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Don’t Just Blame it on the Veins

An Update on Vascular Exertional Limb Pain

Dyer, Kevin T., MD1; Hogrefe, Christopher P., MD, FACEP1,2,3

Current Sports Medicine Reports: October 2018 - Volume 17 - Issue 10 - p 347–353
doi: 10.1249/JSR.0000000000000527
Sports-Specific Illness and Injury: Section Articles

Exertional limb pain is a common problem encountered in recreational and competitive athletes. Affecting both the upper and lower extremities, this broad entity can be musculoskeletal, vascular, neurologic, oncologic, or infectious in origin. This article focuses on the vascular causes of exercise-related extremity pain, which encompass a cadre of elusive diagnoses. Specifically, we examine arterial endofibrosis, popliteal artery entrapment syndrome, and chronic exertional compartment syndrome of both the upper and lower extremities. For each of these conditions, we offer updates regarding the respective epidemiology, common signs and symptoms, worthwhile diagnostic modalities, and pertinent treatment options, all based on evidence and reports published over the past year.

1Department of Emergency Medicine, Northwestern Medicine, Chicago, IL;

2Department of Medicine-Sports Medicine, Northwestern Medicine, Chicago, IL; and

3Department of Orthopaedic Surgery-Sports Medicine, Northwestern Medicine, Chicago, IL

Address for correspondence: Christopher P. Hogrefe, MD, FACEP, Suite 1300, Lavin Family Pavilion, 259 East Erie, Northwestern Medicine, Chicago, IL 60611; E-mail:

Copyright © 2018 by the American College of Sports Medicine.