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Motorcycle racer develops rare injury in arm

A 26-year-old motorcyclist developed a rare injury in his lower arm due to the repeated nature of intense braking manoeuvres on the racing track.

He was diagnosed with chronic exertional compartment syndrome (CECS), a disabling condition, usually found in enthusiastic sports participants such as rowers, climbers, and swimmers, and is most commonly observed in the legs, but rarely in the forearm.

The patient was admitted to a sports medicine department in the Netherlands, where he described progressive weakness of his right index finger, and pain, weakness and swelling of his right forearm, for a period of 1 year.

His symptoms were more prominent towards the end of races, and he noticed that the pain had already started within 5 minutes after the start of a race. He was not able to finish his last few races due to severe discomfort.

Pain intensity appeared to be related to the number of braking manoeuvres. The frequent and intensive braking required on short tracks with multiple curves caused swelling, tightness and tense muscle compartments in his right forearm.

As a result, he could no longer control the hand brake lever, and he was unable to flex his index finger. Moreover, he felt progressive numbness in his right hand. The swelling and tightness usually disappeared within 1 hour after racing, but the numbness and weakness of his hand was present until the day after.

He tried medication, rest, ointments and physiotherapy, but none of these helped.

Therefore, he underwent a surgical procedure where the fascia (connective tissues) were cut to relieve the tension, and to treat the resulting loss of circulation in the muscles of both his lower arms.

After 6 weeks, he was able to start training again at the preoperative level, and within 3 months, he was was able to perform at a higher competitive level.

Article: Motorcycle racer with unilateral forearm flexor and extensor chronic exertional compartment syndrome, Michiel B Winkes, Joep A Teijink, Marc R Scheltinga, BMJ Case Reports, doi:10.1136/bcr-2016-214739, published 5 May 2016.