Running Biomechanics and Clinical Features Among Adolescent Athletes With Lower Leg Chronic Exertional Compartment Syndrome

Objective: To compare clinical measures between patients with chronic exertional compartment syndrome (CECS) and healthy controls and evaluate running biomechanics, physical measurements, and exertional intracompartmental (ICP) changes in adolescent athletes with lower leg CECS. Design: Cross-sectional case-control study. Setting: Large tertiary care hospital and affiliated injury prevention center. Participants: Forty-nine adolescents with CECS (39 F, 10 M; age: 16.9 +/- 0.8 years; body mass index (BMI): 23.1 +/- 2.9 kg/m(2); symptom duration: 8 +/- 12 months) were compared with 49 healthy controls (39 F, 10 M; age: 6.9 +/- 0.8 years; BMI: 20.4 +/- 3.7 kg/m(2)). Interventions: All participants underwent gait analyses on a force plate treadmill and clinical lower extremity strength and range of motion testing. Patients with chronic exertional compartment syndrome underwent Stryker monitor ICP testing. Main Outcome Measures: Symptoms, menstrual history, and ICP pressures of the patients with CECS using descriptive statistics. Mann-Whitney U and chi(2) analyses were used to compare CECS with healthy patients for demographics, clinical measures, and gait biomechanics continuous and categorical outcomes, respectively. For patients with CECS, multiple linear regressions analyses were used to assess associations between gait biomechanics, lower extremity strength and range of motion, and with ICP measures. Results: The CECS group demonstrated higher mass-normalized peak ground reaction force measures (xBW) compared with controls (0.21 +/- 0.05 xBW (P < 0.001) and were more likely to have impact peak at initial contact (P = 0.04). Menstrual dysfunction was independently associated with higher postexertion ICP (ss = 14.6; P = 0.02). Conclusions: The CECS group demonstrated increased total force magnitude and vertical impact transient peaks. In women with CECS, menstrual dysfunction was independently associated with increased postexertion ICP. These biomechanical and physiological attributes may play a role in the development of CECS.