Understanding Myositis Ossificans

What Is Myositis Ossificans?

Myositis ossificans is a condition where bone tissue forms inside muscle or other soft tissues after an injury. Most commonly, this occurs following a significant contusion that results in a hematoma. Over time, instead of healing normally, the body lays down calcium within the injured muscle, creating hardened, bone-like deposits.

While many muscle injuries heal without complication, myositis ossificans can develop if the area is subjected to further trauma or is not properly managed early on. The condition is especially relevant in contact sports or high-impact activities, where athletes are frequently exposed to blows, collisions, or blunt force trauma. 

What Happens When a Hematoma Becomes Ossified?

If a hematoma does not resolve effectively, the body may mismanage its healing response. Instead of breaking down and absorbing the pooled blood, it begins to deposit calcium salts into the damaged tissue. This response can lead to the formation of hard, bone like masses within muscle. The hallmarks of myositis ossificans.

These masses may feel like firm lumps under the skin and can be painful to touch or with associated movement.  They’re most common in large muscle groups such as the quadriceps, hamstrings, or biceps. For athletes and generally active individuals, this can limit mobility, impact performance, or irritate nearby soft tissue like the neighboring nerves and tendons.

What Causes Myositis Ossificans?

Myositis ossificans typically follows a direct impact injury, such as a forceful blow from a sporting collision or a hit from a hard implement. Cases also commonly result from falls where the thigh or buttock wear the brunt of the impact. 

• The risk increases when a muscle is repeatedly injured before the original bruise has fully healed.
• And when aggressive massage or exercise is introduced too early on.

What Does It Mean If a Hematoma Hardens?

A hardened hematoma may suggest the presence of fibrosis or calcification. In cases of myositis ossificans, this hardening is caused by the transformation of part of the soft tissue into bone. This can restrict range of motion and compromise muscle function. Patients may also experience discomfort during movement or muscle contraction.

To confirm the presence of ossified tissue, imaging techniques like X-rays or ultrasound are typically used. These assist the treatment strategies be tailored based on the size and exact location of the calcification.

How Is Myositis Ossificans Treated?

Early physio intervention can play a key role in managing myositis ossificans. Mild cases may resolve on their own with time, but more significant calcifications may often require a more structured rehabilitation approach. The main goals of treatment include pain management, restoring flexibility and function. As well as preventing further damage.

Common treatments for calcification of a bruise include:

• Soft tissue therapy: Targeted soft tissue massage techniques to help restore soft tissue mobility and reduce local tension.
• Shockwave therapy (ESWT): In chronic cases, ESWT can be used to disrupt the calcified tissue and stimulate tissue repair. 
• Ultrasound therapy: Is a gentle approach that can be used early on to  improve blood flow and potentially assist in breaking down smaller calcifications.
• Laser therapy: Similar to ultrasound therapy is a gentle approach that can be used early on to  reduce inflammation, improve blood flow and potentially assist in breaking down smaller calcifications.
• Exercsie therapy: Carefully prescribed exercises to maintain range of motion and support the overall functional recovery.

Treating A Hematoma To Prevent Calcification

Appropriate initial management of muscle injuries can reduce the risk of developing myositis ossificans. Some helpful strategies should you suffer a significant bruise include:

• Applying ice and compression ASAP following injury
• Avoiding deep tissue massage of the bruised area
• Avoid vigorous exercise and stretching during the acute phase
• Graduated return to activity once the acute swelling and pain have reduced.

Sydney Physio Clinic And Myositis Ossificans

Though it may start as a what appears simply to be a large bruise, myositis ossificans can evolve into a complex condition. One that affects general  movement and function. Physiotherapy treatment at Sydney Physio Clinic offers non-invasive, effective treatments to manage the symptoms and more importantly promote healing and recovery. If you suspect you may be experiencing myositis ossificans, call our team at Sydney Physio Clinic for a personalised treatment plan tailored to your goals and needs.