Chronic Exertional Compartment Syndrome
Chronic Exertional Compartment Syndrome (CECS) can cause pain, swelling and weakness in the lower leg and can be progressive in nature. The symptoms can be replicated by repeating the activity. Symptoms usually improve with rest.
What causes it?
CECS usually comes on from a chronic overload of a particular compartment, leading to a restriction in blood flow and swelling of the muscle, which further exacerbated these changes. In turn, as the pressure builds, pain develops and with repeated episodes, there can be injury to nerves supplying the muscles.
How can I help myself?
It is useful to think back to when the symptoms come on and what continues to aggravate it. Sometimes, if it is due to running technique or tightness, then working with a coach or sports therapist can be helpful.
If there is considerable pain or swelling, offloading will reduce exacerbating it and also measures such as PRICE can help to reduce swelling. Pain killers can make the symptoms more tolerable.
When to seek help?
If you are having significant symptoms, particularly an inability to exercise, or if the measures to improve things your symptoms are ineffective, it would be good to have your problem assessed.
What are the treatment options?
Once your clinician assesses you with a thorough history and examination, they may undertake an X-ray to look for a stress fracture, or an ultrasound scan to look at the tendons or soft tissue in the leg. If both are normal, an MRI may be helpful to look for a stress reaction with bone bruising.
For the most part, treatment with rehabilitation and a running gait analysis with a focus on footwear, stride and cadence will suffice. In some situations, if this not improve symptoms, compartment pressure testing is needed and if it is elevated, a surgical release may be required.