Myositis Ossificans / (Heterotopic Bone Formation)
What is Myositis Ossificans?
Quad contusions can lead to a complication called myositis ossificans. Myositis ossificans literally means inflammation of muscle leading to bone formation. Heterotopic ossification means formation of bone in an unusual or peculiar place. Myositis ossificans has been reported in 9% to 20% of all cases of quad contusions. When the quadriceps muscles bleed, a cascade of cellular responses can occur, causing heterotopic bone formation. The usually elastic, contractible components of the muscle become rigid.
Symptoms of Myositis Ossificans
- Restricted range of movement.
- Pain in the muscle when you used.
- A hard lump in the muscle.
Bone growth (shown by an x-ray).
Causes Myositis Ossificans
Myositis ossificans is an unusual condition that often occurs in athletes who sustain a blunt injury that causes deep tissue bleeding. A typical story is a soccer player who is kicked forcefully in the mid-thigh, and develops pain and significant bruising.
The soft-tissues that were injured in the traumatic event initially develops a hematoma, and subsequently develop the myositis ossificans.
Some studies have identified the following risk factors for the development of myositis ossificans:
- limited knee range of motion,
- previous quad contusion,
- treatment for a quad contusion that was delayed more than 72 hours,
- knee effusion (swollen knee), and
- injury sustained by playing high impact sports
Treatment of Myositis Ossificans
The following guidelines are for information purposes only. Seeking
professional advice before beginning rehabilitation is recommended.
See a sports injury specialist or doctor as soon as possible.
- Treatment plans should include limiting swelling and bleeding; minimizing the amount of scar formation; and preserving the elasticity, contractility, and strength of the injured and uninjured muscle tissue.
- X-ray the muscle to see when it is safe to start rehabilitation.
- Surgery to remove the bone (worst case)
Medical Massage performed by the therapists at Advanced Alternatives Massage Therapy should work under the advice or prescription of a doctor in a case such as this. In such a case, it may be prescribed for massage to be implemented from the periphery of the injury into the middle of hematoma (late subacute on). Lymph Edema Therapy may assist in dissipating the excess fluid and may be helpful in relieving pain associated with this condition.