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J Athl Train. 2000 Oct-Dec; 35(4): 450–452.
PMCID: PMC1323373

Concurrent Periostalgia and Chronic Proximal Deep Posterior Compartment Syndrome in a Collegiate Track and Field Athlete: A Case Report

Kristinn I. Heinrichs, PhD, PT, SCS, ATC, CSCS,* Wendy M. Lachowicz, ATC, and Don E. Detmer, MD, FACS, FACSM



Exercise-induced leg pain may be triggered by abnormally high compartment pressure. In addition to the more widely publicized anterior compartment syndrome, the deep posterior compartment syndrome can just as frequently occur, resulting in severe pain and disability due to muscle and nerve ischemia.


Obtaining a thorough history and compartmental pressure measurements are the usual components in the accurate diagnosis of compartment syndromes. While few other disorders mimic compartment syndromes, differential diagnoses must be considered. Surgical management of deep compartment syndrome, consisting of fasciotomy or fasciectomy, or both, is successful for most patients.

Differential Diagnosis:

Tibial stress fracture or microfracture, tibial periostitis, tibial periostalgia, distal deep posterior chronic compartment syndrome, proximal deep chronic compartment syndrome, superficial lateral compartment syndrome, deep venous thrombosis, popliteal artery entrapment, or chronic compartment syndrome.


Chronic deep compartment syndrome is one of the most common causes of exercise-induced leg pain in aerobic athletes. Therefore, the athletic trainer must be able to recognize the condition. Signs, symptoms, diagnosis, and surgical management of chronic deep compartment syndrome, chronic periostalgia, and superficial lateral compartment syndrame in a 21-year-old Division IA track and field athlete are presented.


With the correct diagnosis, persistent and methodical reevaluation, and appropriate management, the athlete can expect a successful treatment outcome.

Full text

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
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  • Detmer DE. Chronic shin splints. Classification and management of medial tibial stress syndrome. Sports Med. 1986 Nov-Dec;3(6):436–446. [PubMed]

Articles from Journal of Athletic Training are provided here courtesy of National Athletic Trainers Association