![]() 15 It is important to recognize that anterior and posterior CECS may occur exclusively, although combinations of both do occur. Increased muscle pressures in the anterior or lateral compartment may cause athletes to have drop foot (in severe cases) caused by compression of the peroneal nerve or experience skin sensations like numbness or tingling in the dermatome of dorsum of foot (superficial peroneal nerve) or between first and second toes (deep peroneal nerve). 14 Isolated lateral CECS is difficult to discriminate from anterior CECS features and therefore simultaneous dynamic intracompartmental measurement of both anterior and lateral compartments is warranted. 13 Pain exhibited in the calf combined with tenderness of the distal deep flexor muscle with palpation is associated with deep posterior CECS. 13Īnterior and posterior CECS are separate entities with characteristic history and physical examination features that distinctly distinguish them. 13 In addition, only 58% of patients with complaints of anterolateral CECS had elevated pressures in both compartments. ![]() 13 Therefore, the prevalence of lateral CECS alone is lacking, but reports indicate a 7% incidence rate among patients tested with anterolateral CECS. 10-12 Unfortunately, it has not been standard procedure to routinely preform ICP testing of both the anterior and lateral compartments simultaneously among athletes with anterolateral complaints. 7,9 Lateral CECS have either been distinguished as a separate peroneal compartment syndrome, 9 or instead, always occurring in combination with the anterior compartment, thereby classified as "anterolateral" CECS. 8 The anterior compartment is reportedly the most common CECS location followed by the deep posterior compartment. Normal ICP are 30 mmHg after 1 minute or 20 mmHg after 5 minutes. 8 A manometer is one device that detects the dynamic ICP by measuring the resistance that is present when saline solution is injected into the compartment. The gold standard diagnostic tool for CECS is provided by a dynamic intracompartmental pressure (ICP) measurement before and after provocative treadmill testing. The posterior compartment is responsible for plantarflexion of the foot and ankle and is made up of muscles in the superficial and deep compartment and are supplied by the posterior tibial artery and tibial nerve. The superficial fibular (peroneal) nerve and the fibular artery supply the muscles in the lateral compartment. 4-7 The muscles in the anterior compartment are responsible for dorsiflexion, eversion and inversion of the foot and ankle and is supplied by the deep fibular (peroneal) nerve and the anterior tibial artery. These three muscle compartments in the leg include the anterior, lateral, and posterior (superficial and deep) compartment. ![]() 4-6 Three muscle compartments may be involved in CECS. 3 Exertional leg pain caused by CECS leads to local-regional tightness and pain during activities such as walking, running, or even at rest shortly after exercise. 3 This causes venous and capillary pressure to increase to a point where if rapidly accumulates, such as in acute compartment syndrome, arterial inflow may be compromised and lead to leg ischemia and muscle death at rest. This short review describes two conditions (CECS and CPNE) found in athletes and highlights the need for better strategies and recognition to improve the care of athletes with lower extremity pain.Įxercise-induced lower extremity pain caused by CECS is associated with the accumulation of fluid in the intracompartmental space surround by noncompliant fascia, thereby elevating muscle pressure and reducing venous and lymphatic outflow. The aim of this expert analysis is to differentiate and increase awareness between CECS and CPNE in the domain of cardiology, sports cardiology, and vascular medicine. It is not uncommon that a range of specialists, including physical and sports medicine, orthopedic surgeons, neurologist, vascular surgeons, rehabilitation physicians, or vascular medicine specialist, will jointly consult on athletes with exertional leg pain. Individuals engaged in sports activities who report lower leg discomfort may have various conditions, including conditions that may lead to chronic exertional compartment syndromes (CECS) or under-recognized neurovascular entrapment syndromes, such as common peroneal nerve entrapment (CPNE). ![]() 1,2 However, vasculopathies and neurovascular entrapments are another potential cause of pain in athletes. Musculoskeletal injuries are the most common cause of pain and dysfunction in recreational and professional athletes. How to managing chronic exertional compartment syndromes from common peroneal nerve entrapments.Review the signs and symptoms of chronic exertional compartment syndromes and common peroneal nerve entrapments.Identify the difference between chronic exertional compartment syndromes from common peroneal nerve entrapments. ![]()
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