Exertional Compartment Syndrome

Exertional compartment syndrome is an exercise-induced increase in muscle size which can result in elevated intracompartmental pressures and progress to tissue ischemia. 

Patients generally complain of pain after running a particular distance, which may last for a few hours after finishing.  The pain resolves with discontinuing activity. Patients may have transient numbness, parasthesias, and weakness. Symptoms are often occur in both legs.

Exertional compartment syndrome is diagnosed with pre- and post- exercise compartment pressure measurements which is done using a needle and a special pressure measuring instrument.

Treatment options include activity modification and operative compartment release. Non-operative treatment is generally only effective if the offending activity is given up.

Risks of surgery include but are not limited to: Recurrence, Infection, Neurovascular Injury, Bleeding, , Hematoma, Lymphocele, Swelling, Pain unchanged or worse than before surgery, Stiffness, Incisional scar (cosmesis), CRPS, Numbness surrounding the incision, Incomplete relief of pain, Incomplete return of function, Need for further surgery, blood clots (DVT), pulmonary embolus (PE), and the Risks of anesthesia including heart attack, stroke and death. Although complications can occur they are uncommon and most patients are satisfied with their surgical outcomes. You should always discuss any concerns that you have about surgery with your surgeon and ensure that you have a surgeon that you trust and are confident in.

In general, the post-operative course after compartment release proceeds as follows:

  • Patients may go home on the day of the surgery. They should ice and elevate the leg for 3-5 days following the surgery.
  • Patients are allowed immediate range of motion of the ankle and knee. The use crutches only as needed and are encouraged to ambulation.
  • Light activity is allowed at 2-4 weeks after surgery. Full activity at 4-6 weeks.

Other problems that can be confused with an Exertional compartment syndrome include:

  • Tibial Stress fx (tenderness over tibia)
  • Medial tibial stress syndrome
  • Chronic Regional Pain Syndrome
  • Gastrocnemius muscle tear
  • Peripheral nerve entrapment
  • DVT / Venous stasis
  • Radiculopathy
  • Arterial vascular disease
  • Popliteal artery syndrome

Further information about Exertional Compartment Syndrome can be found at the following sites:

Every person and their particular circumstances are different so the treatment for your leg may be different than those discussed above. Please read this information carefully. Write down any questions that you have about your injury and its treatment and discuss them with your surgeon. Working together you and your surgeon will determine the best treatment for you.

Appointments to discuss Exertional Compartment Syndrome with Dr. Grutter can be made here. If you have continued questions or concerns after seeing your orthopaedic surgeon a second opinion from Dr. Grutter is often beneficial.
Dr. Grutter's offices are located just outside Nashville in Gallatin, Tennessee. Directions to the Gallatin office from Nashville or surrounding areas in Tennessee can be located here. Please contact our office if you are from outside the Nashville, Tennessee area and would like assistance in arranging lodging or transportation for a consultation.