Chronic Exertional Compartment Syndrome – Symptoms and Causes
Symptoms
Chronic exertional compartment syndrome typically affects the same muscle compartment on both sides of the body, most commonly in the lower legs where four distinct compartments exist.
Common symptoms include:
- Aching, burning or cramping pain in the affected area
- Muscle tightness in the limb
- Numbness or tingling sensations
- Weakness when using the affected limb
- In severe cases involving the legs, foot drop may occur
- Some patients experience visible swelling or bulging from muscle hernias
The pain pattern follows a predictable course:
- Pain begins consistently after a specific duration, distance, or intensity of exercise
- Symptoms gradually worsen during continued activity
- Discomfort diminishes or disappears within about 15 minutes after stopping
As the condition progresses, recovery time following exercise often increases.
While temporarily avoiding exercise or switching to low-impact activities might provide relief, symptoms typically return once regular activities resume.
Many people notice these symptoms are bilateral (affecting both sides) and highly consistent, occurring at similar points during their exercise routines. This predictable pattern helps distinguish this condition from other exercise-related pain issues.
When to see a doctor
Contact your doctor if you experience ongoing unusual pain, swelling, weakness, numbness, or soreness during exercise or sports activities.
Chronic exertional compartment syndrome is sometimes confused with shin splints. Shin splints are a more common leg pain issue in young, active people who do high-impact activities like running.
If you’ve tried treating what you think are shin splints but the pain doesn’t improve with rest and self-care, it’s time to speak with a healthcare provider.
Early diagnosis can help prevent long-term complications and get you back to your activities sooner.
Causes
Exercise-Related Muscle Compartment Pressure
Exercise-related muscle compartment pressure occurs when muscles swell during physical activity but can’t expand properly. This condition happens because the tough tissue (fascia) surrounding muscle groups doesn’t stretch enough when muscles enlarge during exercise.
During exercise, muscles naturally increase in size as blood flow increases. In a healthy person, the surrounding tissue accommodates this growth.
However, in people with this condition, the fascia remains tight, creating excess pressure within the muscle compartment. This increased pressure causes pain, tightness, and sometimes numbness.
Several factors may contribute to this problem:
- Movement Patterns: How a person runs or performs other exercises might put extra stress on certain muscle groups.
- Muscle Characteristics: Some people have muscles that expand more than average during exercise.
- Fascia Flexibility: Having particularly rigid fascia tissue can restrict normal muscle expansion.
- Vascular Issues: Higher than normal pressure in blood vessels may play a role.
This condition most commonly affects the lower legs, where there are four distinct compartments separated by fascia. Any or all of these compartments can develop symptoms when exercising.
Risk Factors
Several factors may increase your chance of getting chronic exertional compartment syndrome:
- Age: This condition most commonly affects young athletes under 30 years old, both male and female.
- Exercise Type: Activities with repetitive impact, especially running, create a higher risk of developing this problem.
- Training Intensity: Exercising too hard or too often can raise your risk. People who overtrain without proper rest periods are more likely to develop this condition.
Complications
Living with chronic exertional compartment syndrome isn’t dangerous to your life, but it can affect your physical activities.
When you have this condition, you might experience:
- Pain during exercise
- Muscle weakness
- Numbness in affected areas
These symptoms can make it hard to maintain your regular exercise routine or sport at the same intensity level you’re used to.
With proper treatment, most people avoid permanent damage to their muscles or nerves. Without treatment, the ongoing pain might force you to reduce your activity levels or change your exercise habits.
