Observed Running Biomechanics During a Multimodal Treatment Approach for Chronic Exertional Compartment Syndrome in an Active-Duty Service Member: A Case Study- MHSRS 2024
Velasco t, reilly n, hulsopple c, roberts k, wise s, goss d, leggit, j
Abstract accepted for poster presentation at the 2024 Military Health System Research Symposium
Chronic exertional compartment syndrome (CECS) is a debilitating condition for runners, causing intense pain, paresthesia, and weakness in the lower limb muscles. This condition often affects active-duty service members (ADSMs) who engage in regular running and vigorous physical training. Although treatments like botulinum toxin A (BoTN-A) injections, structured running gait retraining, and fasciotomy exist, no single best approach exists, and outcomes may vary. This case study examines the running biomechanics and efficacy of a multimodal treatment approach for CECS in an ADSM.
A 27-year-old male ADSM presented with bilateral anterior and lateral CECS as defined by Pedowitz’s criteria. Baseline running assessments were performed utilizing instrumented pressure insoles (LoadSol, Novel USA, St. Paul, MN) to ascertain running mechanics, including cadence, loading rates, and peak ground reaction forces (GRF) incurred during running. The patient also reported subjective pain at cessation of running and functional scores via the University of Wisconsin Running Index (UWRI). The patient received BoTN-A injections to the 4 compartments, and completed a supervised gait retraining program as a non-surgical intervention. Running assessments and clinical outcomes were obtained at 6-weeks, 3, 6 and 12-months post-injection. The patient elected to undergo a bilateral fasciotomy following the 6-month visit.
This case study demonstrates how both surgical and non-surgical methods can influence the treatment of CECS and impact running biomechanics for an ADSM. In this case, non-surgical techniques resulted in more significant enhancements in running mechanics and clinical outcome scores. However, further data is required to ascertain the reliability of these results and to develop more efficacious treatment strategies for CECS