Chronic exertional compartment syndrome
DEFINITION
Chronic exertional compartment syndrome is an exercise-induced muscle and nerve condition that causes pain, swelling and sometimes even disability in affected muscles of your legs or arms.
Anyone can develop chronic exertional compartment syndrome, but it’s more common in athletes who participate in sports that involve repetitive impact exercise, such as running and fast walking. Chronic exertional compartment syndrome is sometimes called chronic compartment syndrome or exercise-induced compartment syndrome.
If conservative treatment doesn’t help with chronic exertional compartment syndrome, your doctor may recommend surgery. Surgery is successful for many people, allowing you — whether you’re a recreational or serious athlete — to return to your sport.
CAUSES
Excessive pressure within an isolated segment of muscle (a muscle compartment) causes chronic exertional compartment syndrome. Exercise increases the blood supply to working muscles, making them expand. If the connective tissue (fascia) that holds the muscle fibers together in a compartment doesn’t also expand, pressure builds up in the compartment. Over time, the pressure cuts off some of the muscle’s blood supply, leading to chronic exertional compartment syndrome.
Some experts suggest that biomechanics — how you move — may have a role in causing chronic exertional compartment syndrome. Other causes may include having enlarged muscles, an especially thick or inelastic band of tissue (fascia) surrounding a section of muscle, or high pressure within your veins (venous hypertension).
SYMPTOMS
The pain and other symptoms associated with chronic exertional compartment syndrome may be characterized by:
- Aching, burning or cramping pain in the affected limb — usually the lower leg
- Tightness in the affected limb
- Numbness or tingling in the affected limb
- Weakness of the affected limb
- Foot drop, in severe cases, if nerves in your legs are affected
- Occasionally, swelling or bulging as a result of a muscle hernia
Pain due to chronic exertional compartment syndrome typically follows this pattern:
- Begins soon after you start exercising the affected limb
- Progressively worsens as long as you exercise
- Stops within 30 minutes after the affected limb comes to rest
- Over time, may begin to persist longer after exercise, possibly lingering for a day or two
- Taking a complete break from exercise or performing only low-impact activity may relieve your symptoms, but usually only temporarily. Once you take up running again, for instance, those familiar symptoms usually come back.
When to see a doctor
- If you experience unusual pain, swelling, weakness, loss of sensation, or soreness related to exercise or sports activities, talk to your doctor immediately, because these symptoms may be associated with conditions that require emergency medical treatment. Don’t try to exercise through the pain, as that may lead to permanent muscle or nerve damage — and jeopardize continued participation in your favorite sports.
- Sometimes chronic exertional compartment syndrome is mistaken for shin splints, a more common cause of leg pain in young people who do lots of vigorous weight-bearing activity, such as running.
