Chronic exertional compartment syndrome


Chronic exertional compartment syndrome is a medical condition caused by intensive, repetitive exercise or physical activity that causes the muscles in the affected legs or arms to swell, pain, and occasionally become disabled. It is not often considered an emergency and typically resolves with rest or a change in habit.

A compartment consists of a collection of muscles, nerves, and blood vessels. Each compartment is covered by a thin but firm membrane called a fascia. It helps to maintain the muscles in place. Chronic exertional compartment syndrome can cause swelling or bleeding from a serious injury or too much physical exertion in the compartment. Since the fascia is not designed to stretch to make more room, the swelling or bleeding places pressure on the nerves and muscles.

Anyone is at risk of this condition. However, it is more prevalent among young adult runners and athletes who engage in repetitive impact sports. Nonsurgical treatment and activity adjustment may help with chronic exertional compartment syndrome. If nonsurgical treatment fails, the doctor may suggest surgery.


The same compartment of an affected limb on both sides of the body typically experiences chronic exertional compartment syndrome. When this occurs, the patient may experience these signs and symptoms:

  • Aching, burning or cramping pain in a affected limb compartment
  • Tightness in the muscle
  • Paresthesia, a tingling or burning sensation in the skin
  • In severe cases, foot drop of the affected leg.
  • Muscle hernia can cause swelling or bulging
  • Weakness of limb

With chronic exertional compartment syndrome, the pressure in the compartment continues to build up which can cause pain. It typically follows a certain sequence:

  • Starts occurring on a regular basis if they exercise the affected limb for a set amount of time, distance, or level of effort.
  • Gets worse during workout
  • Decreases in intensity or stops altogether within 15 minutes after ceasing the activity
  • Rest period after exercise may lengthen over time

Chronic exertional compartment syndrome usually goes away once the exercise stops. However, symptoms may recur, once the intense or repetitive activities are performed again. Rest and modifications to the exercise routine may help relieve the condition.

Consult a healthcare provider if the symptoms persist such as unexplained discomfort, swelling, weakness, loss of sensation, or soreness while exercising or participating in sporting activities. Or if the pain does not improve with self-care.

Chronic exertional compartment syndrome is occasionally misdiagnosed as shin splints, a more prevalent cause of leg pain in young adults who engage in a lot of strenuous weight-bearing activity, such as running.


It is believed that muscles grow in size during workout. Chronic exertional compartment syndrome occurs when the fascia does not expand with the muscle, resulting in pressure and pain in a compartment of the affected area. However, the exact cause of chronic exertional compartment syndrome is still unknown.

In addition, possible causes of this condition may be due to having a very rigid fascia covering the damaged muscle compartment, or having muscle that has excessive enlargement during exercise, or having intense pressure within the veins. Some specialists believe that how people move while exercising may play a role in the development of chronic exertional compartment syndrome.

Risk factors

There are several factors that can contribute to one’s risk of getting chronic exertional compartment syndrome:

  • Age: Male and female athletes under the age of 30 are more susceptible by this condition.
  • Physical activity: The risk of developing this condition becomes high with impact activities or sports with very repetitive movements such as biking, running, and swimming.
  • Excessive training: Chronic exertional compartment syndrome might develop if someone exercise too frequently or too intensely.