Myositis Ossificans

A muscle contusion, when the skin and underlying tissue become bruised, can be a painful condition. But infrequently, this injury can give way to myositis ossificans: the growth of bony protrusions within the bruised muscle. After six or seven weeks, this bone growth stops and is slowly reabsorbed; still, the bone itself remains and can be felt through the muscle and skin. Even after this resorption, however, some bone may remain in the muscle.

The reason why some contusions cause myositis ossificans and others don’t isn’t known. However, injuries that are very severe, aren’t properly managed and treated, or occur repeatedly can increase the chance of this bone growth. Because contusions are often caused by blunt trauma to the body, athletes most at risk are those in sports in which a ball or another player can hit them, such as football, hockey, cricket or rugby.

Myositis ossificans is not detectable immediately; initially, symptoms are those of a contusion, such as pain, tenderness and swelling in the affected area. After a few weeks, however, bone growth may begin, and it may be detected as a hardness or lump within the muscle; accompanying this may be increased pain upon waking in the morning, and increased discomfort with activity. Eventually, the bone stops growing and begins to be reabsorbed by the body; it’s possible this new bone will never be completely absorbed, however.

If you suspect you have developed myositis ossificans, consult a sports medicine specialist. He or she will examine the area, try to identify the source of the injury, and X-ray the affected limb to detect bone growth. A magnetic resonance image, or MRI, or an ultrasound might also be necessary to rule out other causes of pain.

There is little that can be done to speed up the rate at which the extra bone is reabsorbed. However, your sports medicine specialist might recommend exercises to increase range of motion, and instruction to avoid activities that aggravate the pain. In some cases, surgery is performed to remove the bone growth, but this remains a controversial method as in some cases it can accelerate the regrowth of the bone.

In the future, prevent myositis ossificans by promptly and properly treating injuries with rest, ice, a compression bandage and elevation of the injured limb. These treatments can not only put you on the road to recovery more quickly than continuing to use the injured muscle–it can also prevent further conditions such as myositis ossificans.