Options, explained
A treatment plan built around the activity you want back.
Professor Lee offers Botox injections, minimally invasive compartment release and full open release for CECS. Together, you will choose a treatment that fits the affected compartments, your symptoms and the activity you want back, with rehabilitation supporting your progress.
At a glance
Treatment with a clear purpose.
Professor Lee offers Botox, minimally invasive release and full open release, with rehabilitation tailored to the activity you want back.
Work with your activity
Activity and rehabilitation
A tailored rehabilitation plan supports movement, strength and activity progression. Adjusting the activities that trigger symptoms and supervised gait retraining can help some people manage CECS. Professor Lee and the rehabilitation team review your response and whether an injection or release would better support your goal.
Buerba et al. (2019): CECS management strategies
A preliminary lower-leg study followed patients for up to nine months. See the published findings and strength effects alongside.
An injection option
Botox injections
Clinic price: £1,200 per compartment. The compartments to treat and the overall cost are agreed following consultation.
Botox (botulinum toxin A) is a non-surgical injection option offered by Professor Lee for suitable CECS patients. Its effect is temporary, with repeat injections where appropriate. A preliminary lower-leg study of 16 patients reported reduced compartment pressures and relief of exercise pain in 15 patients, followed for up to nine months. Muscle strength decreased in 11 patients, without reported functional consequences in that study. A separate retrospective study of 16 upper- and lower-limb cases found initial benefit in 11 patients, with recurrence common. Professor Lee discusses expected benefit, possible weakness, off-label use and follow-up before treatment.
Isner-Horobeti et al. (2013): botulinum toxin in 16 lower-leg patients · Charvin et al. (2022): botulinum toxin, retrospective study of 16 cases
The effect is temporary. Repeat injections may be appropriate, with review of your strength, symptoms and activity.
Already have a diagnosis and want to move ahead with treatment?
Book a consultationWith Professor Lee at London Cartilage Clinic.
Not sure about the next step, or want to understand how things work?
Book a discovery callA free call with the team to discuss the process.
Still need a diagnosis? Explore the complete diagnostic pathway →
Understand the operation
Compartment release surgery
Clinic price: £7,500 for compartment release surgery covering both legs. Professor Lee discusses the appropriate approach and confirms your treatment plan after consultation.
Compartment release, or fasciotomy, opens the fascia around the affected muscles to give them more room during activity. Professor Lee offers minimally invasive release through smaller incisions and full open release, choosing the approach for the compartments involved and the release required. His minimally invasive approach uses small incisions to limit scarring; small scars remain. Local anaesthetic may be used for suitable patients, depending on the procedure and clinical assessment.
Human studies report improved symptoms and return to activity with both approaches. In an 18-patient minimally invasive series, 17 returned to their previous or a higher sporting level. In a 50-patient open-release study with mean six-year follow-up, 42 reported improved symptoms. A small comparative study found similar return-to-sport outcomes after open and endoscopically assisted release.
Risks include nerve injury, bleeding, wound problems and persistent or recurrent symptoms. Your surgeon explains these alongside the expected benefit and recovery plan.
Maffulli et al. (2016): minimally invasive release in 18 patients · D’Amore et al. (2022): open and endoscopically assisted release · Moore et al. (online 2024): open fasciotomy, mean six-year follow-up
Already have a diagnosis and want to move ahead with treatment?
Book a consultationWith Professor Lee at London Cartilage Clinic.
Not sure about the next step, or want to understand how things work?
Book a discovery callA free call with the team to discuss the process.
Still need a diagnosis? Explore the complete diagnostic pathway →
Small incisions limit scarring; small scars remain. Local anaesthetic may be used for suitable patients. Professor Lee selects the approach for the compartments involved.
A closer look — only if you choose
Real clinical photographs.
These photographs show lower-leg surgery, including open incisions, blood and exposed tissue. Some people may find them upsetting. You can read all treatment information without viewing them.
Your priorities belong in the decision
Decide together
Your consultation brings the options into focus: the benefit you are aiming for, the procedure involved, the recovery plan and the risks that matter to you. Professor Lee explains his recommendation and how progress will be assessed. Rehabilitation and activity adjustments remain part of the conversation, whether you choose an injection, surgery or continued non-operative care.
decisionBenefitsRisksAlternativesYour goal
Common questions
Does everyone with CECS need surgery?
No. Options depend on symptom severity, activity goals, the assessment and response to previous treatment. Surgery and its alternatives should be discussed individually.
What should I ask when comparing treatment options?
Ask about likely benefits, risks, evidence limits, alternatives, activity changes, follow-up and what happens if symptoms persist. Check that the option fits your diagnosis and goals.
Sources and further reading
- Isner-Horobeti et al. (2013): botulinum toxin in 16 lower-leg patients
- Maffulli et al. (2016): minimally invasive release in 18 patients
- D’Amore et al. (2022): open and endoscopically assisted release
- Moore et al. (online 2024): open fasciotomy, mean six-year follow-up
- Buerba et al. (2019): CECS management strategies
- Charvin et al. (2022): botulinum toxin, retrospective study of 16 cases