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Chronic exertional compartment syndrome: muscle changes with isometric exercise
Deirdre B Birtles1, David Minden, Simon J Wickes
1Applied Biomedical Research Group, GKT School of Biomedical Sciences, King's College London, Shepherd's House, Guy's Campus, London SE1 1UL, UK.
Medicine and Science in Sports and Exercise
|December 10, 2002
Summary
Chronic exertional compartment syndrome (CECS) patients experience more pain during exercise than healthy individuals. Despite similar muscle fatigue rates, CECS patients show reduced strength, indicating factors beyond muscle size contribute to their pain.
Area of Science:
- Sports Medicine
- Exercise Physiology
- Orthopedics
Background:
- Chronic exertional compartment syndrome (CECS) is a common cause of lower leg pain in athletes.
- The exact cause of CECS pain, particularly the role of muscle function, remains unclear.
- Increased intramuscular pressure is suspected, but direct links to muscle performance and pain onset are poorly understood.
Purpose of the Study:
- To compare anterior tibial muscle strength, fatigue, and recovery between CECS patients and healthy controls.
- To investigate the relationship between muscle function, pain perception, and physiological responses during isometric exercise in CECS.
- To explore potential underlying mechanisms of CECS pain through objective measurements.
Main Methods:
- An isometric exercise protocol involving intermittent maximal voluntary contractions (MVC) was administered to 20 CECS patients and 22 healthy controls.
- Central and peripheral fatigue were assessed by comparing voluntary and electrically stimulated forces before, during, and after exercise.
- Muscle size (ultrasonography), pain levels, and cardiovascular responses were monitored throughout the study.
Main Results:
- CECS patients exhibited lower MVC relative to body mass and muscle cross-sectional area, but similar absolute forces and fatigue rates compared to controls.
- Patients reported significantly higher pain levels during exercise and early recovery.
- Muscle size increased similarly in both groups post-exercise, and cardiovascular responses were comparable.
Conclusions:
- CECS patients are weaker but do not fatigue faster than healthy individuals during isometric exercise.
- Higher pain levels in CECS patients, despite similar muscle fatigue and size changes, suggest that tight fascia may not be the primary pain driver.
- The findings highlight a potential disconnect between muscle function, structural changes, and pain perception in CECS.