Myositis Ossificans or Heterotopic Ossification: Symptoms, Causes, Treatment

Myositis ossificans, also known as heterotopic ossification, is a condition where there is abnormal bony formation in the soft tissues. There is new bony growth in areas where normally bone is not present such as muscles, ligaments etc. this commonly occurs after an injury or trauma such as a contusion to the muscle where the muscle gets squashed against the underlying bone. This results in bleeding and may lead to formation of hematoma, which can harden into a bone. Conservative treatment helps in alleviating the pain and swelling and eventually an individual can continue with normal activities. The bony growth sometimes may also shrink in size. However, if the problem persists, then surgery is done to remove the bony growth.

• Pain in the arm where the injury has occurred.
• Tenderness to touch.
• Bruising is present.
• Swelling is present.
• The skin is warm to touch.
• Pain upon contracting and/or stretching the injured muscle.
• Limited range of motion of the elbow or shoulder.
• A solid, bony lump can be felt in the muscle.

• Direct impact or trauma to the muscle belly.
• The following causes increase the risk of hematoma hardening into a bone
  1. Heat application to an injury instead of ice application causes increase in the blood flow to the injured area.
  2. If sports massage or electrotherapy treatment is done in the acute stage i.e. immediately after injury has occurred, then this also causes an increase in the blood flow and the temperature. The treatments which can raise the temperature should be started only after the acute phase of the injury has passed (usually 72 hours after injury).
• This condition can also occur due to genetic disorders such as fibrodysplasia ossificans progressiva and progressive osseous heteroplasia.
• Some surgical procedures can also cause this condition.
• Injury to brain or spinal cord.

• The arm should be rested for the injury to heal.
• Ice application helps in reducing pain and swelling.
• Elevating the arm above the heart level also helps in decreasing the bleeding and swelling.
• A compression bandage can be used to reduce bleeding and swelling.
• The arm should be gently moved to avoid stiffness.
• Once the pain has subsided, gentle stretching of the muscles should be done.
• Sports massage can be done after the acute phase has passed. This helps in relaxing the muscles and improving flexibility.
• High doses of nonsteroidal anti-inflammatory medications (NSAIDs) helps in reducing further development of the bony growth.
• After the pain and swelling has subsided, the athlete can get back to the training program gradually.
• If the pain persists or if there is a problem in range of motion of the arm then surgery is required in order to remove the bony growth.