Chronic exertional compartment syndrome of the leg in the military.

CECS is a common source of lower extremity disability among young athletic cohorts and military personnel. The five cardinal symptoms are pain, tightness, cramps, weakness, and diminished sensation. History and clinical examination remain the hallmarks for identifying CECS, although ICP measurements during exercise stress testing may be used to confirm diagnosis. Nonsurgical management is generally unsuccessful, although gait retraining may have benefits in selected individuals. When conservative measures have failed, operative management may be considered with fascial release of all affected compartments. Although clinical success has been documented in civilian cohorts, the results of surgical treatment in military service members have been far less reliable. Only approximately half of the military service members experience complete resolution of symptoms and at least 25% are unable to return to full duty.