Exercise-related bilateral leg atypical claudication in female olympic taekwondo player: A case report

We report the case of an Olympic taekwondo athlete with an atypical bilateral intermittent claudication that represented a handicap in her performance during competition fight. Diagnosis of chronic compartment syndrome was established by confirmation of compartment hypertension and the patient was submitted to fasciectomy. Recurrence of symptoms like numbness or tingling after 6 months raised the suspicion of deep compartmental hypertension that, once confirmed, was treated by a repeat deep fasciectomy. New symptoms appeared 4 months after surgery but no hypertension in the compartment was detected. Functional popliteal artery entrapment syndrome (FPAES) was suspected, an unusual form of this syndrome, in which a hypertrophic plantaris tendon as the cause of the entrapment was observed. Resection of the band was performed in a third operation. The patient evolved favourably, maintaining high competition level. Key points We need a thorough clinical examination to reach a satisfactory clinical diagnosis. FPAES is an uncommon disease that is frequently misdiagnosed and overlooked. Dynamic tests are essential for diagnosis de FPAES. Key words: Entrapment syndrome, popliteal artery, compartment pressure, lower extremity claudication Introduction Taekwondo is an Olympic sport in which legs are of paramount importance and the slightest movement can be decisive in the result of a competition. We report the case of an Olympic taekwondo athlete with an atypical bilateral intermittent claudication that represented a handicap in her performance during competition fight. Although tendon and muscular injuries are the most common cause of problems in such circumstances, it may be difficult to make an accurate diagnosis and choose an effective treatment. Functional popliteal artery entrapment syndrome (FPAES) should be considered when symptoms like numbness or tingling are present, with or without paresthesias. PAES is an uncommon cause of lower extremity claudication, first described in 1879 by Stuart (Stuart, 1879), which is usually attributed to an anomalous anatomic relationship between the popliteal artery and the medial head of the gastrocnemius muscle. We present an unusual form of this syndrome caused by hypertrophy of the plantaris muscle tendon that produces the entrapment.