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Causes
By Mayo Clinic staff
Your arms and legs have several groupings, or compartments, of muscles, blood vessels and nerves. Each of these compartments is encased by a thick layer of connective tissue called fascia (FASH-ee-uh), which supports the compartments and holds the tissues within each compartment in place. The fascia is inelastic, which means it has little ability to stretch.
In chronic exertional compartment syndrome, exercise or even repetitive muscle contraction causes the tissue pressure within a compartment to increase to an abnormally high level. But because the fascia can't stretch, the tissues in that compartment aren't able to expand sufficiently under the increased pressure. Imagine shaking up a soda bottle but leaving the cap on — an enormous amount of pressure builds up.
As the pressure builds up within one of your muscle compartments, with no outlet for release, nerves and blood vessels are compressed. Blood flow may then decrease, causing tissues to get inadequate amounts of oxygen-rich blood, a condition known as ischemia (is-KE-me-uh). Nerves and muscles may sustain damage.
Experts aren't sure why exercise or muscle contraction creates this excessive pressure in some people, leading to chronic exertional compartment syndrome. Some experts suggest that biomechanics — how you move, such as landing styles when you jog — may have a role. Other causes may include having enlarged muscles, an especially thick or inelastic fascia, or high pressure within your veins (venous hypertension).
- Chronic exertional compartment syndrome. In: Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/206761326-3/1016341470/1584/350.html#4-u1.0-B978-0-323-03329-9..50049-0--cesec4_2495. Accessed June 22, 2010.
- Choi L. Overuse injuries. In. DeLee JC, et al. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-1-4160-3143-7..10014-4--s0210&displayedEid=4-u1.0-B978-1-4160-3143-7..10014-4--s0290&uniq=206761326&isbn=978-1-4160-3143-7&sid=1016341470. Accessed June 22, 2010.
- Barr KP. Compartment syndrome. In: Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/206761326-3/1016341470/1678/61.html#4-u1.0-B978-1-4160-4007-1..50060-2--cesec8_953. Accessed June 22, 2010.
- Wilder RP, et al. Exertional compartment syndrome. Clinics in Sports Medicine. 2010;29:429.
- Sports injuries. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Sports_Injuries/default.asp. Accessed June 22, 2010.
- Compartment syndrome. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00204. Accessed June 22, 2010.
- Laskowski ER (expert opinion). Mayo Clinic, Rochester, Minn. July 8, 2010.
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