Management of Neurogenic Heterotopic Ossification: Three case histories to illustrate the role of physiotherapy

Neurogenic heterotopic ossification is a process of abnormal bone formation of multi-factorial aetiology. It occurs at varying sites to produce deformity and restriction of joint movement, and has a major impact on physical ability. There is extensive literature on the medical management of heterotopic ossification, but the role of physiotherapy is poorly described.This article aims to illustrate the importance of proactive physiotherapy in the team management and treatment of this condition. The authors show that physiotherapy is not contra-indicated in the presence of neurogenic heterotopic ossification and illustrate how interventions for improving range of movement can be used. The authors suggest that integrated team management was essential to the successful outcomes in these complex cases.