Muscles are enclosed within a strong, inelastic layer of tissue called fascia, which helps support and organise muscle groups while allowing them to function effectively. In some cases, this compartment is too tight to accommodate the normal expansion of muscle during exercise. This leads to a build-up of pressure within the muscle compartment, causing pain and reduced performance.
This condition is known as chronic exertional compartment syndrome (CECS). It is different from acute compartment syndrome, which is a medical emergency and requires urgent surgical treatment.
CECS most commonly affects the lower leg and typically presents in athletes who experience symptoms that come on predictably with exercise.
Because symptoms can resemble conditions such as shin splints, accurate diagnosis is essential.
Careful assessment is key, as symptoms can overlap with other common causes of exercise-related leg pain such as shin splints. Identifying the correct diagnosis is therefore essential before treatment begins.
Diagnosis is usually confirmed by:
The most effective treatment for chronic exertional compartment syndrome is a fasciotomy, a procedure that releases the tight fascia. This is typically performed through one or two small incisions, creating more space for the muscles to expand during activity.
With appropriate diagnosis and treatment, outcomes are generally very good, allowing athletes to return to pain-free training and competition.
