Abstract
Chronic compartment syndrome (CCS) is a pressure increase within a non-expandable
fibro-osseous space resulting from continuous and intense physical activity. Its symptoms
usually improve with rest or reduced activity. It is a critical cause of lower limb
pain in athletes and the second most common cause of effort-related leg pain. Less
frequent reports include CCS in the lumbar paravertebral compartments, in the hand,
the forearm, the thigh, and the foot. Although CCS mainly affects long-distance runners,
it may also occur in sports such as lacrosse, football, basketball, skiing, and field
hockey. Muscle tension, cramps, symptoms worsening with physical exercise, pain, and
reduced sensitivity in the upper part of the foot are the main CCS findings, and diagnosis
is essentially clinical. Even though controversial and with some limitations, CCS
diagnosis has relied on measuring the intracompartmental pressure after exercise.
However, new alternative tools are under study, particularly those less invasive,
such as magnetic resonance imaging (MRI) after the exercise protocol. For years, open
fasciotomy was the most relevant treatment for CCS in athletes, but new surgical techniques
are gaining importance, such as minimally-invasive fasciotomy and endoscopic procedures.
Some conservative therapies hold promise as potential alternatives for patients who
do not want surgery, but robust evidence to support them remains lacking, especially
for athletes.
Keywords
athletes - compartment syndromes - sports injuries - sports medicine
