Causes and Risk Factors of Exercise-Induced Compartment Syndrome

Chronic Compartment Syndrome is also known as Exercise-Induced Compartment Syndrome and Exertional Compartment Syndrome.

Chronic Compartment Syndrome is a rare exercise-induced neuromuscular disorder that often results in swelling, pain and disability in affected muscles of the arms and legs.

Chronic Compartment Syndrome involves microtrauma and repetitive loading such as in physical activity due to which it is also known as Exercise-Induced Compartment Syndrome or Exertional Compartment Syndrome.

Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome can affect anyone. Athletes participating in sports that involve repetitive movements like biking, swimming, running and fast walking more commonly get affected with Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome.
Conservative treatment is not helpful most of the times for treating Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome and therefore surgery is often required to treat the condition.

Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome

Epidemiology of Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome

Ascertaining the exact prevalence of Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome is really difficult. However, anterior exercise-induced compartment syndrome is estimated to be 14 percent in United States.

Chronic Compartment Syndrome or Exercise-induced compartment syndrome is more common among athletes less than 40 years of age. Although men and women equally get affected with Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome, but lower leg Chronic Exertional Compartment Syndrome is more common in women when compared to men.

Causes and Risk Factors of Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome

The legs and arms consist of many compartments of nerves, muscles and blood vessels. Each of the compartments is covered by a thick layer of connective tissue known as fascia. The fascia is an inelastic thick layer which helps in supporting the compartments in order to hold the tissues of each compartment to keep them in their place.

Repetitive muscle contraction and exercise pressurizes the tissues present in a compartment to higher extent, but due to the inexpandability of fascia it fails to expand with increased stress. The pressure developed in the muscle compartments, when does not find any releasing outlet, results in compression of the blood vessels and nerves. This may result in compromising the flow of blood due to which tissues acquire insufficient amounts of oxygen-rich blood leading to ischemia and causing damage to the muscles and nerves. This phenomenon is similar to shaking up a soda bottle and leaving it without opening the cap where lot of pressure builds up in the bottle.

Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome is often suffered by individuals who participate in sports activities such as soccer, tennis, running, gymnastics, biking and football.

Signs and Symptoms of Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome

  • Burning pain and cramping is experienced in the affected limb is one of the symptoms of Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome.
  • Generally the lower leg is affected, however, forearm, hand, thigh and upper arm is also affected in some cases.
  • The limb affected with Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome may also become tight.
  • Tingling and numbness in the affected limb.
  • Feeling of weakness in affected limb.
  • Sometimes there is swelling and bulging also experienced in Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome due to muscle hernia.
  • Exacerbation of pain due to exercise.
  • Foot drop in severe cases.
  • Pain relief after 15 to 20 minutes of resting the affected limb.

Treatment for Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome

Rest from weight-bearing activities and stressful movements usually helps in controlling the symptoms of Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome. Surgery is performed when conservative methods fail to yield satisfactory results in the treatment of Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome.

Surgical procedure called Fasciotomy is performed in order to release the tight fascia. This procedure is done by making an incision over the affected region in order to cut the tight tissue surrounded by the muscle, but this may involve risk of cutting a small nerve that helps in providing sensation to the top side of the foot. However, the surgeons have a good knowledge about it and can identify and avoid damaging the nerve, but there still is a small risk of nerve damage.

Tests to Diagnose Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome

Review of family history and a thorough subjective and physical examination needs to be performed looking for specific symptoms implicating Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome. Pain can make the diagnosis more difficult as there may be many reasons for it. However, in many cases the diagnosis may take several weeks and sometimes even months. Other common conditions such as stress fractures and shin splints are ruled out before arriving at the diagnosis of Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome. Normal physical exam usually adds to the difficulty in diagnosing this condition.

Compartment Pressure Test: A special test known as compartment pressure test is used for diagnosing Chronic Compartment Syndrome. This test is an invasive test which involves inserting needles into the muscles and hence it can be painful. For this reason compartment pressure measurement is performed only after the other tests and medical history strongly implicate the condition.

Other Tests for Diagnosing Chronic Compartment Syndrome or Exercise-Induced Compartment Syndrome May Include:

  • CT scan.
  • X-rays.
  • Doppler Studies.
  • Ultrasound.
  • MRI.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: June 29, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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