Chronic exertional compartment syndrome is an exercise-induced muscle and nerve condition that causes pain, swelling and sometimes disability in the affected muscles of the legs or arms. It can affect muscle compartments in any of your limbs but occurs most commonly in the lower legs. The lower leg has four compartments, and any one or all of them can be affected. Anyone can develop the condition, but it is more common in young adult runners and athletes who participate in activities that involve repetitive impact.
Causes:
The cause of chronic exertional compartment syndrome is not completely understood. When you exercise, your muscles expand in volume. If you have chronic exertional compartment syndrome, the tissue that encases the affected muscle (fascia) does not expand with the muscle, causing pressure and pain in a specific area (compartment) of the affected limb.
Symptoms:
The signs and symptoms associated with chronic exertional compartment syndrome can include:
Aching, burning or cramping pain in a specific area (compartment)
Tightness
Numbness or tingling
Weakness
Foot drop in severe cases
Often occurs in the same compartment of both legs
Occasionally, swelling or bulging as a result of a muscle hernia
Pain caused by chronic exertional compartment syndrome typically follows this pattern:
Begins consistently after a certain time, distance, or intensity of exertion after you start exercising the affected limb
Progressively worsens as you exercise
Becomes less intense or stops completely within 15 minutes of stopping the activity
Over time, recovery time after exercise may increase
Taking a complete break from exercise or performing only low-impact activity might relieve your symptoms, but usually only temporarily. Once you take up running again, for instance, those familiar symptoms usually come back.
Treatment:
Treatment of compartment syndrome begins with a conservative regimen of reduced exercise, deep massage therapy, and addressing any contributing biomechanical abnormalities. Cross-training with low-impact activities may be an option. Some athletes have symptoms that are worse on certain surfaces (concrete vs. running track, or artificial turf vs. grass). When conservative management fails, surgical release is usually required.
