Posteromedial pain in the lower leg

Intramuscular pressure was recorded in 28 patients with exercise-induced posteromedial pain in the lower leg. Pressure was recorded simultaneously in the pos-terior tibial muscle and in the flexor digitorum muscle during an exercise test and at rest after exercise. This study shows that intramuscular pressures during ex-ercise and the time period for normalization of the pressure at rest after exercise were within normal limits. The result of pressure recording depends on which muscle in the deep posterior compartment is investi-gated and on the type of work performed. This article describes some of the difficulties associated with pres-sure recording in the deep posterior compartment. Chronic compartment syndrome in the deep posterior compartment as a reason for pain in the posteromedial part of the lower leg could not be demonstrated. Chronic compartment syndrome (CCS) is defined as a re-current exercise-induced increase of pressure in skeletal muscle accompanied by pain, swelling, and impaired muscle function. Pain along the posteromedial border of the tibial diaphysis is a common condition in athletes and has been reported to account for 60 % of all lesions causing pain in the leg in athletes. ’ The existence of CCS in the deep posterior compartment in patients with exercise-induced posteromedial pain has been under debate. Some authors believe this condition is a CCS in the deep posterior com-partment of the leg,1-3,9 while others have suggested a non-CCS condition.7, 18 Davey and coworkers2 have reported that the posterior tibial muscle constitutes a separate fifth com-partment. It has been shown that history and clinical find-ings alone are insufficient to establish the diagnosis of CCS in the anterior compartment.14, 15 The purpose of the present study was to investigate the existence of CCS in the deep posterior compartment by simultaneous recording of pressure in the flexor digitorum muscle and posterior tibial muscle (fifth compartment) dur-ing a standardized exercise test