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  • Chronic Compartment Syndrome

    (Chronic Exertional Compartment Syndrome; Compartment Syndrome, Chronic; Compartment Syndrome, Exercise-induced; Compartment Syndrome, Recurrent; Exercise-induced Compartment Syndrome; Recurrent Compartment Syndrome; Exercise Myopathy)

    Definition

    Chronic compartment syndrome (CCS) occurs when pressure builds up within the body’s muscle compartments. Compartments are made of sheets of connective tissue called fascia. These sheets are under the skin of the arms and legs. They wrap around groups of muscles, nerves, and blood vessels. When pressure builds up in the compartments, it disrupts or blocks blood flow to the muscles.
    Unlike acute compartment syndrome, CCS is not an emergency. But you should see your doctor to get treatment.
    Compartment Syndrome in Lower Leg
    Compartment Syndrome
    Copyright © Nucleus Medical Media, Inc.

    Causes

    CCS is most commonly caused by intense exercise.

    Risk Factors

    Participating in endurance sports increases your chance of getting CSS. You are at greater risk if you participate in sports that involve running or jumping.

    Symptoms

    CSS can affect the lower leg. But, it can also affect the arms, hands, feet, and buttocks. If you have any of these symptoms, do not assume it is due to CCS. These symptoms may be caused by other conditions.
    • Pain on both sides of the body, such as in both legs
    • Severe pain during exercise that typically goes away an hour after stopping
    • Fullness or tightness in the muscle
    • Tender, aching muscles
    • Muscle weakness
    • Numbness, tingling
    • In severe cases, foot drop—a foot slaps hard on the ground when running

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done.
    • You may have the pressure inside your compartments measured. This can be done with a slit catheter or tonometer.
    • Your doctor may ask you to perform range-of-motion stretches to assess the damage.
    • Your doctor may need to see pictures of your body structures. This can be done with:

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include the following:

    Surgery

    Surgery, called fasciotomy, is the main treatment for CCS. This is done to open the compartment and relieve pressure. A long slice will be made into the fascia to open the tissue and relieve pressure. It takes about three months to recover. You will have to do physical therapy.

    Nonsurgical Approaches

    If you decide not to have surgery, your doctor may recommend that you:
    • Stop the activity that is causing CCS and rest.
    • Change your training routine.
    • Do physical therapy.
    • Take anti-inflammatory medications or muscle relaxants.

    Prevention

    To help reduce your chance of getting CCS, take the following steps:
    • Avoid overexercising.
    • Change your training routine.

    RESOURCES

    American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/

    National Institutes of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov

    CANADIAN RESOURCES

    Canadian Orthopaedic Foundation http://www.canorth.org

    Physical Therapy Canada http://www.physicaltherapy.ca

    References

    Chronic compartment syndrome. American Academy of Podiatric Sports Medicine website. Available at: http://www.aapsm.org/chroniccompartment.html . Accessed January 31, 2013.

    Compartment syndrome. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00204#Cause . Updated October 2009. Accessed January 31, 2013.

    Compartment syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated May 24, 2011. Accessed January 31, 2013.

    Stedman’s Medical Dictionary . 28th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2005; 700;1894-1895.

    Revision Information

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