Chronic compartment syndrome (CCS) occurs when pressure builds up within the body’s muscle compartments. Compartments are made of sheets of connective tissue called fascia. These sheets are under the skin of the arms and legs. They wrap around groups of muscles, nerves, and blood vessels. When pressure builds up in the compartments, it disrupts or blocks blood flow to the muscles and nerves.
Unlike acute compartment syndrome, CCS is not an emergency. However, you should see your doctor to get treatment.
Compartment Syndrome in Lower Leg
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CCS is most commonly caused by intense exercise.
CCS usually occurs in people less than 30 years old. Other factors that may increase your chance of CCS include: Participating in endurance sportsParticipate in sports that involve running or jumpingAnabolic steroid and creatine useEccentric exercisePoor biomechanics in runners
CSS can affect the lower leg. However, it can also affect the arms, hands, feet, and buttocks.
Symptoms may include: Severe pain during exercise that typically goes away an hour after stoppingPain on both sides of the body, such as in both legsFullness or tightness in the muscleTender, aching musclesMuscle weaknessNumbness, tinglingIn severe cases, foot drop—a foot slaps hard on the ground when running
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Slit catheter or tonometer can measure compartment pressure.Range-of-motion stretches can assess the damage.
Imaging tests to evaluate bodily structures may include:
MRI scanCT scanElectromyogram
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Surgery, called fasciotomy, is the main treatment for CCS. This is done to open the compartment and relieve pressure. A long cut will be made into the fascia to open the tissue and relieve pressure.
It can take up to 3 months to recover. After surgery, you will need physical therapy.
If you are only had CCS for a short time or you decide not to have surgery, your doctor may recommend that you: Stop the activity that is causing CCS and restChange your training routineDo physical therapyTake anti-inflammatory medications or muscle relaxantsCustom made orthotics
To help reduce your chance of CCS: Avoid overexercisingChange your training routineAvoid anabolic steroids and creatine
Chronic compartment syndrome. American Academy of Podiatric Sports Medicine website. Available at:
http://www.aapsm.org/chroniccompartment.html. Accessed January 31, 2013.
Compartment syndrome. American Academy of Orthopaedic Surgeons Ortho Info website. Available at:
http://www.aapsm.org/chroniccompartment.html. Updated October 2009. Accessed January 31, 2013.
Stedman’s Medical Dictionary. 28th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2005; 700;1894-1895.
Tucker AK. Chronic exertional compartment syndrome of the leg. Curr Rev Musculoskelet Med. 2010;3(1-4):32-37.
Last reviewed December 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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