Exercise pain could be compartment syndrome, says UK team doctor

Dr. Kimberly Kaiser

Written by Dr. Kimberly Kaiser, a physician with UK Orthopaedic Surgery & Sports Medicine and a team physician with UK Athletics.

Each of our arms and legs have compartments that contain muscles and nerves which are surrounded by tough walls of tissue called fascia.

When we experience an injury or overuse our muscles, these compartments can fill with fluid and swell. In some people, the fascia surrounding each compartment is not very flexible and swelling can restrict blood flow, which can lead to pain, numbness and weakness in the affected limb. These may be signs of compartment syndrome.

Compartment syndrome occurs when excessive pressure builds up in an enclosed muscle space. The acute condition is often the result of bleeding or swelling into the muscle after an injury like a severe bone fracture or a crush injury, and while rare, it is a surgical emergency.

The chronic condition, called chronic exertional compartment syndrome or CECS, is often the result of prolonged physical activity and is most common in endurance athletes like runners and soccer players.

Symptoms and treatment

For those experiencing CECS, the associated symptoms occur, or worsen, during physical activity and subside immediately after stopping. Symptoms of CECS can mimic symptoms of other overuse injuries such as plantar fasciitis or shin splints, and if you’re middle aged or older, it may be the result of cholesterol build-up in the blood vessels. Your doctor may want to perform several tests to rule out other diagnoses.

Treatment for CECS depends on your activity levels and fitness goals. A physician may suggest modifying or taking a break from the exercise causing the injury or performing low-impact activities such as biking or swimming. Physical therapy, strengthening and stretching are a few approaches that can help relieve symptoms.

For those who don’t respond to conservative measures, or if activity modification is not an option, surgery may be the most effective treatment. The surgical procedure, called a fasciotomy, involves opening or removing the fascia in each affected compartment to relieve pressure. While there is a risk of complications associated with surgery, compartment syndrome left untreated can lead to permanent muscle and nerve damage, or the inability to continue participating in your favorite activity.

If you experience symptoms after an injury, or if symptoms develop during physical activity and worsen over time, it’s important to talk with your primary care provider and see a doctor who specializes in sports medicine.


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