SPORTS
Forearm pump, or chronic exertional compartment syndrome (CECS) is a condition that causes forearm pain often accompanied by numbness and tingling in the hand. It occurs most commonly in prolonged motocross riding. It may also occur with weight lifting, rock climbing, and paddle sports. Symptoms usually occur during the activity and resolve with rest after the activity is stopped.
There are distinct compartments within the forearm containing muscles, arteries, and nerves. When prolonged activity causes excessive muscle swelling within a compartment, the pressure may diminish blood flow to the muscles resulting in decreased oxygenation causing pain. Increased pressure and the resulting diminished oxygenation can also affect the nerves in the compartment causing numbness.
The diagnosis of this uncommon condition is usually by patient history of symptoms occurring with exertion during specific physical activity. They may include excessive forearm swelling, pain, and numbness. The symptoms are noted to resolve after the aggravating activity is completed and time has passed to rest. A diagnostic procedure can also be performed where a needle attached to a pressure gauge is inserted into a forearm compartment before and immediately after activity that causes symptoms. An increase of pressure over a certain level may confirm the diagnosis.
Initial treatment for forearm pump is conservative. Activity can be modified in an effort to improve symptoms. If the symptoms persist, surgery may be indicated. The surgical procedure, a compartment release, will open the tight compartment. When this is done, the pressure caused by muscle swelling will not build within the compartment to the level causing diminished blood flow, deoxygenation, and subsequent pain and numbness. This will allow return to participation in the desired sport usually without ongoing symptoms.
Scott Allen, MD
