Chronic Exertional Compartment Syndrome of Bilateral Lower Limbs and Forearms in an Elite Ice Hockey Athlete: A Case Report

Chronic exertional compartment syndrome (CECS) involves increased intracompartmental pressures (ICPs) induced by physical activity, leading to intense pain and associated neurological symptoms that resolve with rest. Classically, it is associated with young male athletes. The lower limbs are typically affected in running athletes and marching military members, while the upper limbs are generally involved in motorcyclists and rowers. Conservative treatment options involve activity modification, such as alteration of foot strike patterns and botulinum injections, while surgical treatments range from open to percutaneous fasciotomy. CECS is rare and remains a challenging diagnosis. In addition to history and physical exam, magnetic resonance imaging and intracompartmental measurements throughout exercise stress tests are described. In this article, we outline the first reported case of CECS in an ice hockey athlete involving all four limbs that was successfully diagnosed with a continuous ICP monitor and treated with open fasciotomy of all four limbs.