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Muscle injuries are common and can have various causes, from minor slips and falls to more severe car accidents or sports injuries. While many muscle injuries heal without complications, some can lead to lumps in the affected area. This is often due to the formation of a hematoma, a pool of blood that collects within the damaged tissue, creating a noticeable lump. In some cases, muscle injuries can also result in a condition called myositis ossificans, where bone or bone-like tissue forms within the soft tissues or muscles, causing a lump. This condition typically arises from direct trauma to the muscle and can be quite painful, impacting an individual's range of motion.
| Characteristics | Values |
|---|---|
| Name of condition | Myositis Ossificans (MO) |
| Cause | Bone or bone-like tissue growth in muscle or soft tissue |
| Symptoms | Pain, tenderness, swelling, warmth, reduced range of motion |
| Risk factors | Trauma, especially blunt trauma, sports injuries, surgery, fractures, hereditary factors |
| Prevention | Proper conditioning, stretching, adequate rest, immobilization, compression, icing, elevation |
| Treatment | Conservative physical therapy, imaging tests, drainage of haematomas, compression bandages |
| Prognosis | Bony mass and symptoms shrink over time, full recovery possible |
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What You'll Learn
Myositis ossificans (MO)
MO typically occurs in young adults, with male and female individuals equally affected. It is most common in young, active people and athletes. The most common sign of MO is a large lump beneath the skin, which is usually painful and tender. Greater than 75% of cases occur in the large skeletal muscles of proximal extremities, with the quadriceps and brachialis muscles being the most common sites. MO can also occur in fat or connective tissue like tendons, ligaments, and fat.
The clinical and pathologic appearance of MO will vary depending on the time after the injury at which the mass is discovered. Early lesions (within the first few weeks) can simulate spindle cell sarcomas of various types, whereas lesions examined later in their evolution consist of mature lamellar bone.
To diagnose MO, a doctor will examine the affected area and ask about the patient's medical history. Imaging tests such as X-rays, ultrasounds, MRIs, CT scans, or bone scans may be ordered to confirm the diagnosis. Treatment for MO is typically non-surgical, with physical therapy being conservative as symptoms and the size of the bony mass tend to shrink over time.
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Hematomas (blood clots)
A hematoma is a collection of blood outside of a blood vessel following an injury to the vessel. Hematomas can occur anywhere in the body, including the legs, and can be intermuscular (between two muscle groups) or intramuscular (confined within a single muscle parenchyma). They are usually the result of a traumatic injury to the skin or the tissues underneath the skin. When blood vessels under the skin are damaged and leak, the blood pools and results in a bruise. Hematomas can be as minor as a small bruise or as serious and potentially life-threatening as deep vein thrombosis (DVT).
Hematomas usually happen with injuries, so pain is one of the key symptoms. Shallower hematomas commonly cause visible colour changes. They can be tiny (like petechiae), slightly larger (like purpura), or very large (like bruises). Hematomas can cause swelling (edema) as the pooled blood pushes surrounding tissues like muscles or skin outward. Nerve symptoms may also occur, causing a pins-and-needles (paresthesia) feeling, as well as numbness or nerve pain.
Hematomas inside the head are particularly dangerous because there is limited space for blood to fill. Bleeding in the brain produces blood clots, and surgery may be necessary to remove these clots and relieve pressure on the brain. Warning symptoms from hematomas in the head include confusion and lethargy. Symptoms of a hematoma will depend on their location, the severity of the injury, and the involvement of nearby tissues or structures that may become inflamed or swollen.
If a hematoma is causing pain and placing a limb at risk, US-guided evacuation may be necessary. This is usually performed two weeks after the initial injury. When hematomas are more serious, treatment starts with managing dangerous effects or complications. For instance, blood transfusions may be necessary to make up for severe blood loss. In less severe cases, treatment focuses on addressing whatever caused the hematoma. This may include removing pooled blood so that it does not press on surrounding areas, making it easier for the body to heal.
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Pyomyositis
The illness typically unfolds gradually over several weeks, with patients experiencing pain and tenderness in the affected muscle. Ultrasound examinations may reveal diffuse muscle swelling with oedema and hyperaemia. In some cases, multiple abscesses may develop, and symptoms such as low-grade fever, muscle aches, and cramping can occur.
In summary, pyomyositis is a bacterial infection that affects the skeletal muscles and is commonly associated with minor trauma. It is more prevalent in tropical regions and can lead to serious complications if left untreated. Early symptoms include pain and tenderness, and prompt diagnosis through ultrasound examinations is crucial for effective management.
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Muscle strain symptoms
Muscle strains are common but painful injuries that can often be treated at home. They are one of the most common reasons for missed playing time in professional sports, and they can range from mild to severe. A mild strain might only break tiny fibres within the fabric of the muscle, whereas a severe strain can tear through it.
Muscle strains occur when the force on a muscle is so great that the tissue is damaged. This can happen during activities that require explosive movements, such as pushing off during a sprint or changing directions in cutting sports. They can also occur when a muscle is contracting while it is elongating, or when it is over-fatigued. The hamstrings, calf, quadriceps, and hip adductor muscles are the most susceptible to injury.
The symptoms of a muscle strain include sudden pain that worsens when contracting the muscle, swelling, bruising, loss of strength and range of motion, and sometimes difficulty moving the limb. If it is an acute muscle strain, the pain will be immediate and may feel like tearing. Chronic muscle strains develop gradually, and the pain will develop over a few days.
In severe cases, surgery may be required to reattach the damaged muscle and tendon. However, most people recover completely from a muscle strain, even a severe one.
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Treatment and prevention
- Rest: Avoid stressing the injured muscle.
- Ice: Apply ice or cold packs for 15 to 20 minutes at a time, several times a day.
- Compression: Wrap an elastic bandage firmly, but comfortably, around the injury to minimize swelling and stabilize the area.
- Elevation: Raise the injured limb above the level of the heart to help drain excess fluid and reduce swelling.
Over-the-counter medications such as ibuprofen (Advil) and acetaminophen (Tylenol) can help manage pain and swelling. If pain and bruising persist or worsen after 7 to 10 days, or if there is excessive swelling or severe pain, it is recommended to consult a doctor.
For more severe soft tissue injuries, such as torn ligaments or ruptured tendons, immediate medical attention is required to prevent further damage and instability. Surgery may be necessary in some cases, although this is rare.
In the case of myositis ossificans, a condition where bone forms inside muscles or soft tissues after a traumatic injury, treatment options are limited. Most cases of myositis ossificans resolve on their own within several weeks or months. To prevent myositis ossificans, proper conditioning, stretching, and adequate rest are crucial for reducing the risk of injury.
Lumps on tendons can be caused by fluid buildup, overuse, injury, or certain medical conditions such as rheumatoid arthritis and diabetes. Treatment depends on the underlying cause and can range from physical therapy and exercise to surgical tendon repair in more severe cases. To prevent tendon lumps, physical therapy can help teach proper body mechanics and movement to avoid further injury.
For muscle contusions (bruises), the RICE protocol is also recommended during the first 24 to 48 hours to control bleeding, swelling, and pain. Gentle stretching exercises can begin as early as the day after the injury to improve flexibility. Immobilization of the affected limb may be necessary to minimize the size of any hematomas (pools of blood that form lumps). Protective devices, such as padding, crutches, or slings, may be used to prevent further injury and reduce impact during rehabilitation.
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Frequently asked questions
Yes, muscle injuries can cause lumps. These lumps are usually haematomas (blood clots) that form when a pool of blood collects within the damaged tissue. They can be felt as hard lumps in the muscle and may delay recovery time.
Muscle injury lumps can cause pain and tenderness, limited movement in the affected limb, and swelling. The lump may feel warm or hot to the touch.
Most muscle injury lumps will heal on their own. Treatment typically involves rest, ice, compression, and elevation of the affected area. In some cases, a doctor may drain the haematoma to speed up healing.
Yes, in some cases, muscle injury lumps can lead to complications such as compartment syndrome, myositis ossificans, and pyomyositis. Myositis ossificans occurs when bone or bone-like tissue forms within the muscle, causing a large lump. It is often the result of trauma to the muscle.
