Spinning-Related Exertional Thigh Compartment Syndrome | Dr. Daniel Gould

Dr. Daniel Gould co-authored this case report published in Cureus, documenting a rare case of acute thigh compartment syndrome following an intense indoor cycling, or spinning, workout.

Thigh compartment syndrome occurs when pressure rises within the enclosed muscle compartments of the thigh, restricting blood flow and potentially causing tissue damage. Although the condition is more commonly associated with trauma or anticoagulation, exercise-induced cases are considerably less common.

The report describes a 19-year-old woman who developed severe bilateral thigh pain and swelling, numbness, and dark urine after participating in a spinning class. Laboratory testing revealed markedly elevated creatine kinase levels, consistent with significant muscle injury and rhabdomyolysis.

Because of the severity of her symptoms and the clinical suspicion for compartment syndrome, the patient underwent emergency bilateral decompression fasciotomy to relieve pressure within the thighs. The affected muscles remained viable, and no debridement was required.

Following surgery and aggressive intravenous fluid treatment for rhabdomyolysis, the patient's symptoms improved and her wounds were subsequently closed. She ultimately recovered without functional deficits.

The case highlights the importance of recognizing severe exercise-related muscle pain and swelling as potentially more than routine post-workout discomfort. Prompt diagnosis and surgical intervention can be critical in preventing permanent muscle and nerve damage in acute compartment syndrome.