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What Causes Compartment Syndrome and How is it Treated?

Author: CHKD Sports Medicine, Thomas Canty, ATC
Published Date: Friday, February 09, 2018

Thomas Canty, ATC

Compartment syndrome is a painful condition that occurs when too much pressure builds up inside a muscle, reducing blood flow to muscle and nerve cells. This is most often a result of bleeding or swelling after an injury. Without a steady supply of oxygen and nutrients, nerve and muscle cells can be damaged.

Compartment syndrome can be acute or chronic. Acute compartment syndrome is caused by a severe injury, like a broken bone or car accident. Symptoms of acute compartment syndrome include intense pain and discomfort with the injured area becoming warm to the touch. The surrounding skin may feel tight and appear glossy and pale. If these symptoms are present, immediate medical attention is needed. Acute compartment syndrome is a medical emergency and, without surgery, can lead to permanent damage or disability.

Chronic, or exertional, compartment syndrome is caused by exercise. Athletes who participate in activities with repetitive motions such as running are more likely to develop this problem, which most often occurs in the leg. Symptoms of chronic compartment syndrome include pain and cramping during exercise, weakness or tingling of the ankle or foot, and decreased strength – all of which subside when the activity stops. Chronic compartment syndrome is not a medical emergency, but for athletes with continued discomfort, a visit to the doctor may be necessary.

To diagnose chronic compartment syndrome, your doctor must first rule out other conditions that could be causing pain in the lower leg, such as tendonitis or a stress fracture. A definitive diagnosis can be made by measuring the pressure within the compartments of the affected leg before and after exercise. If chronic compartment syndrome is confirmed, non-surgical treatment options include anti-inflammatory medicines, physical therapy, evaluation of biomechanics or musculoskeletal issues, orthotics (inserts) for shoes, and adjustments to the intensity and duration of activity. Some athletes have symptoms that are worse on certain surfaces (concrete vs. running track, or artificial turf vs. grass), which can be reduced by switching surfaces. If conservative treatment fails, surgery may be an option to relieve the pain and allow the athlete to return to full activity. Unfortunately, exertional compartment syndrome may reoccur in some cases, regardless of the treatment.


  • Acute compartment syndrome occurs as a result of a traumatic injury
  • Acute compartment syndrome is a medical emergency
  • Chronic (exertional) compartment syndrome appears slowly over time with symptoms that occur during periods of exercise
  • Exertional compartment syndrome is not a medical emergency

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About CHKD Sports Medicine

CHKD's sports medicine program offers the most comprehensive care for your young athlete. From diagnosis and treatment to customized rehabilitation plans, we specialize in physical therapy and injury prevention programs for active children and teens. Our team is composed of pediatric orthopedic surgeons, sports medicine specialists, physician assistants, certified athletic trainers and pediatric sports medicine physical therapists.

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