Compartment Syndrome, Exertional

Exertional compartment syndrome is a painful problem that can happen over and over. The arms and legs have different compartments. Each compartment is made up of muscles, nerves, and blood vessels. Each compartment is enclosed by a layer of tissue called the fascia. The fascia can stretch but only a little. During exertion, the muscle swells due to increase blood flow. This may increase the pressure within the fascia, compressing the nerves and blood vessels. This leads to pain, numbness, or weakness. The pain starts while exercising and is relieved by rest. Sometimes, the pain can be severe and may even restrict activities. Usually, both legs are affected, and it almost always affects the lower legs. Rare cases may affect thighs or arms. Men and women are equally affected. It mostly affects athletes who are in very good shape and are less than age 40.

CAUSES

  • Repetitive activities that take a lot of effort.

  • Doing demanding activities or exercises without any conditioning.

  • Training level that is quickly increased.

SYMPTOMS

  • Pain and swelling.

  • Aches and cramps after demanding activity.

  • Feeling of tightness.

  • Tingling, burning, or numbness.

  • Weakness.

  • Any or all of the above coming on with exercise and going away with rest.

DIAGNOSIS

Your caregiver may suspect the problem based on how you describe the pain. The diagnosis is made by using a special device that measures the pressure in the affected area both during rest and exercise. Blood tests and special X-rays may be done to help rule out other problems, but they do not diagnose compartment syndrome.

TREATMENT

The symptoms may be reduced by stopping the activity that starts the pain. Other treatments include:

  • Applying ice to the affected area.

  • Elevating the limb(s).

  • Physical therapy.

  • Massage.

  • Pain medications.

  • Increased cushioning in the shoes.

Unfortunately, these methods may not be effective in controlling the symptoms. Athletes do not want to stop exercise. Surgery is the only effective treatment for relief of recurrent pain. It involves the surgeon cutting (incision) in the fascia to release the pressure in the compartment.

HOME CARE INSTRUCTIONS

  • Warm up and stretch properly before starting any exercise.

  • Cool down after you complete your exercise.

  • Stop activity if it causes pain.

  • Talk to your caregiver before you start any new exercise program.

  • Eat a balanced and healthy diet.

  • Drink lots of liquids.

  • Try other low impact exercises, such as swimming and cycling.

  • Do not wrap the affected area.

  • Use proper fitting shoes.

SEEK MEDICAL CARE IF:

  • Your symptoms come back (recur) or worsen even with treatment.

  • Pain continues despite rest and avoiding exercise.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.