Exercise-induced rhabdomyolysis is a frequent event occurring after se
vere forms of exercise. This is usually a short-lived, uncomplicated p
henomenon that is seldom of any clinical significance. The rare progre
ssion of this muscle injury to compartment syndrome is, however, a lim
b- and life-threatening condition that typically presents in the anter
ior compartment of the lower leg. A case is reported of a young man wh
o participated in physical activity well beyond his normal level of ex
ertion and subsequently developed bilateral lower extremity compartmen
t syndrome requiring surgical decompression. To our knowledge, this is
the only description of this complication occurring in a multicompart
ment, bilateral distribution. The combination of the rarity and morbid
ity of this condition, as well as the multitude of very common benign
injuries that present in the same manner as the problem discussed, mak
e this insult especially dangerous.