Comparison of Non-Surgical Treatment Options for Chronic Exertional Compartment Syndrome (CECS)

  • End date
    Nov 1, 2024
  • participants needed
  • sponsor
    Walter Reed National Military Medical Center
Updated on 7 June 2022


Chronic Exertional Compartment Syndrome (CECS) in the lower leg is a debilitating condition in highly active individuals. Pain occurs in 1 or several leg compartments upon an exertional activity, typically running, that quickly dissipates once the activity stopped. Surgical fasciotomy is the standard for treating lower leg CECS, but success is variable. Complications may occur post-surgery and there is a potential for a repeat procedure. Recovery times post-surgery also vary greatly. Conservative treatments, such as gait retraining and botulinum toxin injections, are emerging as non-surgical options for the treatment of CECS with success through published case reports and case series. This study aims to evaluate the use of these non-surgical treatment options for CECS in the anterior and lateral leg compartments with a follow up for at least 2 years across multiple study sites.

Condition Chronic Exertional Compartment Syndrome
Treatment Saline Injection, botulinum toxin injection, Supervised Gait Retraining, Home Based Gait Retraining
Clinical Study IdentifierNCT04409600
SponsorWalter Reed National Military Medical Center
Last Modified on7 June 2022


Yes No Not Sure

Inclusion Criteria

Active duty service
Fluent in speaking and reading English
Unable to run 2 miles without producing pain and/or symptoms
Difficulty completing the running portion of their service-specific physical training due to pain and/or symptoms in their lower leg
Meets clinical diagnostic criteria for CECS of the anterior or lateral compartment per clinical examination (palpation, intramuscular compartment pressure, lower leg MRI)

Exclusion Criteria

Prior botulinum injection in the lower leg compartment of the affected limb
Prior compartment release of affected lower leg
Recent (within the last 6 months) lower limb injury that needed medical intervention
Completed formal gait retraining within the last 6 months
Allergic to botulinum toxin
Pregnant or breastfeeding
Medical examination that indicates a condition other than CECS
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