Compartment syndromes of the leg, and to a lesser extent the forearm a
nd other areas, occur in both acute and chronic exertional forms. Simi
lar inciting events may precipitate either form, with different presen
tations, prognoses and implications for treatment. A complete knowledg
e of the anatomy and pathophysiology of these syndromes is essential f
or diagnosis. Measurement of compartment pressures is a valuable tool
in the diagnosis of chronic exertional compartment syndrome. In our ex
perience, athletes who desire to return to the same level of exercise
will require fascial release, although symptoms may improve if the int
ensity or duration of the activity is decreased. Fascial release is th
e treatment of choice in acute compartment syndrome and in chronic exe
rtional compartment syndrome unresponsive to nonoperative treatment.