PERSPECTIVE article
Front. Physiol.
Sec. Exercise Physiology
Challenges in Diagnosing and Treating Chronic Exertional Compartment Syndrome: Perspective from a Student Nurse with Lower Extremity Pain
Provisionally accepted
Madelyne Marbel
Robert Knoerl*- University of Michigan, Ann Arbor, United States
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Chronic Exertional Compartment Syndrome (CECS) is an uncommon yet debilitating condition that causes activity-induced pain due to increased pressure within muscle compartments. While typically diagnosed through dynamic intercompartmental pressure testing, CECS presents significant diagnostic challenges due to overlapping symptoms with other musculoskeletal conditions. This first-person narrative describes a 23-month journey through inconclusive imaging, multiple rounds of physical therapy, and pressure testing that met, but was ultimately dismissed despite established CECS diagnostic criteria. The case underscores the mismatch that can occur between objective findings and clinical interpretation, particularly when symptoms affect atypical compartments. With surgery ruled out and conservative treatments offering minimal relief, the experience reveals critical gaps in diagnostic consistency, clinician-patient communication, and care pathways for individuals whose symptoms reside in a diagnostic gray zone. This narrative calls for more nuanced application of diagnostic tools, greater attention to patient-reported symptoms, and improved support systems for those navigating prolonged diagnostic uncertainty.
Keywords: chronic exertional compartment syndrome, Chronic Pain, Fasciotomy, intramuscular pressure monitoring, Musculoskeletal Pain
Received: 07 Jul 2025; Accepted: 27 Nov 2025.
Copyright: © 2025 Marbel and Knoerl. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Robert Knoerl
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.