Bone Bruises

[ski_adk]

Any maggot tips on healing up from bone bruises? I nailed my my left knee on a rock on mid-mtn. 2 weeks ago. I got it right near where the funny bone on the outside of the knee. Doc said it's mostly a bone bruise and to come back in a couple of weeks if it still felt bad. He said he couldn't tell if I pulled my ACL out (had hamstring auto-graph about 6 years ago.) So far, my research is saying 8-12 weeks...that's more than a couple. I'm sure someone out there has to have experience with this sort of thing.

[Theodore]

I had a severe bone bruise along w/ my torn acl and as far as I know, rest is all you can do. Not the best news for active people, but injuries need to heal!

[Jim S]

Time. To my knowledge there is nothing you can to accelerate healing of a bone bruise. I guess ice (early on) and NSAIDS could be considered unless contraindicated.

[Whiteroom_Guardian]

I think it just depends on how bad the bruise is and how active you are. When I broke my ankle last April I had alot of surrounding bone bruising as well and it still hurts. Then again I hit a rock hard enough to break my ankle in a tight ski boot with good liners which is pretty hard to do and I skateboard and stuff like an idiot.

I'm sure it would heal alot faster if I wasn't active.

[Jim S]

Bone bruises are not the same as conventional fractures.

[Whiteroom_Guardian]

Bone bruises are not the same as conventional fractures.

yeah I know.

The break in my ankle was a side effect of just hitting my ski really hard on a rock. The break was on the medial mallelous, but according to my MRI I had bad bone brusing on pretty much the rest of the foot/ankle which hurts just about as bad as where it broke and according to my doc should hurt for 6-8 months.

I just realized that you are a radiologist. Why the hell am I telling you about this!?

[ski_adk]

Thanks all. You wouldn't believe how many shitty thoughts have been going through my head b/c of this. I'm just hoping and praying that the soreness, stiffness and instability is just caused by the bone bruise and that my ACL is still anchored into the bone tunnels.

In the meantime, does anyone know if I can do some PT or light lifting to keep my muscles strong?

[Theodore]

Thanks all. You wouldn't believe how many shitty thoughts have been going through my head b/c of this. I'm just hoping and praying that the soreness, stiffness and instability is just caused by the bone bruise and that my ACL is still anchored into the bone tunnels.

In the meantime, does anyone know if I can do some PT or light lifting to keep my muscles strong?

I would say avoid anything that would put shock on it. No running, just reduce impact as much as possible. My bone bruise was on my tibial plateau and I could definitely feel it in everyday things. Mine probably took around a month or so to get back to normal. Then as soon as it was, I got my ACL repaired...

[andrewjesaitis]

I am battling a bruised kneecap right now. I hurt it while on a July 4th ski/mountaineering outing. I was forced to quit being active due to an extended work trip for about 6 weeks after I injured it. It was still bothering me after I got home so I got it checked out at Virgina Mason Sports Med in Seattle. They said that I had bruised the back of my kneecap (I'm still trying to figure out how you do this, but I did it) and it would be 12+ weeks to be completely healed, but 9 weeks out it is feeling pretty good. It doesn't hurt day to day and I have started biking again, but am trying to limit high impact activities. I just got out on my first session with my mountain bike since the injury last weekend. The knee held up really well. I did around 15 miles of pretty techie single track without problem.

I think it will just take a bunch of time. I know how you feel, it seemed like it would never heal--just going up stairs hurt for 6 or 8 weeks. In anycase, heal up man...

[RShea]

I went down on my hip while road riding in July. Was sore and tender along with bruising for 2 weeks almost 3 weeks. I could walk on it but movements you take for granted like getting out of the car were painful for much longer than I expected. Three weeks in the doctor recommended doing some rehab exercises- stretching as a start. Painful to even do that at the beginning of the 3rd week, so I held off another few days of rest. After about 1 month it is coming back and I am riding again. Advil was a regular solution to help with the pain.

[TBS]

Many years ago I hit a tree on a motorcycle (they don't steer well when airborne), and bruised my knee pretty badly. Doc said (like all the experience here) - "rest". Walking hurt like hell for about a month, but then things started to improve and after two months could play again without too much pain. It was still a year before I could put that knee on the ground and put weight on it.

Good luck dood. That had to have hurt!

[ski_adk]

Thanks, guys! I'm now feeling a lot better about the prognosis, despite the long recovery ahead. I'm betting that the ACL is fine and that the soreness is just the bruising.

It did hurt quite a bit at first, but I thought that had more to do with the hole in my knee — not a bone bruise. Hell, it didn't really feel too bad riding out and back to the car. It was kinda like a badge of honor that day. I encountered about 5 other parties on the ride out and everyone's response included pointing to the blood trickling down my leg and the words "Hey, you got a good one there!"

[peterslovo]

I had severe bone bruising of both knees after getting hit by a car (well, not from the car, but hitting the pavement at 30 mph as a result of getting hit by the car). It took me a solid 2 months - maybe even a touch longer in one knee - to not have pain while walking and running. It sucked.

Advice: Non impact activities (swimming, cycling) are your friends, as are ice and nsaids. Best of luck.

[fallguy]

bone bruises are micro fractures of the bone. there is NO displacement of these micro fractures so the bone is completely stable, but it can still be painful. i had one on my rt. knee around 8 yrs. ago from a twisting fall while skiing, and continued to ski the rest of the winter because of the stability in the bone and very minimal pain. there is only two ways to know for sure about the ACL, get an MRI or have surgery.

[ski_adk]

there is only two ways to know for sure about the ACL, get an MRI or have surgery.

Any idea on the chances that I could have pulled my ACL out of the bone tunnels? Also, I wonder what the probability of an ACL injury is related to the way I fell. Imagine sitting on your bike, with both feet in their pedal cages (I know -- way too old school) and then just tip over...that's pretty much how I did it. Not that it matters much, as I probably won't see about getting an MRI unless the thing still doesn't feel good after 10 weeks...health insurance sucks these days.

[fallguy]

doesn't sound likely, but anything is possible. bummer on the delay for a possible MRI. hope everything comes out on the positive.

[Theodore]

Ummm.... there are plenty of clinical tests to determine if you've torn your ACL. My knee was pretty stable, but when the doc start cranking on it, it is very apparent if the ACL is intact. I would say pulling an anchor would be highly unlikely. They aren't the failure point in the system, the ACL itself is.

Based on your description, I don't see it as being an ACL, but I'm not a doc!

[Vitamin I]

Ummm.... there are plenty of clinical tests to determine if you've torn your ACL...

If you just want a quick check, my ghetto method below was good enough to show a significant difference in anterior laxity between my injured knee and good knee. My injured knee measures 4mm more lax than my right knee. MRI report says "Probable torn ACL".

Heavy pot filled with water, ruler can slide freely under the pot between 2 ski DVD's. Pencil taped to pot so ruler measures the straight pencil instead of curved pot.

0. If knee is swollen or in too much pain to relax leg muscles, results will not be valid.
1. Keep all leg muscles as relaxed as possible. Line up so pot handle touches bony knee cap, and so ruler touches only the bony part of shin bones (later you'll push calf from behind, which will make soft tissue bulge forward next to the shin bone, but make sure that soft tissue bulge will not touch the ruler).
2. Try to move your head forward so eyes are almost directly over pencil, inch your butt forward off the chair until both the ruler and pot both slide together, then stop immediately (so it slid only a few mm), hold still, read number off ruler.
3. Keep everything still, especially your butt and femur, except push forward on your calf really hard (45 lbs of force is even better), watch ruler slide under the pot, and notice pot did NOT move this time, read number on ruler with eye directly above, then stop pushing with your hand.
4. Subtract the 2 numbers.
5. Repeat all steps on your other knee. And keep repeating back and forth until you get consistent measurements.
6. I got 6-7mm on bad knee, 2-3mm on good knee, so subtract to get 4mm of anterior laxity in bad knee. Gotta be error in my raw measurements, but I figure most of the error is eliminated with the difference calculation.
7. If more than 3-4mm, you can stop worrying and start crying.

[fallguy]

sorry i wasn't clear enough. yes by clinical exam an ortho can be fairly certain about a torn ACL, but the MRI is more sensitive to dertermine is it a full or partial tear.

[Patches]

I've had a number of bone bruises in the last few years, and they took 4-5 weeks to stop hurting. Most of the injuries were ribs, I have no idea if they heal faster or slower than leg bones.

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[SUPERIOR]

I'm a good skier, bad skateboarder. The worst injuries I've gotten over the course of my 29 years all happened on skateboards

-----------------------------------------------

So, I've repeatedly bruised my bone while skateboarding on the medial femoral condyle (inside right fork of the femur).

One real big one two years ago that had me hurting for months, with associated patella instability, tracking issues, and all-around pain.

Next, I went over the handlebars on my mt. bike and banged the exact same spot on the frame. Ouch. Hurt for about a week, and after a couple weeks of rehab, decided I was an idiot and this was going to prolong my rehab.

It did.

Now, after 2 years of dealing with patellar instability caused by this initial injury, I have jammed a skateboard into my knee again. Sharp pain. Limping.

The real lesson learned here is:

skating is much harder on your body than many sports. If you value you the sports you can do with less trauma on your body -- aka skiing, running, etc.

Bone bruises can last over a year. My first one did. I'm going to try to take extra care not to let this one go that long.

The key is to rest the area and don't keep pounding on it until healed.

Ice it regularly, several times a day.

I've eaten enough ibuprofen that my liver must have holes in it.

-ENJOY!