Exercise-related leg pain is a frequent problem seen in recreational and competitive
athletes. There is a broad differential in the diagnosis of leg pain in athletes;
however, the majority is related to overuse. Chronic exertional compartment syndrome
(CECS) is a relatively common cause of leg pain with an incidence ranging from 27%
to 33%, second only to medial tibial stress syndrome (13%–42%).
1
,
2
Chronic exertional compartment syndrome is defined as reversible ischemia within
a closed fibro-osseous space, which leads to decreased tissue perfusion and ischemic
pain. CECS is often recurrent and associated with repetitive physical activity. It
is most commonly seen in athletes, with a particularly high incidence in runners as
well as athletes in jumping and cutting sports. Despite the predominance of CECS in
athletes, it can also occur in nonathletes or sedentary individuals who have activity-related
leg pain.
3
The diagnosis should also be considered in diabetic patients with activity-related
leg pain, especially in the absence of claudication symptoms.
4
Pain symptoms occur at an exertion level at which the elevation in pressure exceeds
the rate of metabolism. The tissues, in turn, become tight and painful. The pain typically
disappears quickly with rest, and no permanent damage to the tissue within the compartment
occurs. In rare cases when an athlete continues to compete through pain, CECS can
convert to an irreversible acute compartment syndrome.Keywords
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© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
