Chronic exertional compartment syndrome is an exercise-induced muscle and nerve condition that causes pain, swelling and sometimes disability in the affected muscles of your legs or arms. Anyone can develop the condition, but it's more common in athletes who participate in activities that involve repetitive impact, such as running.
Chronic exertional compartment syndrome may respond to non-operative treatment and activity modification. If non-operative treatment doesn't help, your doctor might recommend surgery. Surgery is successful for many people, and might allow you to return to your sport.
The signs and symptoms associated with chronic exertional compartment syndrome might include:
- Aching, burning or cramping pain in the affected limb — usually the lower leg
- Tightness in the affected limb
- Numbness or tingling in the affected limb
- Weakness of the affected limb
- Foot drop, in severe cases, if legs are affected
- Often occurs in the same compartment of both legs
- Occasionally, swelling or bulging as a result of a muscle hernia
Pain due to chronic exertional compartment syndrome typically follows this pattern:
- Begins after a certain time, distance or intensity of exertion after you start exercising the affected limb
- Progressively worsens as you exercise
- Subsides within 10 to 20 minutes of stopping the activity
- Over time, recovery time after exercise often increases
Taking a complete break from exercise or performing only low-impact activity might relieve your symptoms, but usually only temporarily. Once you take up running again, for instance, those familiar symptoms usually come back.
When to see a doctor
If you have unusual pain, swelling, weakness, loss of sensation, or soreness related to exercise or sports activities, talk to your doctor immediately. Don't try to exercise through the pain; that can lead to permanent muscle or nerve damage.
Sometimes chronic exertional compartment syndrome is mistaken for shin splints, a more common cause of leg pain in young people who do a lot of vigorous weight-bearing activity, such as running. If you think you have shin splints but they don't get better with self-care, talk to your doctor.
The cause of chronic exertional compartment syndrome isn't completely understood. However, it's associated with increased pressure in a muscle compartment with exertion.
When you exercise, increased blood flow to working muscles expands them. If the connective tissue (fascia) that binds the muscle fibers in a compartment doesn't also expand, pressure builds up in the compartment. Over time, the pressure cuts off some of the muscle's blood supply.
Some experts suggest that how you move (biomechanics) might have a role in causing chronic exertional compartment syndrome. Other causes might include having enlarged muscles, an especially thick or inelastic band of tissue (fascia) surrounding a section of muscle, or high pressure within your veins (venous hypertension).
Certain factors increase your risk of developing chronic exertional compartment syndrome, including:
- Age. Although people of any age can develop chronic exertional compartment syndrome, the condition is most common in male and female athletes under 30.
- Type of exercise. Repetitive impact activity — such as running or fast walking — increases your risk of developing the condition.
- Overtraining. Working out too intensely or too frequently also can raise your risk of chronic exertional compartment syndrome.
Chronic exertional compartment syndrome isn't a life-threatening condition and usually doesn't cause lasting damage if you get appropriate treatment. However, continuing to exercise despite pain can be difficult if severe weakness or numbness is present.