Massage therapy · Kitchener–WaterlooCompartment Syndrome - Chronic

Compartment syndrome happens when pressure builds up inside a group of muscles. The pressure reduces blood flow, which stops oxygen and nourishment from reaching the muscle and nerve cells (AAOS, n.d.). The condition can be either acute or chronic.

Acute compartment syndrome is a medical emergency. It is usually caused by a severe injury, and without prompt surgery it can cause permanent muscle damage (AAOS, n.d.).

Chronic compartment syndrome, also known as exertional compartment syndrome, is usually not a medical emergency. It is most often caused by athletic exertion. It causes pain or cramping during exercise that goes away when the activity stops, and it may also cause numbness, difficulty moving the foot (sometimes with the foot slapping down when running) and visible muscle bulging (AAOS, n.d.). It most often affects the lower leg (AAOS, n.d.).

Compartment Syndrome Chronic Anatomy

Compartments are groups of muscles, blood vessels and nerves within your legs and arms. A tough membrane called the fascia covers these tissues. The fascia’s role is to keep all of the tissues in place, so it does not stretch or expand easily (AAOS, n.d.).

How to Treat Compartment Syndrome Chronic

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• Pain and swelling are brought on by exercise and usually ease with rest (AAOS, n.d.).
• Chronic compartment syndrome is more likely in people who do activities with repetitive motions, such as running or marching (AAOS, n.d.), and is most common in runners, skaters and footballers (Tarabishi et al., 2023).
• Stopping or cutting down the exercise that causes the symptoms usually relieves them (AAOS, n.d.).
• Pain that comes on suddenly and severely after an injury is different: it may be acute compartment syndrome, which is an emergency.

I work with the chronic, exercise-related kind of compartment syndrome. Every case is different, but if you can go about your daily activities, I can usually work with it; if anything suggests you need a medical check first, I'll refer you to your family doctor or nurse practitioner. After a fasciotomy, I need your surgeon's okay first and work within their limits. Acute compartment syndrome is an emergency: call 911 or go to the emergency room (see When to Get Help).

I start by assessing how your lower leg and foot move, your calf and shin strength, how you run, and what training brings symptoms on.

Hands-On Treatment

• Warmth first, then skin rolling, slow myofascial work and longer strokes through the calf and along the edges of the affected compartment
• Cross-fibre work on stuck spots in the shin muscles, followed by a gentle stretch and a short cool application
• Trigger point work in the thigh and hip, and getting a stiff ankle and foot moving

After Surgery

• Work on your hips, back and other leg if they've been compensating
• Gentle lymphatic drainage for swelling, and scar work once the wound has healed
• Easing stiffness, then rebuilding strength before a graded return to running

Back to Activity

• Building your training back up gradually, with a proper warm-up
• Self-massage along the shin and calf, and stretching the calf, then the front of the shin

1. American Academy of Orthopaedic Surgeons (AAOS) OrthoInfo (n.d.) Compartment syndrome. Available at: https://www.orthoinfo.org/en/diseases--conditions/compartment-syndrome/ (Accessed: 7 October 2026).
2. NHS (2026) Compartment syndrome. Available at: https://www.nhs.uk/conditions/compartment-syndrome/ (Accessed: 7 October 2026).
3. Tarabishi, M.M., Almigdad, A., Almonaie, S. et al. (2023) 'Chronic exertional compartment syndrome in athletes: an overview of the current literature', Cureus, 15(10), e47797. doi: 10.7759/cureus.47797
4. Maffulli, N., Loppini, M., Spiezia, F. et al. (2016) 'Single minimal incision fasciotomy for chronic exertional compartment syndrome of the lower leg', Journal of Orthopaedic Surgery and Research, 11, 61. doi: 10.1186/s13018-016-0395-9