Lower Leg

Compartment Syndrome

Chronic exertional compartment syndrome (CECS or Compartment Syndrome) is a muscle and nerve condition that causes pain and swelling in your arm or leg muscles. It is typically brought on by exercise and observed in long-distance runners, basketball players, skiers, and soccer players. The pain is relieved by rest. In some cases, weakness and/or numbness occur as well.


Despite the common name for lateral epicondylitis, tennis elbow, the condition can be caused by other activities besides playing racquet sports. Many commonplace activities can strain the tendons. Basically, any activity that twists and extends the wrist can lead to lateral epicondylitis. Rarely, a direct blow to the outside of the elbow can also lead to the condition.


The diagnosis of CECS is based on your medical history, physical examination, and the exclusion of other conditions.

Compartment pressure testing with and without exercise is the best way to diagnose CECS. The criteria to diagnose CECS requires one or more of the following:

  • A pre-exercise/rest pressure of 15 mm Hg or higher
  • A one minute post-exercise pressure of 30 mm Hg or higher
  • A five minute post-exercise pressure of 20 mm Hg or higher
  • Although the diagnosis of CECS can be made if just one of the above criteria is met, the greater the number of criteria that are satisfied, the greater the confidence level of the diagnosis.


Conservative treatments include pain medication, stretching or strengthening regimens, orthotics, massage, and a break from exercise. Surgery to relieve the pressure is the most effective treatment for CECS.