About Compartment Syndrome
Leg pain during physical activity is a common complaint, and while this can be due to a variety of muscular or bone stress issues, one less well-known cause of this pain could be “Chronic Exertional Compartment Syndrome” (CECS).
CECS typically presents as a gradual increase in lower leg pain during continuous exercise—often severe enough to stop you from continuing. The condition occurs as blood flow increases and muscles swell with activity. The tight connective tissue around the muscle compartment (fascia) cannot accommodate the increase in muscle volume, causing increasing pressure and pain.
This is therefore a functional problem seen during exercise, and at rest cannot be seen on Ultrasound, MRI or other imaging. Diagnosis requires direct measurement of compartment pressures, which remains the ‘gold standard’ test for confirming if one has CECS.
Compartment Pressure Testing
If CECS is suspected, your doctor may refer you for compartment pressure testing to confirm if this is the case. This is the most reliable way to confirm the diagnosis, and identify which compartments are involved. While some mild cases can improve with physiotherapy and gait retraining, others may benefit from a simple surgical release (fasciotomy) to relieve pressure and restore function. However, before any invasive treatments are considered, it is generally recommended that a clear and accurate diagnosis of CECS is made.