Active life with a bone bruise?

December 31, 2007 2:43 PM

Does anyone have experience with a bone bruise? I have one, apparently, just when I wanted to get serious about exercising again.

Ten days ago, I tripped and fell smack on my knees on hard concrete. The screaming, the limping, the recriminations. Although the right knee got better, I went to get an X-ray for the left, since I was afraid I'd fractured the patella. Thankfully there was no breakage. I was told that it was probably a bone bruise or [some kind of] hematoma, and that it would take a good while to heal in either case.

This was an out-of-town injury; treatment was brief. Advice to "ease up" on it and to ice it is not encouraging, especially when some sources say it may take months to heal. Walking doesn't pain me, although descending stairs does (and gives me a weird feeling of motion in my knee, which I hate).

I've got the grim feeling I need to go back to my regular doctor, bite the bullet and ask for an expensive opinion. But what do you think he'll say? If you were me, a young relatively healthy woman who needed to shed a couple but was game, what would you feel free to do? I was just about to start exercising daily again, really for serious true this time right after the holidays, and I was honestly looking forward to it. Long brisk walks and/or elliptical cardio is what I want to start with, plus squats to build leg strength.

posted by Countess Elena to health & fitness (14 answers total)

Hmmm . . . I did the same thing like 3 months ago, and I still get occasional pain. I didn't know what it was, but after reading this, I'd put money on it being a bone bruise. My experience is 3 weeks before it stops hurting all but occasionally and probably 4 months (I hope!) before it goes away completely.
posted by Ironmouth at 2:47 PM on December 31, 2007

After a line drive to the tibia, a massive lump, and a negative x-ray, my doctor told me that there was really no option other than taking enough NSAIDs to make movement comfortable. She insisted that I continue to go about moving around as normally as possible to avoid any kind of gait problems from limping.

It was about a month until the pain was nearly gone, and a few more months before I'd say things were totally normal... though there's still a mark.
posted by rxrfrx at 3:03 PM on December 31, 2007

The comment about discomfort with stairs sets off my warning signals. I had a knee injury 3 years ago (180 degree spin + fall off bike in my own driveway!) and the most problematic aspect turned out to be in my knees, and the one thing that I absolutely couldn't do was take stairs.

IANAD, but my hunch is that yes, you need to take it easy, but don't stop exercising altogether. Walking is good, as long as you can avoid stairs. When it hurts, put ice on it; aleve-type drugs are good for reducing swelling. In my case, cycling turned out to be the best possible exercise, weirdly enough...once we cleaned the wet frozen leaves out of the driveway!

Squats might be good, to build the strength around your knee, but your grim feeling is quite likely correct. After my accident I spent some time in physical therapy and it was very helpful. She gave me exercises that were good for my particular situation, helped me improve my overall gait, and told me to keep off the stairs for 6 months. I probably wouldn't have thought to stop with the stairs, given the building I was working in, and it would've taken me a lot longer to get better.

Eventually, I found out that I have arthritis in both knees, partially from the bike accident. Which sounds scarier than it is: in certain weather I take an anti-inflammatory before I go to bed; I have to be careful kneeling; and I have to keep working on the strength in my upper legs.

I hope you feel somewhat better before too long. Good luck!
posted by epersonae at 3:14 PM on December 31, 2007

Swimming doesn't put any weight on the leg and doesn't even require that much knee bending (depending on the stroke, but for freestyle, the kick is mostly from the hip, with some knee).
posted by salvia at 3:38 PM on December 31, 2007

I had something similar on my right hand where I took a baseball right off the side of the palm. It wasn't broken, but for several weeks it was painful enough that I couldn't lift anything or ride a bike. Even today, about five months later, there's still a bit of lingering pain if I squeeze my hand a certain way.

Now, I am fortunate enough to live in Canada so I had no qualms about visiting my doctor several times. The first visit was the x-ray where they told me to take it easy. Two weeks later I went back and was told that I should start slowly using the hand again, while icing it and taking anti-inflammatories. A month later I went back, surprised that it wasn't fully healed, and was told this was normal but if in another month I'm not satisfied, come back to set up physiotherapy. That proved not to be necessary. In your case the treatment for knees may be different. You don't want to screw around and wind up with long-term damage so I absolutely think you should see your doctor.

I found that exercising my hand actually made it feel quite a bit better, though it would get very sore after only a little exertion so I had to take it slow.
posted by PercussivePaul at 3:39 PM on December 31, 2007

I got a really ugly one; left tibia. It left a huge lump on the bone, visible on Xray. They seen to think that's normal. If they tell you that about yours, it's probably OK. IANAD; I just have wierd lump on my tibia.
posted by unrepentanthippie at 4:05 PM on December 31, 2007

Yeah, they heal slow, which can be frustrating, but respect the injury and avoid compounding it with further problems. I acquired a bone bruise on my tibia a few years back courtesy of a car accident. Like you, walking was ok, stairs were a little painful, and I was raring to resume a vigorous exercise regimen. I ditched the water-based training after a few weeks, resumed running, and pretty quickly acquired a stress fracture in my other leg. Lesson: be wary of jumping back into weight-bearing exercise with a lingering injury. Favoring one part often winds up hurting another. That said, elliptical training is pretty low impact, walking's not too bad either, but I'd definitely talk to someone professional (which I am definitely not) before jumping into the squats.
posted by bepe at 4:21 PM on December 31, 2007

Many years ago I got a pair of rollerblades for xmas. Took me at least 20 seconds to land on my hip. The bruising didn't show up until two weeks later and I had (at least) minor pain there for a couple of years. So, yes, it can take a long time.
posted by trinity8-director at 6:39 PM on December 31, 2007

Years ago, at summer camp, I got a bone bruise in my foot by jumping off the top bunk and landing wrong. The pain didn't go away for weeks, so I went to a sports medicine clinic. They gave me a series of ultrasound treatments which basically applied a gentle heat to the inside of my foot. It worked, my foot finally healed after several of the (pleasant) treatments.
posted by TungstenChef at 6:45 PM on December 31, 2007

Exercise is good for recovery in general, don't avoid exercise! That said, I would avoid weight bearing leg exercises like squats and I would avoid high impact exercise like jogging. Walking is fine as long as the pain is manageable. Others have suggested swimming and cycling. In your original post you mention elliptical machines, I think those are a great idea since on the machine your motion will be controlled and there shouldn't be any knee impact from using it, just increased strength in the leg muscles that will help you heal.
posted by TeatimeGrommit at 6:46 PM on December 31, 2007

Thanks, guys. I'm staying off it this evening -- a long day of half-running and carrying bags in airport limbo seems to have aggravated it. I have been bad to my knees in the past, falling painfully on them and then refusing to get them looked at. Once I even got a Baker's cyst that way. So it's important that I do right this time.

Swimming is the perfect idea; I'll see if there's anywhere I can feasibly join for a pool.
posted by Countess Elena at 7:22 PM on December 31, 2007

Try arnica, in addition to ice and antiflamatories. I banged my thigh really hard on a metal corner back in August and there's still a faint shadow of a bruise there, but it stopped hurting after a few weeks. Applying arnica gel a few times a day seemed to help the bruising in my case. (I did see a doctor and she said that serious bruising is not unusual and not really anything to worry about.)
posted by min at 9:08 AM on January 1, 2008

I would talk to your doctor.

After having given the standard advice (which is correct) I will tell you what I do. I had a nasty riding accident as a young person and my knees are in bad shape. I do elliptical training to strengthen the muscles around the knees. No running! If your knees are in a bad place even temporarily running/jogging will finish them off - it's brutal on your knees.

When you do elliptical training, make sure you warm up properly beforehand and stretch afterward. It will get more blood to the area and hopefully help with the healing process. Here is a previous question about preparing to do elliptical work.

I am not a fitness trainer or a doctor.
posted by winna at 3:16 PM on January 1, 2008

Avoid climbing or squatting until you feel well healed. Either activity puts five times your weight across your kneecap. That includes cranking up the incline on the treadmill or elliptical.

When they say that you have a bone bruise or edema or hematoma *in* the bone, you were a step away from breaking it completely. Keep that in mind while waiting for it to heal. In a healthy adult person, a bone takes six to eight weeks to heal. Also, antiinflammatory medicines have shown to slow bone healing.

As a side note, sometimes fractures don't show up right away.

I am in no way a doctor. Talk to your doctor. Yadda yadda ske ne ne.
posted by Elsbet at 5:13 PM on January 1, 2008