Exertional compartment syndrome: review of the literature and proposed rehabilitation guidelines following surgical release.

BACKGROUND: There is little published information regarding postoperative management of patients with Chronic Exertional Compartment Syndrome (CECS). Reports of recurrence of symptoms following surgical decompression exist, and are not uncommon depending on the specific technique used. Recurrence suggests that more time and effort may need to be spent on implementing strategic post-operative rehabilitation management in order to avoid repeat surgical intervention or prolonged symptoms.
OBJECTIVE: To summarize relevant literature regarding CECS and propose scientifically-based guidelines for rehab following compartment release with the rationale based on tissue healing, muscle loading, and scar tissue formation and consideration of all tissues contained in the involved compartment. LITERATURE REVIEW: A LITERATURE SEARCH WAS PERFORMED IN PUBMED, SPORTDISCUS, CINAHL, PEDRO, AND GOOGLE SCHOLAR USING THE PHRASE: "chronic exertional compartment syndrome."
RESULTS: No specific rehabilitation guidelines following surgical compartment release for lower extremity CECS were found in the literature search performed for this clinical commentary. DISCUSSION: The development of the proposed post-operative guidelines may allow for improved long-term outcomes following anterior compartment release.
SUMMARY: Adequate description of long-term follow-up of outcomes following compartment release for CECS is lacking in current literature. The proposed guidelines for rehab following compartment release include consideration of tissue healing, muscle loading, scar tissue formation, and consideration of soft tissues contained in the involved compartment. Utilization of the proposed guidelines may allow for future research to be performed in order to assess outcomes following surgical intervention for CECS.