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Causes of Exercise-Induced Compartment Syndrome
Exercise-induced compartment syndrome is due to a pressure build-up within the muscles. Muscles are enclosed within a tight tissue called fascia. This fascia wraps around and contains the muscle. Normally, the fascia has enough extra room to allow the muscle to function without a problem.
The most common location of exercise-induced compartment syndrome is the leg, in particular around the shin bone. Symptoms are often seen in runners and cross-country skiers. Compartment syndrome can also occur in the thigh (common in weightlifters and cyclists), forearm (rowers and motocross riders), and other muscle compartments of the body.
Pain With Compartment Syndrome
Before you begin to worry, ischemia of the heart and exercise-induced compartment syndrome are very different! Furthermore, relief of exercise-induced compartment syndrome is usually very easy—simply stop exertion of the muscle.
Symptoms of Exercise-Induced Compartment Syndrome
The most common symptom is pain during activity that is quickly relieved with rest. Patients may notice a tingling or numbness due to a lack of blood flow to the nerves that pass through the compartment. Often when the symptoms are present, the area over the muscles of the affected compartment feels very tight.
Treatment of Exertional Compartment Syndrome
A period of rest may be attempted, as well as avoiding any activities that cause the symptoms. However, if the diagnosis of exercise-induced compartment syndrome is clear and the symptoms persist, surgery may be needed.
The surgery involves releasing (cutting) the tight fascia, called afasciotomy. An incision is made over the affected area. Next, the surgeon cuts the tight tissue that surrounds the muscle. The major risk of this surgery is cutting the small nerves that provide sensation to the extremity. Usually, the surgeon can identify the nerves and avoid them, but it is still possible to damage the nerves.
A Word From Verywell
Exercise-induced compartment syndrome can be a frustrating problem. Without an easy test to diagnose this condition, many people struggle to find relief from their symptoms. Usually, relief can only come from one of two methods: modifying activities to prevent the muscles from having to work excessively, or a surgical procedure that allows more room for the muscles.
Modifying activities can be difficult for athletes who require high-intensity activity in order to compete at the highest levels of their sport. In these situations, surgical solutions are typically the most effective treatment. However, there are some recent breakthroughs in treatment through gait and running retraining that may also be effective.
Frequently Asked Questions
There are two ways to prevent exertional compartment syndrome: avoid or alter exercises that trigger pain and receive surgery. For example, if running on concrete causes symptoms to occur, running on other surfaces or performing low-impact exercises may help. Nonsurgical treatments such as anti-inflammatory medications, shoe inserts, and physical therapy are not always effective for preventing symptoms, but it may be worth mentioning these to your healthcare provider.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Buerba RA, Fretes NF, Devana SK, Beck JJ.Chronic exertional compartment syndrome: current management strategies. Open Access J Sports Med. 2019;10:71–79. doi:10.2147/OAJSM.S168368Joyner MJ, Casey DP.Regulation of increased blood flow (hyperemia) to muscles during exercise: a hierarchy of competing physiological needs.Physiol Rev. 2015;95(2):549–601. doi:10.1152/physrev.00035.2013Chandwani D, Varacallo M.Exertional Compartment Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing,Zimmermann WO, Hutchinson MR, Berg RVD, Hoencamp R, Backx FJG, Bakker EWP.Conservative treatment of anterior chronic exertional compartment syndrome in the military, with a mid-term follow-up.BMJ Open Sport & Exercise Medicine. 2019;5(1). doi:10.1136/bmjsem-2019-000532American Academy of Orthopaedic Surgeons. OrthoInfo.Compartment Syndrome.Additional ReadingFraipont MJ and Adamson GJ “Chronic Exertional Compartment Syndrome” J. Am. Acad. Ortho. Surg.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Buerba RA, Fretes NF, Devana SK, Beck JJ.Chronic exertional compartment syndrome: current management strategies. Open Access J Sports Med. 2019;10:71–79. doi:10.2147/OAJSM.S168368Joyner MJ, Casey DP.Regulation of increased blood flow (hyperemia) to muscles during exercise: a hierarchy of competing physiological needs.Physiol Rev. 2015;95(2):549–601. doi:10.1152/physrev.00035.2013Chandwani D, Varacallo M.Exertional Compartment Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing,Zimmermann WO, Hutchinson MR, Berg RVD, Hoencamp R, Backx FJG, Bakker EWP.Conservative treatment of anterior chronic exertional compartment syndrome in the military, with a mid-term follow-up.BMJ Open Sport & Exercise Medicine. 2019;5(1). doi:10.1136/bmjsem-2019-000532American Academy of Orthopaedic Surgeons. OrthoInfo.Compartment Syndrome.Additional ReadingFraipont MJ and Adamson GJ “Chronic Exertional Compartment Syndrome” J. Am. Acad. Ortho. Surg.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Buerba RA, Fretes NF, Devana SK, Beck JJ.Chronic exertional compartment syndrome: current management strategies. Open Access J Sports Med. 2019;10:71–79. doi:10.2147/OAJSM.S168368Joyner MJ, Casey DP.Regulation of increased blood flow (hyperemia) to muscles during exercise: a hierarchy of competing physiological needs.Physiol Rev. 2015;95(2):549–601. doi:10.1152/physrev.00035.2013Chandwani D, Varacallo M.Exertional Compartment Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing,Zimmermann WO, Hutchinson MR, Berg RVD, Hoencamp R, Backx FJG, Bakker EWP.Conservative treatment of anterior chronic exertional compartment syndrome in the military, with a mid-term follow-up.BMJ Open Sport & Exercise Medicine. 2019;5(1). doi:10.1136/bmjsem-2019-000532American Academy of Orthopaedic Surgeons. OrthoInfo.Compartment Syndrome.
Buerba RA, Fretes NF, Devana SK, Beck JJ.Chronic exertional compartment syndrome: current management strategies. Open Access J Sports Med. 2019;10:71–79. doi:10.2147/OAJSM.S168368
Joyner MJ, Casey DP.Regulation of increased blood flow (hyperemia) to muscles during exercise: a hierarchy of competing physiological needs.Physiol Rev. 2015;95(2):549–601. doi:10.1152/physrev.00035.2013
Chandwani D, Varacallo M.Exertional Compartment Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing,
Zimmermann WO, Hutchinson MR, Berg RVD, Hoencamp R, Backx FJG, Bakker EWP.Conservative treatment of anterior chronic exertional compartment syndrome in the military, with a mid-term follow-up.BMJ Open Sport & Exercise Medicine. 2019;5(1). doi:10.1136/bmjsem-2019-000532
American Academy of Orthopaedic Surgeons. OrthoInfo.Compartment Syndrome.
Fraipont MJ and Adamson GJ “Chronic Exertional Compartment Syndrome” J. Am. Acad. Ortho. Surg.
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