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What is it?

Acute compartment syndrome is a condition that occurs when pressure increases to a very high level within your extremities, usually due to a serious injury. Compartment syndrome is most common in the lower leg and forearm, however can occur in other parts of the body. Compartments are areas within the body containing muscles, nerves, and blood vessels, surrounded by a tissue called fascia. When an injury causes bleeding or swelling, sometimes the fascia is unable to expand and pressure builds up. This can cause decreased blood flow to the muscles and nerves, and can result in permanent damage if not treated in a timely manner. Acute compartment syndrome is considered a medical and surgical emergency.



• Pain that is much more severe than expected based on type of injury

• Pain that is often difficult to control and worsens when affected limb is moved

• Muscle may feel swollen or firm and may be painful with squeezing or stretching

• Numbness, burning, or tingling sensation


Risk Factors:

• Fractures (injury resulting in broken bones)

• Severe muscle injury or muscle tear

• Injury resulting in bleeding into the muscle/tissues

• Vigorous exercise

• Tight compressive wraps, splints, or casts

• Any activity that increases pressure within a compartment


Sports Medicine Evaluation

A sports medicine physician will review your history, ask questions in order to understand your symptoms, and perform an examination. The examination will evaluate for pain, swelling, sensation, and pulses on the affected limb and surrounding areas. If there is concern for acute compartment syndrome, your physician will send you to the emergency department, as this condition is a true medical emergency.


Further testing may involve the measurement of compartment pressures with a special device.



The treatment for acute compartment syndrome is surgery, referred to as a fasciotomy. An incision of the skin and fascia is made to allow the pressure to be released from the confined space of the compartment and restore oxygenated blood flow to the tissues. The goal is to prevent permanent damage and loss of function.


Injury Prevention

• Pay close attention to symptoms, and inform your doctor if condition is worsening

• Avoid tight compression

• If cast/splint is too tight, and there is increased pain and/or swelling, inform your doctor as soon as possible

• Given that acute compartment syndrome often occurs due to a serious injury or accident, in some cases it may not be preventable


Return to Play

Given the nature of the injury, surgical treatment, and adequate time needed for healing, it is important to follow your physician’s advice for ideal recovery. Your physician will provide guidance in regards to your activity level and when it would be appropriate for you to return to sports participation.

AMSSM Member Authors
Melissa Nayak, MD and Sarah Lucey, MD

Acute Compartment Syndrome. Updated January 17, 2017. Accessed July 6, 2017.
Compartment Syndrome. Last reviewed: October 2009.
Haller PR. Chapter 275. Compartment Syndrome. In: Tintinalli JE,
Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 7e. New York, NY:McGraw-Hill; 2011.§ionid=40381766.







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