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Chronic exertional compartment syndrome



Chronic exertional compartment syndrome (CECS) is a common condition affecting runners and other endurance athletes. It is characterised by the development of increased pressure within the muscle compartments during exercise, leading to pain and discomfort. While CECS can be challenging to manage, there are several effective strategies available to help runners recover and prevent further complications.



The first step in managing CECS is obtaining an accurate diagnosis. If you suspect you have compartment syndrome, it is crucial to consult with a healthcare professional. They will evaluate your symptoms and conduct a physical examination.



In many cases, conservative treatment options are effective in managing CECS. These strategies focus on reducing the pressure within the affected muscle compartments and alleviating symptoms. Some common conservative treatments include:


  • Rest and Modification of Activities: Reducing or temporarily avoiding activities that trigger symptoms can help alleviate pain and promote healing. It is essential to listen to your body and give it adequate time to recover.


  • Physical Therapy: A skilled physical therapist can guide you through specific exercises to stretch and strengthen the affected muscle groups. They may also use techniques such as manual therapy and massage to relieve tension and improve muscle flexibility.



After successfully managing CECS, it is essential to implement preventive measures to minimize the risk of recurrence. These strategies include:


  • Gradual Training Progression: Avoid sudden increases in training volume or intensity. Gradually increase mileage, speed, or intensity over time to allow your muscles to adapt and reduce the risk of overloading the compartments.


  • Cross-Training and Strength Training: Engage in cross-training activities, such as swimming, cycling, or low-impact exercises, to vary the stress on your muscles and reduce repetitive strain. Additionally, incorporating strength training exercises that target the lower limbs can improve muscle endurance and overall performance.


  • Regular Stretching and Foam Rolling: Prioritise regular stretching exercises, focusing on the muscle groups prone to CECS. Foam rolling can also be beneficial in reducing muscle tightness and promoting flexibility.



Chronic exertional compartment syndrome can be a frustrating condition for runners, but with proper management, it can be effectively treated and prevented. Seeking an accurate diagnosis, utilising conservative treatments, and implementing preventive strategies are all vital steps in managing CECS.

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