Chronic Compartment Syndrome
(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.
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.
Last reviewed December 2020 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM Last Updated: 2/16/2021