Virginia Research Day 2025

Medical Resident Research Case Reports

02 A Leap to New Heights: Chronic Exertional Compartment Syndrome in a High Jumper

Vincent Morra, DO; Alyna Duong, OMS III; Kailee Semon, BS, LAT, ATC; Matthew Chung, DO Corresponding author: vmorra@vcom.edu

Virginia Tech Athletics, Blacksburg, Virginia

leg deep posterior compartment pressure of 16 mmHg and a post-exercise pressure after 1 minute of rest at 18 mmHg and after 5 minutes of rest at 7 mmHg. Clinical Discussion/Conclusion: A thorough history and physical exam are critical in the diagnosis of CECS. Although the gold standard treatment for CECS is fasciotomy, this is the first reported case where hydrodissection was utilized to successfully treat CECS. We believe that hydrodissection can be considered as part of a CECS patient’s treatment plan, especially in cases where surgical intervention may have a poor prognosis. The authors received patient consent to use their data for this report.

Introduction: Chronic exertional compartment syndrome (CECS) has an incidence of about 1 in 2,000 individuals and is especially common in young athletes, particularly runners. CECS is the second most common cause of exercise-induced lower limb pain after medial tibial stress syndrome. Exact pathophysiology is still unknown, but it is postulated that the increase in blood flow to muscle tissue, along with limited fascial flexibility, leads to expansion of the muscle in the closed fascial compartment and results in increased intra-compartmental pressures. The gold standard for treatment of CECS is fasciotomy to relieve pressure and alleviate symptoms but, literature notes a poor prognosis with surgical intervention of the posterior compartments of the lower leg.

Case Presentation: A 24-year-old NCAA Division I high jumper initially presented with left calf tightness and rapid lower extremity fatigability. The patient initially received multiple dry needling sessions and a Fascial Distortion Model treatment along with routine manual therapies with minimal relief of his symptoms. An MR arteriogram was performed and ruled out popliteal artery entrapment syndrome. Initial compartment testing was performed with a Stryker intra-compartmental measuring system and measured the left deep posterior compartment at 31 mmHg, confirming a diagnosis of CECS. Six rounds of hydrodissection were performed to the deep posterior compartment of the left leg. Repeat compartment testing was performed after completion of the treatments which revealed a pre-exercise left

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