Compartment Pressure Test
Chronic Exertional Compartment Syndrome (CECS) is a condition where exercise induces high pressure within a closed space, which results in decrease tissue perfusion causing symptoms such as pain, cramping, burning, tightness and weakness of the effected lower limb. The reason why this occurs is not known, however four factors are believed to contribute to an increase in compartment pressure.
- Inelasticity of the fascial sheath
- Increase in volume of skeletal muscle secondary to blood volume and edema
- Muscle hypertrophy in response to exercise
- Dynamic contraction factors due to demands in the gait cycle.
Note: Recently the supplement creatine has been implemented as a cause of CECS in athletes due to its effect on fluid retention and increase in muscle size.
Anyone can develop CECS, but it is more common in athletes who participate in sports that involve repetitive movements such as running.
Compartment Pressure Testing is the “Gold Standard” for diagnosis CECS. The test involves inserting a small catheter under local anaesthetic into one of the four well recognized Compartments (Anterior, Lateral, Deep Posterior and Superficial Posterior) of the lower leg.
Along with the history, compartment pressure testing is an extremely useful diagnostic tool to exclude other causes of exercise induced leg pain such as stress fractures, periostitis, Medial Tibial Stress Syndrome various tendinopathies, neurological compression syndromes and infection.