Chronic exertional compartment syndrome

Chronic exertional compartment syndrome

overview

Chronic exertional compartment syndrome is an exercise-induced muscle and nerve disorder that causes pain, swelling, and sometimes disability in the affected muscles of the legs or arms. Anyone can develop the condition, but it is more common in young adult runners and athletes who participate in activities that have repetitive effects.

Chronic exertional compartment syndrome may respond to nonsurgical treatment and activity modification. If nonsurgical treatment doesn't help, your doctor may recommend surgery. Surgery is successful for many people and may allow you to return to your sport.

Symptoms

Your limbs have specific muscle areas (compartments). For example, your lower leg has four chambers. Chronic exertional compartment syndrome often occurs in the same compartment of an affected limb on both sides of the body, usually the lower leg.

Signs and symptoms can include:

• Schmerzende, brennende oder krampfartige Schmerzen in einem Kompartiment der betroffenen Extremität
• Engegefühl in der betroffenen Extremität
• Taubheit oder Kribbeln in der betroffenen Extremität
• Schwäche des betroffenen Gliedes
• Fallfuß, in schweren Fällen, wenn die Beine betroffen sind
• Gelegentlich Schwellung oder Vorwölbung als Folge eines Muskelbruchs

Pain caused by chronic exertional compartment syndrome typically follows this pattern:

• Beginnt regelmäßig nach einer bestimmten Zeit, Strecke oder Intensität der Anstrengung, nachdem Sie mit dem Training der betroffenen Extremität begonnen haben
• Verschlechtert sich zunehmend, wenn Sie trainieren
• Wird innerhalb von 15 Minuten nach Beendigung der Aktivität weniger intensiv oder stoppt vollständig
• Im Laufe der Zeit kann sich die Erholungszeit nach dem Training verlängern

A complete break from exercise or just a low-impact activity may relieve your symptoms, but the relief is usually only temporary. For example, when you start running again, the familiar symptoms usually reappear.

When to go to the doctor?

If you have recurring unusual pain, swelling, weakness, loss of feeling, or pain while exercising or participating in sporting activities, talk to your doctor.

Sometimes chronic exertional compartment syndrome is confused with shin splints, a more common cause of leg pain in young people who do a lot of strenuous activity such as running. If you think you have shin splints and the pain doesn't get better with self-treatment, talk to your doctor.

Causes

Chronic exertional compartment syndrome

Chronic exertional compartment syndrome

Chronic exertional compartment syndrome is a musculoskeletal disorder caused by physical exertion. It can affect muscle compartments in any of your limbs, but is most common in the lower legs. The lower leg has four chambers, one or all of which may be affected.

The cause of chronic exertional compartment syndrome is not fully understood. When you exercise, your muscles expand in volume. When you have chronic exertional compartment syndrome, the tissue that covers the affected muscle (fascia) does not expand with the muscle, causing pressure and pain in one compartment of the affected limb.

Some experts suggest that the way you move during exercise could play a role in causing chronic exertional compartment syndrome. Other causes may include muscles that enlarge excessively during exercise, particularly inflexible fascia surrounding the affected muscle compartment, or high pressure in your veins.

Risk factors

Certain factors increase the risk of developing chronic exertional compartment syndrome, including:

• Das Alter. Obwohl Menschen jeden Alters ein chronisches Belastungskompartmentsyndrom entwickeln können, tritt die Erkrankung am häufigsten bei männlichen und weiblichen Sportlern unter 30 Jahren auf.
• Art der Übung. Wiederholte Aufprallaktivitäten – wie Laufen – erhöhen das Risiko, an dieser Krankheit zu erkranken.
• Übertraining. Zu intensives oder zu häufiges Training kann auch das Risiko eines chronischen Belastungskompartmentsyndroms erhöhen.

Complications

Chronic exertional compartment syndrome is not a life-threatening condition and usually does not cause permanent damage if you receive appropriate treatment. However, pain, weakness, or numbness associated with chronic exertional compartment syndrome may prevent you from continuing your workout or sport at the same intensity.

Sources:

1. Miller M, et al. Beinschmerzen und Belastungskompartmentsyndrome. In: Orthopädische Sportmedizin von DeLee, Drez und Miller: Prinzipien und Praxis. 5. Aufl. Elsevier; 2020. https://www.clinicalkey.com. Abgerufen am 7. Januar 2021.
2. Miller MD, et al., Hrsg. Belastungskompartmentsyndrom. In: Essentielle Orthopädie. 2. Aufl. Elsevier; 2020. https://www.clinicalkey.com. Abgerufen am 7. Januar 2021.
3. Buerba RA, et al. Chronisches Belastungskompartmentsyndrom: Aktuelle Managementstrategien. Open-Access-Journal für Sportmedizin. 2019; doi:10.2147/OAJSM.S168368.
4. Velasco TO, et al. Chronisches Belastungskompartmentsyndrom: Ein klinisches Update. Aktuelle sportmedizinische Gutachten. 2020; doi:10.1249/JSR.0000000000000747.
5. Meehan WP, et al. Chronisches Belastungskompartmentsyndrom. https://www.uptodate.com/contents/search. Abgerufen am 7. Januar 2021.
6. Fragen Sie MayoExpert. Chronisches Belastungskompartmentsyndrom. Mayo-Klinik; 2019.