![]() During exercise, specific muscle compartments swell up to 20%, secondary to increased blood flow and fluid volume. The literature consistently reports the clinical underappreciation of ECS types, particularly the acute subtype, given that there is most commonly an atraumatic presentation. The major differentiating clinical variable separating the two forms of ECS from ACS is the absence of a specific traumatic event in the former. The article provides an overview of the hallmarks and diagnostic considerations surrounding both forms of ECS, including the importance of clinicians maintaining a high index of suspicion to avoid delays in diagnosis. ECS typically occurs in the lower leg but can also occur in other areas like the forearm, thigh, or hand. Just as in acute compartment syndrome (ACS), the diagnosis implies a surgical emergency requiring fasciotomies to help mitigate the risks of ensuing irreversible muscle ischemia and neurovascular injury, which can occur after just a few hours alone. Īcute exertional compartment syndrome (AECS) is a rare entity that, unfortunately, its diagnosis is often delayed. Although benign, the refractory nature of CECS often results in a substantial portion of patients ultimately electing to proceed with fasciotomies. There are two distinct forms of exertional compartment syndrome, acute and chronic types.Ĭhronic exertional compartment syndrome (CECS) occurs in the setting of recurrent, reversible ischemic episodes following the cessation of activity resulting in the predictable decrease in fascial compartment pressures. As a result, you are not training and competing at full capacity.Exertional compartment syndrome is often a diagnosis of exclusion and occurs secondary to increased pressures in a muscular compartment, with resultant ischemia manifesting most commonly as pain. For example, back pain and postural issues. However, if you have tight hamstrings you may be more prone to other problems. Most of the time will not cause a problem. Tight hamstring musclesĪlthough not a specific injury, nor a cause of posterior thigh pain, tight hamstring muscles are common in athletes. More on Ischiogluteal bursitis/tendinopathy. You may have tenderness and thickening of the tendon at the site of pain.Pain just under the crease of the buttocks.It is often difficult to distinguish between the two. More specifically, at the ischial tuberosity of the pelvis.īursitis is inflammation of the small sac of fluid between the tendon and bone. Hamstring tendonitis (or tendinopathy) occurs at the origin of the hamstring muscles. ![]() A positive result for the slump test (but not always).Pain is usually less severe than a hamstring strain, although you may feel occasional acute ‘twinges’.Gradual onset pain at the back of your thigh.Pain in the hamstring region can originate from your lower back, sacroiliac joints, or buttocks. You are unlikely to be able to pinpoint a specific time when your injury occurred. The following injuries cause gradual onset pain at the back of the thigh. Gradual onset/chronic posterior thigh pain Hamstring avulsions also occur in older people who may have had a history of chronic hamstring tendinitis. Symptoms are similar to a hamstring tendon strain, therefore it is important to seek professional advice. This is more common in younger athletes aged 14 to 18 years old. Hamstring tendon avulsionĪn avulsion strain occurs when the tendon tears, pulling a small part of the bone away with it. This depends on the type of contusion and tissue damage. You may or may not have noticeable swelling depending.Pain at the back of the thigh, particularly at the point of impact.It involves a direct blow to the back of your thigh. Hamstring contusionĪ hamstring contusion is also called a dead leg or charley horse. Read more on causes and treatment of Cramp. Cramp often follows a bout of hard, or unaccustomed exercise.You will find it very difficult to relax the muscle and straighten your leg.A sudden involuntary muscle spasm at the back of your thigh.It is very common in the hamstring muscles. Cramp in the hamstringsĪ muscle cramp is a painful involuntary contraction of the muscle. Read more on Hamstring strain or go to our rehabilitation program. Swelling and/or bruising depending on severity.Sudden onset pain at the back of the thigh.The following are causes of sudden onset or acute pain at the back of the thigh: Hamstring strainĬommon in sport, pulled hamstrings are either sprint-related or occur from overstretching the muscles. Medically reviewed by Dr Chaminda Goonetilleke, 27th Jan.
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