Pedowitz RA, Hargens AR, Mubarak SJ, Gershuni DH.ACSM’s Sports Medicine: a comprehensive review, Lippincott Williams & Wilkins, 2013. Soft tissue injuries of the leg, ankle and foot.
If athletes require surgery for CECS, it typically takes about a month to return to sport, and some rehabilitation is usually required prior to returning to play. They tend to exercise at a level below the onset of their symptoms. Creatine use may increase the risk of developing CECS, and discontinuing this over-the-counter supplement may prevent the development of CECS symptoms.Īthletes with mild CECS may be able to continue to train. For athletes with very flat feet, arch supports may also help prevent CECS. This procedure is called a “fasciotomy.”Ĭhanging the way an athlete runs can prevent some types of CECS. An orthopedic surgeon can open up the tight fascial wall. If athletes cannot change their exercise routine, or if changing the exercise program does not help, CECS is a condition that can be treated with surgery. If athletes are willing to reduce the amount of exercise required for their sport, symptoms of CECS may go away. Treatment for CECS initially involves rest and exercise modification to reduce symptoms. In CECS, the pressure in at least one of the leg’s compartments will be higher than expected after exercise. To confirm that the problem is CECS, the physician will measure the pressure inside the compartments of the lower legs before and after exercise. The sports medicine physician will then re-examine the legs when the pain is present. Athletes may be asked to run to reproduce the pain. X-rays and MRI studies may be ordered to exclude other causes of lower leg pain, but will be normal in CECS. Some athletes may even feel like their foot is heavy or slaps the ground firmly while running.Ī sports medicine physician will examine the athlete’s legs, which will likely appear normal. Athletes also may develop a squeezing sensation over the involved compartment, and may experience numbness, tingling, and/or burning in the lower leg and foot. If athletes do not stop exercising and try to push through the discomfort, the pain will increase in severity. With each workout, the leg pain returns at the same time in the exercise routine. If athletes stop and rest, the pain gradually goes away. It is more common in running sports, basketball, gymnastics, soccer, field hockey, and dance.ĬECS causes a dull or crampy lower leg pain which starts at some point during exercise. Men and women athletes are equally affected by the problem. This results in pain in the compartment, as well as pain or tingling in the area of the lower leg supplied by the compartment’s nerves. However, if the fascial wall of a compartment is too tight, blood flow may be cut off to the nerves and muscles. During exercise, muscles swell and fluid enters the compartment spaces. The compartments contain muscles, nerves, and blood vessels. Each compartment has a wall that is surrounded by “fascia,” a thin layer of tissue that surrounds muscles. There are four compartments in the lower leg. Chronic exertional compartment syndrome (CECS) is one cause of exercise-related lower leg pain.
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