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(Chronic Exertional Compartment Syndrome; Compartment Syndrome, Chronic; Compartment Syndrome, Exercise-induced; Compartment Syndrome, Recurrent; Exercise-induced Compartment Syndrome; Recurrent Compartment Syndrome; Exercise Myopathy)

Definition

Chronic compartment syndrome (CCS) is a buildup of pressure in an enclosed bundle (compartment) of muscles. It can block blood flow to the muscles and nerves.

CCS is not an emergency. However, early treatment can improve outcomes.

Compartment Syndrome in Lower Leg
Compartment Syndrome
Copyright © Nucleus Medical Media, Inc.

Causes

Intense exercise is the most common cause.

Risk Factors

This problem is more common in people who are less than 30 years of age. It is also more common in people who do activities with repetitive motions, such as running, biking, or swimming,.

Symptoms

Problems often affect the lower leg. A person may have pain or cramping during activity. They may also feel better after stopping activity. Other problems may be:

  • Numbness
  • A muscle that feels tight or full
  • Muscles that bulge
  • Problems moving the area

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Blood tests will be done.

Images may be taken. This can be done with x-rays.

The pressure inside the compartment will be measured. This can be done with:

  • Slit catheter
  • Tonometer
  • Near-infrared spectroscopy

Treatment

The goal of treatment is to ease pressure. Activities will need to be stopped to allow the area to heal. Treatment choices are:

  • Supportive care, such as wearing shoe inserts
  • Medicines to ease pain and swelling
  • Physical therapy to help with strength, flexibility, and range of motion

People who are not helped by these methods may need surgery to ease pressure. This is done with a fasciotomy. This surgery makes a cut in the tissue to ease swelling and pressure in the compartment.

Prevention

The risk of this problem may be lowered by slowly increase the intensity and duration of exercise.

RESOURCES

National Institutes of Arthritis and Musculoskeletal and Skin Diseases  http://www.niams.nih.gov 

Ortho Info—American Academy of Orthopaedic Surgeons  http://orthoinfo.org 

CANADIAN RESOURCES

Canadian Orthopaedic Foundation  http://www.canorth.org 

Canadian Physiotherapy Association  http://www.physiotherapy.ca 

References

Chronic compartment syndrome. American Academy of Podiatric Sports Medicine website. Available at: http://www.aapsm.org/chroniccompartment.html. Accessed February 16, 2021.

Compartment syndrome. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/compartment-syndrome/#:~:text=Compartment%20syndrome%20is%20a%20painful,be%20either%20acute%20or%20chronic. Accessed February 16, 2021.

Robertson GA, Wood AM. Lower limb stress fractures in sport: Optimising their management and outcome. World J Orthop 2017 Mar 18;8(3):242.

Shin pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/shin-pain. Accessed February 16, 2021.

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