Chronic Exertional Compartment Syndrome: What is It?

Jun 19, 2016

Exercise involves putting stress on the body. Your body then adapts to the stress by thickening and strengthening various tissues involved. As a result, the muscles become stronger, firmer and sometimes bulkier. The tendons become stronger and the bone density increases. But if exercise is applied in such a way your body cannot adapt, it can result in overload which causes tiny injuries, sometimes resulting in inflammation as the body’s response to injury.

Muscle overuse syndromes are not new. Increased frequency and intensity or load of work and practice can predispose you to chronic exertional compartment syndrome.

Chronic Exertional Compartment Syndrome

Chronic exertional compartment syndrome is a condition that occurs almost exclusively with running in which exercise increases intramuscular pressure which then compromises circulation. This affects muscular function and causes pain in the lower leg. It comes on gradually, usually after a long period of repetitive-motion exercise.

Anyone can develop chronic exertional compartment syndrome, but it is more common in athletes who participate in sports that involve repetitive impact exercise, such as running and fast walking. Whilst athletes are known to be at risk of compartment syndrome, other people such as dancers and workers are at risk as well.

Chronic exertional compartment syndrome is associated to an increase in tissue pressure within the area of a closed fascial space during exercise. The muscle size can increase up to 20% of its resting size during exercise. When the muscle volume increases, so is the internal pressure within the fascial compartment.

If the pressure within the muscles reaches to dangerous levels, blood flow can decrease, which prevents nourishment and oxygen from reaching nerve and muscle cells.

Some of the main contributing factors, as taught by top Universities, for compartment syndrome are:

  • Training overload
  • Poor variability within training schedules
  • Continuous running on soft surfaces
  • Excessive sessions of plyometric training
  • Improper foot mechanics

Symptoms most often occur in the leg. If you have chronic compartment syndrome you may experience the following:

  • Numbness
  • Difficulty moving the foot
  • Visible muscle bulging

Cramping pain occurs during exercise that eases when the activity is stopped. The symptoms occur because the swelling or bleeding increases the pressure inside the compartment. If numbness or paralysis occurs, there is likely a permanent tissue damage.

How Physiotherapy Helps

Most cases of compartment syndrome improve with appropriate physiotherapy. A physiotherapist does thorough assessment to identify the factors that have contributed to the development of the condition and then correct these factors.

The success of the treatment largely depends on your compliance. Modified rest from any activity that increases their pain until they are free from symptoms is one of the key components of the treatment. Once free from pain, you can gradually increase the activity as long as there is no increase in symptoms.

Some leg pains aren’t as simple as they seem. Don’t let it get worse, book an appointment with our Physio’s if you have leg pain.