# Chronic Exertional Compartment Syndrome of Bilateral Lower Limbs and Forearms in an Elite Ice Hockey Athlete: A Case Report

## TL;DR

This case report describes a rare instance of chronic exertional compartment syndrome in an ice hockey athlete affecting all four limbs, diagnosed and successfully treated with surgery.

## Contribution

This is the first reported case of CECS in an ice hockey athlete involving all four limbs.

## Key findings

- CECS was diagnosed in all four limbs of an elite ice hockey athlete using a continuous ICP monitor.
- The condition was successfully treated with open fasciotomy of all four limbs.

## Abstract

Chronic exertional compartment syndrome (CECS) involves increased intracompartmental pressures (ICPs) induced by physical activity, leading to intense pain and associated neurological symptoms that resolve with rest. Classically, it is associated with young male athletes. The lower limbs are typically affected in running athletes and marching military members, while the upper limbs are generally involved in motorcyclists and rowers. Conservative treatment options involve activity modification, such as alteration of foot strike patterns and botulinum injections, while surgical treatments range from open to percutaneous fasciotomy. CECS is rare and remains a challenging diagnosis. In addition to history and physical exam, magnetic resonance imaging and intracompartmental measurements throughout exercise stress tests are described. In this article, we outline the first reported case of CECS in an ice hockey athlete involving all four limbs that was successfully diagnosed with a continuous ICP monitor and treated with open fasciotomy of all four limbs.