Chronic Exertional Compartment Syndrome

Updated: Sep 29, 2019



Cause: Overuse, flatfoot, poor gait technique, hereditary, use of creatine.


Appearance: Pain, soreness, cramping in the leg after exertion, possible numbness in toes, drop foot.



How to Diagnose: Clinical exam, Wick’s catheter after exertion (treadmill test). MRI and bone scan have been unreliable for definitive diagnosis but can help rule out other pathology.


Treatment:

- Rest, ice, elevation, compression

- Anti-inflammatories (if ok to take)

- Orthotics if caused by excessive pronation

- Maximalist shoes

- Rest from athletics for 6 weeks

- Surgery (for athletes who have failed conservative care for at least 6 months)

o Return to sports at 6 weeks except for deep posterior compartment

§ Potential 6 month recovery

Long-term prognosis: Conservative care works in the vast majority of cases- icing before and after athletics, compression. Orthotics work well to prevent strain if the athlete has excessive pronation. Endoscopic surgery has the shortest down times.


Who to call: Podiatrist, orthopedic surgeon (skilled in arthroscopy/endoscopy)

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