Leg and foot pain in a female ballet dancer caused by combined bilateral chronic compartment syndrome and bilateral tarsal tunnel syndrome. A case report

A 24-year-old professional elite female ballet dancer developed intolerable leg pain that threatened her career. She was diagnosed with bilateral chronic compartment syndrome of the lower legs and a minimal degree of coexisting bilateral tarsal tunnel syndrome - overlapping conditions that can complicate diagnosis and treatment in athletes and performers with exceptionally high physical demands.

Fasciotomy was performed on all four compartments in both legs. Additional treatment included repeated injections of Marcaine and cortisone along the medial tibiae for shin splints and six months of structured rehabilitation, resulting in a return to high-level performance in a leading contemporary ballet role.

Two years later, the patient sustained a stress injury to the first tarsometatarsal joint, requiring eight weeks away from training and dance. After returning to activity, previously mild tarsal tunnel symptoms worsened and prohibited continued performance.

Because conservative treatment was unsuccessful, bilateral tarsal tunnel decompression was performed, leading to rapid and complete pain relief. Following four months of rehabilitation, the dancer returned successfully to a principal role in a classical ballet requiring extensive pointe work. More than seven years after the final surgery, no further complications were reported.

This case highlights the diagnostic complexity of lower extremity pain syndromes in high-performance athletes and dancers and underscores the importance of long-term follow-up and reassessment when symptoms recur. 

Cues for recognizing these conditions are that physical training and medication, usually recommended for muscular pain, regularly leads to increased local pain, cramps in legs and feet and referred pain whilst relief is achieved by rest only