Other exercise-related problems are more common than chronic exertional compartment syndrome, so your doctor may first try to rule out other causes — such as shin splints or stress fractures — before moving on to more specialized testing.
Physical exams for chronic exertional compartment syndrome are often normal. Your doctor might prefer to examine you after you've exercised to the point of bringing on symptoms. Your doctor may notice a muscle bulge (herniation), tenderness or tension in the affected area.
Your doctor might suggest imaging studies such as MRI or near infrared spectroscopy (NIRS). A typical MRI scan of your legs can be used to evaluate the structure of the muscles in the compartments and rule out other possible causes of your symptoms.
A newer, special MRI scan can help assess the fluid volumes of the compartments during exercise. It has been found to be accurate in detecting compartment syndrome, and may reduce the need for the invasive compartment pressure testing.
NIRS is a newer technique that uses light wavelengths to measure tissue oxygen saturation in your blood. This helps to determine if your muscle compartment has decreased blood flow.
Compartment pressure testing
If imaging studies fail to uncover an abnormality such as a stress fracture or similar cause of pain, your doctor might suggest measuring the pressure within your muscle compartments.
This test, often called compartment pressure measurement, is the gold standard for diagnosing chronic exertional compartment syndrome. Because it's invasive and mildly painful, involving insertion of needles into your muscles, compartment pressure measurement usually isn't performed unless your medical history and other tests strongly suggest you have this condition.