Exertional compartment syndrome

Before interventional procedures are considered, patients are encouraged to consider discontinuing the activities that provoke the pain. You may obtain pain relief by altering the mechanics of your run. In particular, landing on the midfoot or forefoot instead of their hindfoot may decrease pain. A physical therapist or athletic trainer with expertise in running mechanics can analyze your running gait and help make appropriate modifications.

For many years, the definitive treatment for exertional compartment syndrome has been release of the fascia around the involved compartment with surgical procedures such as a fasciectomy or a fasciotomy. Success rates as high as 80% have been reported for this procedure.

More recently, there are other treatments to be considered. One is endoscopic needle fenestration, a procedure in which the fascia is released in the office under ultrasound guidance. Before deciding on a specific treatment, you should meet with a sports medicine specialist who is familiar with the various operative and nonoperative treatment options.

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