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Exercise-Induced Compartment Syndrome

Exercise-Induced Compartment Syndrome, also known as exertional or chronic compartment syndrome, is caused by athletic overuse. Generally, exercise-induced compartment syndrome is not a medical emergency but may cause enough pain to visit Dr. Thomas Hackett. Symptoms are often seen in cyclists, runners, skiers, rowers or weightlifters.


Compartment syndrome refers to a painful condition when pressure within the leg or arm muscles increases to dangerous levels. Compartments are the groups of muscles, nerves, and blood vessels in your legs and arms. Covering the compartment is a strong membrane called fascia, which does not expand easily because it keeps the tissues in place. When pressure from swelling or exercising increases, it may decrease blood flow, preventing proper nourishment and oxygen from reaching the nerve and muscle cell.

Exercise-induced occurs in athletes or active people who participate in repetitive activities, including running, swimming, biking or rowing. The most common area of exercise-induced compartment syndrome is the lower leg or calf.


Exercise-Induced compartment syndrome generally causes pain or cramping during a particular exercise. This pain usually stops when the motions stop. Aside from pain, symptoms may include:

  • Numbness
  • Muscle bulging
  • Difficulty moving your foot


To diagnose exercise-induced compartment syndrome, Dr. Hackett must rule out any other conditions that may cause pain in the lower leg. During the evaluation, he may examine your tendons to test for tendonitis. Dr. Hackett may also order an X-ray to rule out a stress fracture you may have. To confirm the condition, Dr. Hackett measures the pressure in the compartment before and after exercise. If the pressure is increased or high after exercise, you likely have compartment syndrome.

Non-Surgical Treatments

Symptoms of this condition may be alleviated if the individual avoids the exercise that caused the syndrome. Cross-training with lower impact exercises may be helpful in relieving pain. The most common non-surgical treatments for exercise-induced compartment syndrome, include physical therapy, orthotics (shoe inserts), and anti-inflammatory medication.

Surgical Treatments

For some individuals, like professional athletes or active individuals, avoiding a certain exercise isn’t always an option for treatment. Also, if conservative methods fail to eliminate symptoms, surgery may be a useful option. Dr. Hackett generally recommends an elective procedure focusing on correcting or opening the fascia.

  • Fasciotomy or Fasciectomy – During a fasciotomy, the goal is to release the tight fascia, allowing proper blood flow through the leg. This surgical procedure involves the cutting of the fascia to relieve tension or pressure. This procedure has a very high success rate by increasing exercise tolerance, especially when performed by Dr. Hackett. The most common complication is accidently damaging a nearby nerve.

Physical Therapy

Rehabilitation after surgery is generally recommended to get you back to your active lifestyle as soon as possible. Although the surgery may have increased your exercise tolerance, it is still important to gradually return to exercises, training, and high-level activity to ensure a positive outcome. Each rehabilitation program will vary from patient to patient based on their condition and healing process. Generally, patients have a full recovery within 3 to 4 months following surgery. However, it’s necessary to follow Dr. Hackett’s specific aftercare instructions to return safely to your daily activities.

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