It is not uncommon for runners or athletes to experience pain in their legs when running. When this pain becomes severe and is accompanied by other symptoms, it may be time to see a doctor for an evaluation. One cause of leg pain in runners is chronic exertional compartment syndrome. This condition is caused by overtraining or physical exertion, such as excessive running. It can not only affect the lower legs but can affect other parts of the body as well. If you begin to experience severe pain when running or exercising that reoccurs each time you work out, contact a nerve specialist to discuss treatment options that can reduce pressure in the muscles, such as nerve release surgery.
Common Symptoms of Chronic Exertional Compartment Syndrome
There are four muscle compartments in the legs. Chronic exertional compartment syndrome typically occurs in the same compartment of the lower legs on both sides of the body due to the tissue that encloses the muscle not expanding to accommodate swelling and causing pressure and pain in the compartment. It can also affect other areas of the body.
Exertional compartment syndrome is not a life-threatening condition and does not result in permanent damage if treated correctly. It is important to recognize the signs of chronic exertional compartment syndrome so you can seek treatment and return to your normal running routine or physical activity. The symptoms associated with the condition can prevent you from running or exercising. Some common symptoms of chronic exertional compartment syndrome are:
- Leg tightness or weakness
- Tingling or burning sensation
- Pain when stretching
- Cramping or aching
- Foot drop
- Bulging lump or noticeable swelling
The pain caused by chronic exertional compartment syndrome may get worse as you exercise, and you may notice it occurs after running for a certain time or distance. The pain can often become less intense or completely diminish within 15 minutes after you stop running.
Diagnosis and Treatment Options
If you notice symptoms of chronic exertional compartment syndrome, contact a doctor for help. To determine the cause of your symptoms, other problems such as shin splints or a stress fracture will need to be ruled out. To test specifically for chronic exertional compartment syndrome, the following may be done:
- Physical exam after exercising to check for tightness, tenderness, or a muscle bulge in the lower leg
- Imaging studies such as an X-ray or MRI to rule out a fracture or other problem
- Compartment pressure test to measure the pressure in the affected leg. This is done by inserting a needle into the affected muscle to give a pressure reading. The needle may need to be inserted into different areas.
- Repeat pressure test after exercising to compare the results
To treat chronic exertional compartment syndrome, non-surgical options may be effective. Your doctor may recommend stopping the activity that caused it to occur. In addition, conservative treatment may consist of:
- Taking a complete break from exercise or running
- Anti-inflammatory medication to reduce pain and swelling
- Wearing custom orthotics inside of your shoes
- Switching your fitness routine to include lower-impact activities and cross-training
- Running on softer surfaces such as a track rather than on asphalt or concrete
- Physical therapy or massage
If exertional compartment syndrome comes back each time you run or exercise or does not respond to non-surgical treatments, surgery may be needed. Dr. Williams can perform various procedures to treat the condition, such as a fasciotomy or a nerve release to free up nerves compressed by the affected leg muscles. This option of releasing the nerves can provide symptom relief.
If you have signs of exertional compartment syndrome or are experiencing chronic pain when running or exercising, contact a nerve specialist for an evaluation. Dr. Williams can help ease your symptoms and get you back to running as soon as possible. To schedule an appointment in the Baltimore office, contact us at (410) 709-3868 or fill out our contact form online.