My chiropractic health assistant came into the clinic today and was complaining of bruising on the inside of his thigh. He explained that he took a puck to the area of the inner thigh a few days prior which lead to immediate swelling and bruising. After touching the area, he felt a lump and was concerned about whether the contusion or collection of blood in the muscle would cause any long lasting issues…one in particular that was mentioned is myositis ossificans.
Myositis ossificans may develop after a contusion or blow to a muscle usually in the thigh. Specifically, it is when bone grows or takes form within muscle. It is usually as a result of a hard impact (such as a puck to the leg or fall) which causes damage to the sheath that surrounds a bone called the periostium as well as to the muscle. The symptoms of myositis ossificans include pain in the muscle particularly during exercise or sport activities. This will cause a restriction in range of movement in the leg and a hard lump maybe felt in the muscle itself.
How is myositis ossificans diagnosed?
As mentioned above, bone growth within the muscle, called calcification can occur and maybe painful. The bone will grow two to four weeks following the injury and be mature bone within 3 to 6 months. An x-ray can confirm the diagnosis and show bone growth.
How do I avoid getting myositis ossificans?
After injuring the muscle area, apply cold therapy and compression immediately. Furthermore, you may wish to use heat to loosen the tightened and bruised muscles. Ice will help reduce pain, inflammation and swelling and encourage the injured muscle to heal. Furthermore, chiropractic care, physiotherapy and massage therapy will help to drain swelling and assist in healing.
What treatment options exist for myositis ossificans?
My assistant was treated with laser therapy, cryotherapy and soft tissue therapy 3 days following his injury. He immediately felt better. We recommend 2-3 treatments per week for 2-3 weeks in order to facilitate healing and prevent further damage. Furthermore, massage therapy along with ultrasound, electrotherapy and heat therapy may be effective.
The answer is YES! This blog will help you to understand how this occurs.
The type of back pain that I am referring to is muscular in nature. In your lower back (lumbar) you have a muscle called Quadratus Lumborum (QL). The QL muscle is responsible for four actions:
Lateral bending of vertebral column
Extension of lumbar vertebral column
Fixes the 12th rib during forced expiration
Elevates ilium (hip bones)
The QL attaches from the 12th rib and spine to the pelvis. You have two QL muscles, one on each side. The QL is a common source of lower back pain. If you twist, turn, bend or lift improperly you can trigger spasm, strain and injury to the QL muscle. Often times those presenting with QL Syndrome display the following symptoms:
“Locked up” spine
Acute back pain and spasm
Pain is often one-sided
Pain may radiate towards the gluteal region (buttock)
Clinical Features
Pain upon palpation at the top attachment of the quadratus lumborum (3 cm off the vertebrae in the lumbar spine)
Elevated pelvis on the side of pain
Lumbar region may be slightly flexed laterally to the side of pain (antalgic position)
Acute injury often accompanied by lifting and twisting movements
Males and females may experience referral of pain to their groin region due to an injury to QL. You have nerves that branch off the spinal cord at the level of the lumbar spine in close proximity to QL. You have the Ilioinguinal (L1), which supplies cutaneous distribution to the scrotum (labia for females) AND the Iliohypogastric (T12-L1), which supplies cutaneous innervation to the lower abdominal and groin region. It is important to note that you also have other nerves that branch off the spinal cord lower down. When the QL muscle gets taught, spastic and/or injured, it can affect the nerves that pass near it. If the nerves are inluenced, they can refer to their area of their innervation. Thus, sometimes a muscle strain in the back can create symptoms (such as a sharp shooting pain) in the testicle or labia.
Various treatments can be used to heal a QL strain. First off, a combination of ICE and HEAT will assist in decreasing pain and relaxing the muscle. Moreover, electrotherapy, laser therapy, soft tissue therapy and chiropractic adjustments will help as well. Usually four to six treatments of passive treatment helps to decrease the pain and relax the QL muscle. It is recommended that following passive treatments, you focus on some active care (exercises and rehabilitation) to ensure the QL muscle is functioning properly.
