Background and Purpose: Although barefoot running has been investigated for anterior and lateral exertional compartment syndrome, a specific barefoot running program aimed at altering running mechanics has not been determined for posterior exertional compartment syndrome for a college lacrosse player. The purpose of this case report was to examine the effects of adopting a forefoot running pattern through a barefoot running program in a 20-year-old college lacrosse player with posterior chronic exertional compartment syndrome (CECS) in conjunction with a comprehensive physical therapy program. Case description: The patient was a 20-year-old female college lacrosse player who presented to physical therapy with a 9-month history of bilateral, posterior lower leg pain, which was brought on by running on pavement, up hills, and longer than 5-10 minutes. The patient reported extreme tightness and throbbing in the posterior lower leg and numbness and tingling into the feet while running on pavement and long distance runs greater than 1 mile. The patient was seen 1-2x/week for twelve weeks. Outcomes: DF ROM improved from lacking 16° to lacking 8° on the right and lacking 12° to lacking 4° on the left. All hip and ankle strength improved from 4-4+/5 to 5/5 throughout. The LEFS improved from 9% disability to 5% disability. The patient’s running tolerance improved from 1 min shod to 12 min barefoot before experiencing tightness in her legs. Discussion: Barefoot running, in conjunction with manual therapy, lower extremity (LE) stretching, strengthening, and stabilization exercises was found to be effective at improving running tolerance for a female college lacrosse player. Future research should investigate the efficacy of barefoot running programs and appropriate timelines for progression in patients with posterior CECS
