Exertional Compartment Syndrome

Exertional compartment syndrome typically occurs during repetitive impact activities such as running or jumping. It happens when the pressure within one of your muscle compartments increases to dangerous levels, most often during exercise.

Exertional compartment syndrome can be either chronic or acute:

• Chronic exertional compartment syndrome is the most common type. It is typically caused by athletic exertion, like running, and symptoms resolve when the activity is stopped.
• Acute exertional compartment syndrome is a medical emergency and usually occurs after a traumatic injury such as a fracture or severe muscle bruising.

Symptoms of exertional compartment syndrome often begin as a tingling or tightness sensation in the affected limb during exercise. As exercise continues, the individual may experience:

• Aching, burning or cramping pain in the affected limb
• Numbness or tingling
• Foot drop (in severe cases)
• Swelling or bulging in the muscle

When exercise is stopped, symptoms typically subside within 30 minutes.

In cases of chronic exertional compartment syndrome, symptoms may resolve with rest and cessation of the activity that caused them. However, symptoms often return when the activity is resumed. Acute compartment syndrome is a medical emergency and requires immediate treatment to prevent permanent muscle and nerve damage.

Your orthopedic surgeon Dr. Mayo will conduct a physical examination and discuss your symptoms. To confirm the diagnosis, a compartment pressure test may be performed, in which a small needle is inserted into the muscle compartment to measure the pressure before and after exercise.

Non-surgical treatment options for chronic exertional compartment syndrome include activity modification, physical therapy, orthotic devices, and anti-inflammatory medications. For those who fail to improve with conservative management, surgery may be recommended. This usually involves a procedure called a fasciotomy, where the fascia is cut to relieve the pressure in the compartment.

Surgery is recommended for individuals who have debilitating symptoms that interfere with their activities and have not responded to conservative treatments. Timing of surgery depends on the severity of symptoms and the impact on the individual’s quality of life.

The most common surgical treatment for chronic exertional compartment syndrome is a fasciotomy. In this procedure, the Dr. Mayo makes one or more small incisions in the skin and cuts the fascia, relieving pressure in the compartment.

The recovery process can vary greatly depending on the extent of the condition and the individual’s overall health. Generally, it involves a period of rest and rehabilitation, including physical therapy to regain strength and mobility. Most patients can return to sports activities within 3-6 months.