Myositis ossificans is the development of abnormal bone at the injured site. It is a rare condition that is the result of a blunt or a muscle injury. Athletes commonly suffer from myositis ossificans in which the deep tissue bleeds profusely. Soccer players who get hurt in the mid-thigh, develop pain and bruising that may lead to this condition. The soft tissues and muscles of the body that get injured in the trauma initially, develop a hematoma (specific area develop blood cloth and gets swollen). Over a period of time, a bone is formed within the muscle at the injured site.
As we all know, bruising or contusion is typically marked by internal bleeding and skin discoloration. The bleeding is followed by a blood cloth (hematoma in leg) and with improper care, an abnormal bone growth may soon be visible at the site. Myositis describes a condition in which the muscles are inflamed whereas ossification points towards formation of bones, also referred to as calcification. Sportsperson playing games like rugby and hockey can also suffer from muscle sprains and strains, which can also subsequently lead to calcification in the damaged muscle tissue. Studies show that percentage of muscle injuries becoming myositis ossificans is low. As per reports, myositis ossificans accounts for only 10-20% of muscle injuries that cause contusion.
Myositis ossificans refers to formation of bones inside the muscle tissue. With no treatment, the calcification formed at the wrong place completely replaces the muscle tissue in 3 -6 months post injury. This is an unusual condition and no one knows the reason to why it develops. Doctors are still unable to find the cause of myositis ossificans. The abnormal bone can be easily detected using X-rays. However, the cause of concern is that the x-ray procedure also shows a tumor (uncontrolled growth of mass) that is developed within the soft tissues. However, the tumor is localized and does not spread. To ensure that unusual bone mass formed is benign (non cancerous), an x-ray of the injured site is again performed after several weeks.
One of the primary factors that causes a muscle injury to become myositis ossificans is the delay in treatment. This lackadaisical attitude towards treatment increases the chances of developing bone formation. To be precise, ignoring the first line of treatment after a bruise can put a person in the risk zone of calcification. So, taking the treatment as early as possible (in fact immediately) is the safest bet when it comes to substantially minimizing the occurrence of myositis ossificans. Under any circumstances, the treatment must start within two days, once the person has sustained the muscle injury.
Be it hematoma or any other type of physical injury, taking rest as much as possible is always recommended. Keep the injured area immobile for the first 48 hours can not only shorten the recovery time but also inhibit the progression of calcification process inside the muscles. If complete rest is not possible, restricting movements that put minimal strain on the area inflicted with damage is recommended. In case, walking is unavoidable, it is advised to use crutches. This will insulate the damaged area from excessive pressure, thereby preventing worsening of the injury.
In order to treat localized skin inflammation around the injured area use of ice therapy is a good option. As we all know, the inflammation is due to internal bleeding resulting from damage to blood vessels. Application of ice compresses these blood vessels, thereby preventing them from leaking blood. Restricting blood leakage contributes in reducing inflammation of the skin. One can use an ice pack such as a bag of frozen peas and move around the injured site for approximately 15 minutes. You can repeat this session of ice massage 2-3 times in a day.
Compression therapy too can helpful in managing pain and to speed up healing. The procedure involves wrapping up a soft bandage around the injured site. One can also use an ace wrap, which is nothing but an elastic bandage that has an attached Velcro to it. Sometimes these elastic bandages come along with metal clips. The velcro or the metal clip ensure that the bandage is secured firmly around the injured site. The patient is bound to experience considerable amount of discomfort when using this compression wrap as it renders support and stability to the damaged muscle.
Another effective way to decrease swelling associated with contusion is by keeping the injured site raised well above the heart level. Elevating the damaged limb for a maximum duration of time in the first 72 hours can work wonders to reduce pain and inflammation. Elevation inhibits blood circulation at the injured site and in fact in such a position, the blood is directed away from the damaged area, which encourages healing of pain and inflammation.
Anti-inflammatory medications are also effective to treat myositis ossificans, as they relieve the discomfort of the patient. Indomethacin is beneficial as it helps to reduce the pain. Although indomethacin might be available over the counter, taking the consent of the doctor is very important before you start the dosage.
Will surgical removal of abnormal bone formation help to resolve the issue? Not necessarily! Abnormal bone development may begin once again post surgery. To be precise, the bone abnormality may come back to haunt the patient, even after it has been removed through surgery. Doctors generally wait for 6 to 12 months before considering surgical removal. It is likely to come back, if it is removed before maturity.
Certain exercises are recommended to promote flexibility in the injured muscle. For instance, if bruising has occurred in the thigh, a common exercise centers around tightening the thigh muscle. Firstly, put a rolled towel under the knee and then press it using your knee. This will help to tighten up your thigh muscles and now be in this position for around 5 seconds. This procedure needs to be repeated for around 7-8 times at one time. Do not attempt this exercise immediately after injury. Wait for at least 3-4 days after injury and then only begin after consulting with your doctor.
Keep in mind that primary aim of rest, ice therapy, compression and elevation is not only to facilitate recovery but also to prevent muscle injury from advancing to calcification. So, these traditional methods should not be overlooked and treatment should begin without wasting a single minute after the injury.