Dr Jason Toniolo

Chronic Exertional Compartment Syndrome

Chronic exertional compartment syndrome occurs when the muscles in the legs swell during exercise.

The calf muscles are wrapped circumferentially in a very tight, fibrous layer band. This fibrous band is fixed in its size/volume and can not expand. If the muscles swell during exercise, they can get squashed within the fibrous band, which causes severe pain.

Symptoms

Symptoms include pain, tightness, or cramping in the affected muscles during physical activity, which subsides after rest. The condition often affects athletes or people engaged in repetitive physical activity.

Diagnosis

The primary test of choice is compartment pressure monitoring, done after walking on a treadmill. Sports physicians generally do this test, which involves passing needles into the calf after exercising to check the pressure.

Treatment

Non-surgical options include physical therapy and modifying exercise routines. However, in many cases, surgery (fasciotomy) to relieve the pressure may be necessary. Fasciotomy is performed through minor incisions on either side of the shin, and the fascia is released for a length under the skin so that the muscle has more room to breathe and swell without getting strangulated.

treatment options