Compartment Syndrome

The four compartments that can be affected by compartment syndrome.UW Health's Sports Medicine doctors treat a wide range of common athletic injuries, including compartment syndrome, or a lack of oxygen caused by increased pressure in the calves.


About Compartment Syndrome


Compartment syndrome can occur in many areas of the body, but the most common location is in the calf. The lower leg is divided into four compartments - anterior, lateral, posterior and deep posterior. Compartment syndrome is caused by increased pressure within one, two or all the compartments of the lower leg. The increased pressure within the lower leg compresses against very important structures including nerves, arteries and veins.


The compression results in a lack of blood flow to the lower leg and a decrease in the amount of oxygen delivered to the muscles (ischemia). The diagnosis of compartment syndrome is primarily based on clinical symptoms. There is also a diagnostic test to measure the “pressures” of the compartments of the lower extremity.


Two Types of Compartment Syndrome

  • Acute Compartment Syndrome (ACS): ACS is typically caused by blunt trauma that causes immediate swelling and pain to the lower leg. This causes the pressures in your lower leg to increase rapidly causing pressure on your nerves, arteries and veins. This is a medical emergency.
  • Chronic Compartment Syndrome (CCS): CCS is usually associated with pain during exercise. It is also caused by rapidly increasing pressures in your lower leg. This increased pressure occurs during activity and resolves when the activity stops.

Signs and Symptoms of Acute Compartment Syndrome

  • Acute trauma to the lower leg
  • Immediate pain and cramping
  • Immediate swelling and severe tightness
  • Skin changes - may look “black and blue”

Signs and Symptoms of Chronic Compartment Syndrome

  • Cramping, burning, pain, tightness or aching, numbness or tingling in the lower leg associated with exercise
  • Symptoms improve when exercise stops
  • Severe tightness of the lower leg with palpation or touch



Initial treatment of acute compartment syndrome is referral to the emergency room for further evaluation and possible fasciotomy (release of tissue to reduce pressure).


Treatment for chronic compartment syndrome is based on symptoms. Rehabilitation can help, with the focus on calf stretching, soft tissue mobilization, massage and activity modification. Medical professionals may also assist in identifying appropriate shoe wear. Surgical treatment commonly involves a fasciotomy or fasciectomy (release or removal). In this surgical technique the compartments of the lower leg are released to create more space for the tissues to expand.




If you think that you may have the symptoms of compartment syndrome, check with a physician, licensed athletic trainer or physical therapist to help you get the appropriate diagnosis and proper medical care.