Botulinum injections for anterolateral lower-leg chronic exertional compartment syndrome

Treatment of Lower Leg Anterolateral Chronic Exertional Compartment Syndrome With Intra-muscular Botulinum Injections.

Not applicable Interventional University of Calgary · NCT05765071

This will test whether botulinum toxin injections into the lower-leg muscles reduce exercise-related pain in adults with anterolateral CECS.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment50 (estimated)
Ages18 Years to 50 Years
SexAll
SponsorUniversity of Calgary Academic / other
Locations1 site (Calgary, Alberta)
Trial IDNCT05765071 on ClinicalTrials.gov

What this trial studies

This is a triple-blind randomized trial comparing intramuscular botulinum toxin A injections to a normal saline placebo for anterolateral lower-leg CECS. Adults with CECS confirmed by post-exertional compartment pressure measurements will receive the assigned injection at the University of Calgary. Participants complete baseline and web-based follow-up questionnaires at 2, 4, 6, 8, 12, 16, and 24 weeks to track pain during sport activity and other outcomes. Secondary measures include time to pain onset and duration, pain character, foot paresthesias, self-reported ankle instability, ankle dorsiflexion/eversion strength, and SANE score.

Who should consider this trial

Good fit: Adults with confirmed anterolateral lower-leg CECS by post-exertional compartment pressures (immediate >30 mmHg and 5-minute >12 mmHg) who can attend the University of Calgary for injection and follow-up.

Not a fit: Patients with CECS affecting other compartments, those who are pregnant or breastfeeding, people with significant neurologic disorders, or those with contraindications to botulinum toxin may not receive benefit.

Why it matters

Potential benefit: If successful, injections could offer a non-surgical way to reduce exercise pain and improve leg function for people with anterolateral CECS.

How similar studies have performed: Only case reports and small series have reported symptom improvement with intramuscular botulinum injections, and randomized controlled evidence is currently limited.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Confirmed diagnosis of lower leg anterolateral chronic exertional compartment syndrome (CECS), as measured post-exertional compartment pressure measurements of greater than 30 mmHg for immediate post-exertional compartment pressure, and greater than 12 mmHg at 5 minutes after stopping exercise.

Exclusion Criteria:

* Female patients who are pregnant, trying to get pregnant or lactating
* History of keloidal scarring
* History of any significant neurologic disease (ie: amyotrophic lateral sclerosis, motor neuropathy, myasthenia gravis, Lambert-Eaton syndrome)

Where this trial is running

Calgary, Alberta

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Chronic Exertional Compartment SyndromeanterolateralCECSlower leg
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.