Bone Bruise Recovery. Also, can I keep skiing on it?

I have been having knee pain for the past month after an injury in early Jan. I kept skiing on said injury, but it got more painful over time. Finally got it checked out and had X-ray + MRI.

X-ray was negative. MRI showed obvious bone bruise in femur and tibia. Waiting on radiology to confirm if anything else is going on. MRI tech didn't see damage to anything else, but he's not a radiologist.

The PA I spoke with kinda made it sound like it was ok to ski on the bone bruise and that it was more of pain management consideration.

What's the healing time like for a bone bruise? Is it possible to keep skiing on the injury? Would said bruise potentially get worse or progress to something else if I don't rest it?

A "bone bruise" is not like a normal bruise in soft tissue. The bone has been microfractured extensively which causes bleeding within the bone (subperiosteal hematoma and/or intraosseous hematoma). Since it's actually a type of fracture healing time is 2-4 months depending on the severity. I would not ski on it or do any other high-impact activity. Non-impact activity can be done as pain allows, but do not do anything that causes more than minor transient pain. You can absolutely make it worse. Worst-case, since that part of the bone is not receiving proper blood flow you could end up with Avascular Necrosis.

A couple years ago I ended up with double calcaneus bone bruises and they took every bit of 3 months to heal completely, and that was without skiing on them for another 6 weeks after the initial injury.

3-4 months is about right for the recovery. When this happened to me I had to spin on a bike 30+ minutes/day and I think I took off 2-3 weeks of skiing and used an unloader brace for a bit. I remember it being pretty easy to make it sore and swollen with any smack but fresh soft snow seems to fix almost any pains.

Thanks very much Dan and Mofro.

I heard back from my Ortho PA today, who shared the radiology results.

Radiology confirmed the bone bruise and noted some cartilage damage under my knee cap. Meniscus is ok. They also said that my ACL looks like it is stretched a bit, but not torn.

He said I should stay away from weight bearing exercises on my leg for at least 3-4 weeks after the last time I skied to let the bone heal and that hopefully as fluid in the knee goes down the cartilage will be less of an issues.

I'm 2.5 weeks since I last skied, so that's not a huge amount of time TBH. PA said not to push through pain with the bone bruise. If it hurts, put off skiing for longer, etc.

If cartilage continues to hurt, PT and/ or a scope could help.

I hit my knee on a tree 5 1/2 weeks ago. X-Rays were negative but obviously a bone bruise. Been dealing with consistent pain in my calf and on the outside of my leg below the knee and at times down to my ankle. Interesting how the hard shell ski boot distributed the forces. Not too much knee pain, but there's been puffiness in the whole leg from knee to ankle.
It's been slow to respond, even less than 30 min of low resistance spinning on a trainer was aggravating it.
It's only been the past few days that I've felt I'm making progress and able to almost walk with a normal gait (not hobble).
So of course I went skiing today, partly to just take some personal inventory and partly because I couldn't take it any more.
I was only out for 90 min, did 7 runs and that was probably a few too many.
It all felt solid which is good but hurt more and more with each run so even though it's gonna pound all night, I don't think I'll be out again tomorrow AM.

Powpig--what doc have you seen/who ordered the xray. That sounds like maybe something other than a bone bruise. If you've had a good evaluation with your primary doctor and maybe a specialist, carry on. If not, might be worth considering other injuries. Or if you continue to get better, my advice is moot.

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Originally Posted by old goat

Powpig--what doc have you seen/who ordered the xray. That sounds like maybe something other than a bone bruise. If you've had a good evaluation with your primary doctor and maybe a specialist, carry on. If not, might be worth considering other injuries. Or if you continue to get better, my advice is moot.

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I saw Dr Orr at Barton in SLT (an orthopedist) who took and read the x-rays (both knee & ankle images) 3 days after my collision and again for a followup at 22 days.
He didn't seem too concerned, didn't think further imaging was necessary at that point and told me I could ramp up activity as I felt able, could do some PT if I chose, and to come back in a couple months if it was still bugging me.
Thought I'd be further along and feeling better by now (6 weeks tomorrow) but if 3 +/- months is healing time for a bone bruise, then I'm only halfway there.

Today was my first day on skis in 3 weeks. It's been six weeks since the initial injury. I feel like I turned a corner with the bone bruise a couple days ago. I've slept with a wedge pillow under my knee the past 10 days and that seems to have helped with swelling.

I skied for 1.5 hours today. Bone bruise didn't bother me much today, but I could feel the cartilage and had a bit of pain. Maybe I need to PT it or get it scoped or something if it keeps up hurting?