Athlete was kneed in the thigh during a rugby game approximately three weeks ago.

Athlete was kneed in the thigh during a rugby game approximately 

three weeks ago. He thought his leg would just get better with time. Athlete was not 

seen by an athletic trainer at the game as it was recreational rugby. He has not had 

treatment up to this point other than icing. His current pain scale is a 6/10 and he has a 

noticeable limp with gait. No numbness and tingling. He has no past history of injury to 

this leg other than an ankle sprain two years ago. Upon examination, athlete has normal 

neurological testing, all Manual Muscle Testing was 5/5 except for the Rectus Femoris 

Muscle was (+) for pain and palpation with a 3/5. Noticeable “knot” was palpated over 

anterior mid-thigh region. Athlete’s main complaint is having limited flexion of the knee, 

“as it feels like my thigh will not stretch out”. “I cannot run with speed due to pain and 

limp”. Patient had moderate ecchymosis present three days post injury that subsided 

within one week. Ely’s Test (+) pain, not being able to reach full flexion by the clinician 

passively, but (-) for spasticity. All other orthopedic tests noted were (-) in accordance 

with the thigh and hip. X-rays showed a benign ossifying lesion within the thigh 

diagnosed as myositis ossificans. Conservative non-operative treatment will be 

attempted initially. Athlete will come in for treatment 3x a week for four weeks to see 

improvements and work on AROM. 

Diagnosis: Myositis Ossificans after receiving a direct blow to the thigh

Make a non-operative rehabilitation program for this patient