This is the contusion equivalent of cheerleader’s hip. If you’re hit while the quadriceps muscle is contracting(and it usually is during contusions), the blow not only crushes the muscle and ruptures blood vessels, butbecause the muscle is under tension from being contracted, it can pull away from the bone. Except for oneportion (the rectus femoris, which connects to the pelvis), the quadriceps wholly begins in the thigh. Itconnects to a good two-thirds of the front part of the femur. And that’s muscle to bone connection. There areno tendons here to act as intermediaries. More to the point, it’s muscle to periosteum, that dense bonecovering that’s supposed to heal fractures and otherwise keep things shipshape.

So when the muscle pulls away from the bone, it takes some periosteum with it. Meanwhile, theruptured blood vessels are pouring blood into the area, bathing the periosteum, which has set up shop in themuscle an inch away from its former home in the femur. In the face of such adversity the periosteum knowshow to do just one thing: make bone. And with so much nutritious blood around it does so at an unbelievablepace. You can see new bone on an x-ray within a couple of weeks of the injury—that’s almost unheard of.It can grow as large as a flashlight and often has very sharp edges. And the bone is forming precisely whereit shouldn’t, inside the muscle. Needless to say, all that does not promote good muscle function. What it doespromote is pain.

+ What to do about it + The best thing to do about myositis ossificans is prevent it from happening in thefirst place by flexing (bending) the knee as far as possible and keeping it bent for the first twelve to twenty-four hours after the injury. You can wrap an Ace bandage around your thigh and leg to help you in this bent-leg position.

Next, see a doctor. The problem is that there’s no way of knowing at the beginning whether yourcontusion will develop into myositis ossificans—which literally means “bone forming in muscle”—or not.Again, here’s an instance where it’s particularly important to see a doctor who’s had experience with suchthings, because the way you treat the contusion from the beginning will most likely have a bearing on if, orhow badly, bone forms in the muscle. If the bone is already there, a doctor who’s not used to treating athletesmight easily draw the wrong conclusion from x-rays which show a rapidly forming mass that looks suspi-ciously like a malignant tumor.

Usually these injuries are not treated well; in fact, they’re abused. Someone— a high school footballcoach, say—decides that it’s nothing more than a bruise, and tells the athlete to work through it, get in thewhirlpool, get into a massage program. Yet often this injury can lead to another, simply as a result of mistreat-ing the myositis—by vigorous massage, say, or too much activity. Like simple contusions, this injury should berested. Pain is not gain when it comes to myosi-tis ossificans. Once the bone forms, you have to wait until it’srun its course and formed all the bone it’s going to form. Usually, it will reverse itself and reabsorb nearly allthe bone, a process that can take from three to twelve months. And the muscle will eventually reattach to thefemur. You simply have to wait it out.

If it doesn’t reabsorb, then surgery might be the only answer. In any case, don’t muddle through thisone on your own. Have a doctor look at it.

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