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Crural Fascia Injuries in athletes with calf pain and exertional compartment syndrome

It is rare in modern medicine to discover something new.  The following is an exciting discovery by Dr. Silberman not known to have been reported previously in the scientific literature.

Crural Fascia Injuries and Thickening on Musculoskeletal Ultrasound in athletes with calf pain, calf ‘strains’, exertional compartment syndrome and botulinum toxin injections

Marc R. Silberman, Kaitlin Anders


Crural fascia injuries are under recognized and under reported.  Only one known dedicated paper on a crural fascia injury depicting thickening exists in the literature, written in a greater context on an article on a proximal paratendon Achilles injury. The following three cases of fascia thickening surrounding the medial gastrocnemius, none of which involve the Achilles tendon, demonstrate the superiority of ultrasound imaging over the ubiquitous MRI in visualizing the crural fascia and questions whether these injuries are as rare as previously thought.  One athlete suffered from recurrent ‘calf strains’, one athlete had exertional compartment syndrome treated with botulinum toxin, and one athlete suffered an acute injury to his superficial gastrocnemius fascia.  

Keywords: crural fascia thickening, fascia tear, musculoskeletal ultrasound, calf strain, exertional compartment syndrome, botulinum toxin injection.

Copyright © 2017 Marc R. Silberman et al.  This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Link to Full Article


Left Medial Gastrocnemius (MG), Soleus (S), Fascial Thickening (Arrow)













Left Medial Gastrocnemius (MG), Soleus (S), Fascial Thickening (Arrow)














Left Medial Gastrocnemius (MG), Soleus (S), Fascial Thickening (Arrow)














Right superficial Gastrocnemius (MG), Soleus (S) Fascial Thickening (Arrow).
The first known case to be described in the literature.




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