Overview of chronic exertional compartment syndrome

Buerba, 2019 Liu, 2017 Vajapey, 2017

Figure 1. Key points for chronic exertional compartment syndrome.

[NB1]

Chronic exertional compartment syndrome refers to exercise-induced lower leg pain that is reversible with rest.
Diagnosis is usually clinical, and the only definitive investigation is compartment-pressure testing.
The only management that has been shown to be effective is cessation of the inciting activity.
Surgical fasciotomy may be indicated for unacceptable symptoms.

Note: NB1: This list is a summary guide only; refer to full text.

Chronic exertional compartment syndrome is characterised by exercise-induced, reversible increases in pressure within inelastic fascial compartments. This can lead to pain, functional impairment and, in rare cases, neurological compromise. Controversy exists as to whether the pain is related to ischaemia or activation of pressure receptors in muscle compartments.

Pain originating in the anterior or deep posterior muscle compartment of the lower leg is common in those who exercise (eg elite athletes, recreational runners) and may be caused by a chronic exertional compartment syndrome. Chronic exertional compartment syndrome of the deep posterior compartment often presents as medial tibial pain.

The condition can also affect the upper limbs (eg in rowers), the feet and hands.