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7 Bizarre Facts About “Charlie Horses” Advice from a Physio

Updated: Nov 23, 2023


Hey there, sports enthusiasts of our vibrant, action-packed Vancouver! It’s Justin Shing, your friendly neighborhood physiotherapist, ready to dive deep into deep-tissue muscle marvels and mayhem.

Charlie Horse

Ever wondered if hobbling through the hockey rink or sprinting on the field with a bruised leg is a badge of honor or a one-way ticket to trouble? Buckle up, because we’re about to demystify the notorious "Charlie Horse" and its alter-ego, Myositis Ossificans (MO), in a way a sneakier career killer than fumbling a handoff.

So, you’ve embraced the rugged charm of contact sports, and the universe has proven that charlie horses are common, These multicolored deep-tissue bruises, or as the medical elite call it—a contusion can be more than an incredible annoyance. Being the unyielding warrior that you are, may decide to power through, championing the idea that “pain is just weakness leaving the body.” But, can this Herculean perseverance cause more harm to your body? Let's unravel this bruised enigma.



1. Understanding "Charlie Horse" Complications

A “Charlie Horse” or contusions isn’t merely a casual term for a muscle spasm or bruise; it symbolizes a broader saga of muscular disturbances, where, in some rare instances, the curious occurrence of Myositis Ossificans (MO) takes center stage. Grading of Contusions:

  • Grade I (Mild):

    • Minor swelling and discomfort

    • Little to no limitations in joint motion or muscle flexibility

    • Usually does not limit activity

  • Grade II (Moderate):

    • Moderate swelling and pain

    • Possible mild to moderate limitation in joint motion or muscle flexibility

    • May affect the ability to perform high-level activities

  • Grade III (Severe):

    • Significant swelling, pain, and hematoma

    • Severe limitation in joint motion or muscle flexibility

    • Likely to limit most physical activities

2. The Gradual Unfolding of Myositis Ossificans (MO)

MO is a slow, meticulous performer, making its presence known gradually. It manifests over several weeks or months, with symptoms ranging from mild inflammation to the surprising development of bone within muscle tissues. Yes, bone growth develops within your muscles.



3. Recognizing the Symptoms

Key symptoms of this curious condition include persistent pain and limited mobility, accompanied by warmth and swelling. These indicators can often guide healthcare professionals in diagnosing and managing the condition effectively. Factors that can indicate a risk of developing Myositis Ossificans after a contusion include:


The severity of the Initial Injury: Severe contusions, especially those involving deep tissues or multiple muscle groups, are

more likely to lead to MO.

Charlie Horse x ray

  • Persistence of Symptoms: If symptoms such as pain, swelling, and limited mobility persist beyond the expected healing time, it might indicate the beginning of MO development.

  • Unusual Hardening: An unusual firmness or hardening of the muscle could be an early sign of bone formation.

  • Limited Range of Motion: A decreased range of motion that doesn’t improve with time and rehabilitation can also be an indicative sign of MO.

  • History of MO: If you have previously developed MO following an injury, you may be more susceptible.



4. Situations Leading to Deep Tissue Bruises or Contusions

Charlie Horse 2

Vancouver’s active landscape is ripe with scenarios for potential injuries. From an intense hockey clash resulting in a collision, to a misstep during a spirited mountain trail run, numerous situations may culminate in significant muscle bruises or contusions.

5. Managing "Charlie Horse" and Contusions

Effective management at home often revolves around fundamental principles like icing to manage inflammation, elevation to minimize swelling, and sufficient rest to promote the body’s natural healing processes.

6. Professional Guidance: Consulting a Doctor or Physiotherapist

If there’s a suspicion of Myositis Ossificans (MO), medical consultation should be sought promptly. Diagnostic imaging such as X-rays or CT scans may be used to confirm the presence of heterotopic bone. Remember that MO is a rare complication, and the majority of contusions will heal with proper care and rehabilitation.

7. Injury Prevention and Considerate Care

Navigating through the pain might seem a testament to one’s resilience, but it can unknowingly pave the way for complications like MO. Prioritizing thoughtful care and prevention strategies is integral to maintaining the body’s harmony and health.

In the heart of Vancouver’s spirited sports environment, ensuring that our approach towards injuries like a "simple charlie horse and muscle contusions is informed and intentional is essential. May your athletic endeavors be marked by vitality, well-being, and a triumphant spirit! - Justin Shing, Expert Physiotherapist

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