Overview
Chronic exertional compartment syndrome (CECS) is a condition characterized by abnormally increased compartment pressures and pain in the involved extremity during exercise.
Types of Chronic Exertional Compartment Syndrome (CECS)
CECS most commonly affects the lower legs. It differs from shin splints, as CECS pain persists despite rest. The differential diagnosis includes vascular insufficiency, popliteal artery entrapment syndrome, repetitive stress injuries, and neuropathies. CECS can also coexist with shin splints, complicating the diagnosis.
Causes of Chronic Exertional Compartment Syndrome (CECS)
The exact cause of CECS remains unclear. During exercise, muscle fibers expand, and blood flow increases. If the fascia restricts this expansion, compartment pressure rises, leading to reduced blood flow, ischemia, and pain. Increased interstitial fluid also contributes to the process.
Risk Factors of Chronic Exertional Compartment Syndrome (CECS)
Several risk factors contribute to CECS:
- High-impact activities: Athletes engaging in repetitive high-impact exercises are more susceptible.
- Anatomical factors: Certain variations predispose individuals to CECS.
- Training intensity: Overtraining or sudden intensity increases play a role.
Symptoms of Chronic Exertional Compartment Syndrome (CECS)
CECS symptoms include:Preventions of Chronic Exertional Compartment Syndrome (CECS)
To prevent CECS:
- Gradual training: Avoid sudden intensity jumps.
- Proper warm-up: Adequate warm-up and stretching are essential.
- Footwear: Choose appropriate shoes to reduce impact.
Diagnosis of Chronic Exertional Compartment Syndrome (CECS)
A definite diagnosis involves measuring intracompartmental pressures (ICP). MRI can also be used when direct pressure measurements are not feasible. MRI features include muscular hyperintensity on T2-weighted or fast STIR images, with or without muscular swelling.
Treatment for Chronic Exertional Compartment Syndrome (CECS)
Treatment options include:
- Conservative measures: Rest, ice, and physical therapy.
- Surgical release: Fasciotomy to relieve pressure.
- Rehabilitation: Gradual return to activity post-surgery.
When to seek medical attention ?
Seek medical attention if you experience persistent exercise-related leg pain, swelling, or numbness. Early intervention improves outcomes.
