Chronic exertional compartment syndrome of the lower leg
Meaning of chronic exertional compartment syndrome of the lower leg: For the purposes of this Statement of Principles, chronic exertional compartment syndrome of the lower leg: (a) means raised muscle compartment pressure manifesting with exercise-induced pain and tightness originating in the calf or shin which typically resolves or reduces with rest; and (a) excludes: (i) fracture, including stress fracture; (ii) lower leg tendinopathies or bursitis; Chronic Exertional Compartment Syndrome Of The Lower Leg (Reasonable Hypothesis) (No. 98 of 2023) (iii) nerve entrapments (sural or superfoneal); (iv) popliteal artery entrapment syndrome; (v) acute sprain and acute strain; and (vi) vascular insufficiency.
Reasonable Hypothesis (RH) — Statement of Principles No. 98 of 2023
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting chronic exertional compartment syndrome of the lower leg or death from chronic exertional compartment syndrome of the lower leg with the circumstances of a person's relevant service:
- (1)running or jogging an average of at least 30 kilometres per week for the 4 weeks before the clinical onset or clinical worsening of chronic exertional compartment syndrome of the lower leg;
- (2)undertaking weight bearing exercise involving repeated activity of the lower leg on the affected side for: (a) a minimum intensity of 5 METS; and (b) for at least 4 hours per week; and for at least the 4 weeks before the clinical onset or clinical worsening of chronic exertional compartment syndrome of the lower leg; Chronic Exertional Compartment Syndrome Of The Lower Leg (Reasonable Hypothesis) (No. 98 of 2023);
Note: Examples of weight bearing exercise involving repeated activity of the lower leg at a minimum intensity of 5 METS include marching, sustained brisk walking, playing football, and dancing.
Note: MET is defined in the Schedule 1 - Dictionary.
- (3)increasing the frequency, duration or intensity of weight bearing activity involving the lower leg on the affected side: (a) by at least 100 percent; and (b) to a minimum intensity of 5 METs; and (c) for at least 2 hours per day; within the one week before the clinical onset or clinical worsening of chronic exertional compartment syndrome of the lower leg;
Note: MET is defined in the Schedule 1 - Dictionary.
- (4)inability to obtain appropriate clinical management for chronic exertional compartment syndrome of the lower leg before the clinical worsening of chronic exertional compartment syndrome of the lower leg;
Balance of Probabilities (BoP) — Statement of Principles No. 99 of 2023
4 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, chronic exertional compartment syndrome of the lower leg or death from chronic exertional compartment syndrome of the lower leg is connected with the circumstances of a person's relevant service:
- (1)running or jogging an average of at least 60 kilometres per week for the 4 weeks before the clinical onset or clinical worsening of chronic exertional compartment syndrome of the lower leg;
- (2)undertaking weight bearing exercise involving repeated activity of the lower leg on the affected side for: (a) a minimum intensity of 5 METS; and (b) for at least 6 hours per week; and for at least the 4 weeks before the clinical onset or clinical worsening of chronic exertional compartment syndrome of the lower leg;
Note: Examples of weight bearing exercise involving repeated activity of the lower leg at a minimum intensity of 5 METS include marching, sustained brisk walking, playing football, and dancing.
Note: MET is defined in the Schedule 1 - Dictionary.
- (3)increasing the frequency, duration or intensity of weight bearing activity involving the lower leg on the affected side: Chronic Exertional Compartment Syndrome Of The Lower Leg (Balance of Probabilities) (No. 99 of 2023) (a) by at least 100 percent; and (b) to a minimum intensity of 5 METs; and (c) for at least 4 hours per day; within the one week before the clinical onset or clinical worsening of chronic exertional compartment syndrome of the lower leg;
Note: MET is defined in the Schedule 1 - Dictionary.
- (4)inability to obtain appropriate clinical management for chronic exertional compartment syndrome of the lower leg before the clinical worsening of chronic exertional compartment syndrome of the lower leg;
