Mehta Physiotherapy Clinic

29/10/2025

29/10/2025

⚠️ Understanding Why Myositis Ossificans Forms

MO occurs when:
1. Soft-tissue trauma or microbleeding near the brachialis / triceps gets calcified.
2. Aggressive passive stretching or deep massage re-injures healing tissue.
3. Local warmth and repeated irritation trigger ossification.

Hence, the approach should be low-force, high-frequency, and pain-free.

⸻

✅ Safe Physiotherapy Protocol (Post 4 Weeks Internal Fixation)

🔹 Phase 1 – Gentle Tissue Conditioning (Weeks 4–6)

Goal: Improve mobility within tissue tolerance, prevent inflammation.

Exercises:
• Active-assisted elbow flexion–extension
→ Patient-assisted using opposite hand.
→ Hold for 2–3 sec, repeat 10–15 times, 4–5 sets/day.
• Forearm rotation (supination/pronation) in mid-range (no forced end range).
• Isometric biceps & triceps contractions (no load).
→ Improves circulation, prevents stiffness without shear stress.

Modalities:
• Cryotherapy after sessions (10–12 min).
→ Controls any microinflammation.
• No ultrasound / no heat at this stage.

Key Principle:

“Move often, move gently, never move through pain.”

⸻

🔹 Phase 2 – Controlled Stretching & Strength Activation (Weeks 6–10)

Goal: Gradually increase flexion by 5–10° per week.

Exercises:
• Active self-stretching using wall or table:
• Sit beside table, gently slide forearm forward on towel (gravity-assisted).
• End-range holds (5 sec) at tolerable point only.
• Isotonic biceps curls with 0.5–1 kg later when pain-free.

Optional adjuncts:
• Static progressive splinting (only under supervision).
→ Helps gain flexion safely by holding mild stretch for long durations.

27/10/2025

Post-Myositis Ossificans (Elbow) Rehabilitation 💪
After removal of ossification, the main goal is to restore movement while preventing recurrence — and that depends on how carefully physiotherapy is done.

✨ Phase 1 (0–3 weeks):
Focus on pain & inflammation control, gentle pain-free ROM, and cold therapy.
🚫 Avoid massage, heat, or aggressive stretching.

✨ Phase 2 (3–6 weeks):
Gradually increase range, continue gentle ROM, start light isometrics.
🚫 Don’t push beyond pain or do forced mobilization.

✨ Phase 3 (6–12 weeks):
Begin controlled strengthening, progressive functional work, safe modalities like TENS.
🚫 Avoid heavy resistance or jerky movements.

✨ Phase 4 (>12 weeks):
Regain function and strength, slowly return to daily and work activities.
🚫 Avoid trauma or overuse.

💡 Key: Gentle, guided, and consistent rehab prevents recurrence of ossification.
Aggressive stretching or local trauma can restart the process again!

18/10/2025

Heel Pain – Clarification of Diagnosis

Many people believe that calcaneal spur is the cause of heel pain, but that is not correct.
A calcaneal spur is only a radiological finding — it develops as a result of long-term traction and pressure on the heel bone (calcaneus).

The actual clinical diagnosis is Chronic Plantar Fasciitis, which occurs due to repetitive stress and inflammation at the attachment of the plantar fascia on the calcaneus.
Over time, this constant pulling and pressure lead to the formation of a bony spur.

Hence,
👉 Calcaneal spur is not the cause of pain,
👉 It is the result of chronic plantar fasciitis.

Final Diagnosis: Chronic Plantar Fasciitis with secondary calcaneal spur formation.

18/10/2025

Happy Diwali 🪔