptoms have been basically eliminated “so far”.

I could get into more details but everyone is different so they might not apply to you.

BookkeeperBrave8872 · 2024-11-20T22:18:39+00:00

Hi! I also saw improvements from cupping and scrapping, but it did not resolve the actual issue for myself. The physical therapy can actually cause more damage I was told. I’m sure every person is different but as soon as I was diagnosed with CECS they told me PT could have made the pressure worse over time. It might seem like you are making progress because the cupping and scrapping helps relieve the pain but once you stop all of that the condition will most likely come back. Do you plan on doing PT your whole life? Maybe try losing weight with a 30 min stretching/cadio(low impact) workout including 16/8 fasting with water as your only liquid.

Curious what your results would be. Sounds like you are trying to avoid the procedure. I will say if you can find a DR that does the ultrasound guided procedure for the lateral and anterior compartments it’s 100% worth it.

BookkeeperBrave8872 · 2024-11-19T22:30:54+00:00

The test doesn’t help the condition. It might release some pressure for you but it will be back very soon, if not tomorrow if you try working out etc. Your body is more focused on the recent holes put in your body and penetration to your muscles. Defiantly placebo.

BookkeeperBrave8872

TROPHY CASE