Cambridge Sports Union has completed its on-line survey examining the prevalence of chronic exertional compartment syndrome (CECS) within the competitive nordic ski community in North America.
The purpose of the survey was to gauge the extent of CECS among cross-country skiers, and to collect data that contributes to understanding the etiology of CECS.
Fifty coaches responded to the survey, representing roughly 1,500 athletes. The teams represented include youth and regional clubs, the U.S. and Canadian national teams, and college and high school level teams. The geographic distribution of the respondents was New England (35 percent), New York (five percent), West (23 percent), Midwest (23 percent), Alaska (five percent) and Canada (10 percent).
56 percent of the coaches reported skiers with CECS, diagnosed by performing compartment pressure testing. There were a total of 39 cases of CECS reported. No coach had more than three cases of CECS on their team that required medical intervention.
90 percent of the teams had only one case of CECS. Of the 39 reported cases of CECS, 80 percent had surgery to correct it, and more than 90 percent had full recovery post-surgery. There were 3 cases that required a second surgery.
The percentage of woman and men diagnosed with CECS was 57 percent and 43 percent, respectively. The age distribution for women diagnosed with CECS was 14 to 30, with the average age being 19. The age distribution for men diagnosed with CECS was 16 to 30, with the average age being 19.
62 percent of those with CECS had pain in the front of the leg, 24 percent had pain in the side , and 14 percent had pain in the back. The teams that trained over 500 hours a year had a statistically significant (p value 0.06) higher prevalence of CECS than the teams that trained less than 500 hours a year. Those teams with a higher average vertical gain achieved during skate roller-ski workouts had a statistically significant (p value 0.04) increase in CECS. (The survey did not look at vertical gain during classic roller skiing.)
Few athletes were reported who were using the food supplement creatine. There was no correlation between CECS and the use of creatine in this study. The study size did not allow us to find statistical relevance in correlating CECS with geography, stretching, off-snow training or body type.
In summary, there appears to be a high prevalence of CECS in male and female competitive cross-country skiers, particularly among the teams that train at high hours with increased vertical gain during skate roller skiing. We hope that this small study encourages others to work toward understanding the etiology, prevention and treatment of CECS. We are encouraged by the many graduate students and researchers who contacted us and are initiating projects in this direction.
Peter Hoenig, MD David Brams, MD James Stock, PhD Cambridge Sports Union. Address questions to: P.Hoenig, 1073 Concord Road, Sudbury, MA 01776. firstname.lastname@example.org.