Chronic exertional compartment syndrome of the forearm in a professional drummer: Case Report on the interest of botulinum toxin injection after surgery

Chronic exertional compartment syndrome (CECS) is a rare condition usually affecting the lower leg, but can also involve the upper arm. This exercise-induced pathology is considered an overuse injury characterized by increased pressure in a muscle compartment. Forearm CECS is mostly observed in sports requiring prolonged, repetitive and energetic gripping, but also in musicians. The main symptoms are ischemic pain, stiffness, reduced muscle strength and paresthesia. We report here the unique case of forearm CECS in a professional drummer, successfully treated with injection of botulinum toxin following a post-surgical recurrence. The multiple intramuscular pressure measurements of the forearm performed during a 2 years follow-up suggest the efficacy of toxin botulinum injections on stiffness, pain and functional limitation in a patient with upper limb CECS following post-surgical recurrence. Injection of botulinum toxin should therefore be considered in CECS.