The Trainer’s Room: Knee Bone Bruise Treatment and Diagnosis

Knee Bone Bruise Treatment and DiagnosisEditor’s Note: This is first edition of a new regular feature here at Midwest Sports Fans called The Trainer’s Room. This feature will rely on the expertise of Denver chiropractors Dr. Niall McNally and Dr. Ihsan Erhuy of the Mountain View Pain Center in Denver, CO.

Dr. McNally and Dr. Erhuy are certified in chiropractic neurology and have a strong background in sports injuries and in the rehabilitation of common nagging athletic problems. Our goal with The Trainer’s Room will be to provide timely background information on relevant injuries as they occur in the sports world.

All treatment options provided in this article should not be taken as specific advice, but rather as a general guide regarding what is typically done to treat the injury being described. You should always consult your doctor before beginning any pain management or rehab program.

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Today we will focus on knee bone bruises. Carmelo Anthony of the Denver Nuggets bruised his knee on Wednesday, February 18th against Philadelphia and felt limited by it during Friday’s game at Chicago. Lamar Odom also suffered a similar injury to his right knee earlier in the year.

What is a Knee Bone Bruise?

A “bruised bone” typically refers to bleeding that occurs under the tough fibrous covering of the bone called the periosteum. It causes pain in the area of the bone but heals quickly as the blood is reabsorbed just like a bruise of the skin. The bruising may or may not involve the skin and soft tissues as well. The most painfulKnee Bone Bruise Treatment and Diagnosis bruises can sometimes take months to heal. What happens in a bone bruise is a compressive force pushes the femur and tibia on itself. When this happens the outer layer of the bone (most likely the femur), which is fibrous, breaks down. This leads to leaking of fluid.

Knee Bone Bruise Diagnosis and Treatment

After the initial onset of the injury beware not to jump to the conclusion of a bone bruise, even if you are experiencing similar symptoms. The knee joint can support a handful of injuries and it is important to reach the proper diagnosis and to come up with the appropriate treatment to avoid future risks of injury. This is done by doing a thorough exam of the joint. X-rays should be taken to rule out a fracture or any possible underlying pathology that could be masking the symptoms. After that, an MRI is necessary to rule out any ligamentous or meniscus injuries. This will also show the bone bruise if that is in fact the cause of the symptoms.

First – Assess Knee Bone Bruise Symptoms

Recognize the symptoms of a bone bruise. Common symptoms are severe pain and swelling. Sometimes a blackish-blue discoloration around the affected area may be visible. Along with the initial stage ice massage, another valuable step that cannot be overlooked is rest. This step may be very difficult for any athlete as they may be willing to push their body to the extremes to get back in the game. The reason we suggest rest in this stage is simple: the healing process is just beginning. To push or rush the injury could lead to further problems, and in the long run keep the athlete on the sidelines for an even longer period of time.

Second – See a doctor

Consult your doctor and get an MRI (Normally X-rays do not show bone bruises very well).

Third – Treatment of Knee Bone Bruise

At the Mountain View Pain Center we have seen many injuries to various athletes. A bone bruise can becoming a nagging injury leaving the player unable to participate due to lack of range of motion and often very intense pain. The methods with which we treat each player are specific to their needs. As we realize it is Knee Bone Bruise Treatment and Diagnosisimportant for a player to get back into the game, our methods involve rehab and therapy to speed up the patient’s recovery time with as little pain as possible.

The first step of the knee pain treatment process for bone bruises is the application of an ice massage provided by your doctor of choice several times a day, for no more than 5 minutes per application. The purpose of the ice massage is to move the edema (swelling) out of the affected area, reduce pain, and also to promote the healing process.

The next step in the process is to apply microcurrent therapy to the affected area, in this case the knee. Many different therapies can be used to treat pain, break up adhesions (scar tissue), or stimulate healing. The reason the Mountain View Pain Center prefers to use microcurrent therapy for this specific injury is that this particular modality has all of these benefits, thus decreasing the amount of time and money the patient would need to spend.

Another important step in the healing process is to perform full range of motion, non-weight bearing exercises to the joint. Getting the player back to their original state of health is the upmost importance for them to return to the game 100% effective. The range of motion exercises will be performed to keep the joint in full motion and inhibit the chance of further development of scar tissue. This step can be done concurrently with the rest as it is a more natural approach and will assist the body in its healing process.

Additional treatment recommendations:

Start with

  • Vitamin K – 500mcg: Vitamin K is a fat-soluble vitamin which is needed in the body to produce blood-clotting components and help strengthen bones.
  • Vitamin C – 500mg 2-3 times a day: Ascorbic acid, known as vitamin C, helps support the immune system, acting as an antioxidant to hasten recovery.
  • Vitamin A – 50,000 IU per day (not to be used by pregnant or women at risk of pregnancy): Vitamin A contains fat soluble compounds that help fight infection and speed recovery.
  • Bromelain – 250-750mg: Bromelain comprises protein-digesting enzymes found in pineapple plants to reduce swelling, inflammation, and pain

Also, Kinesio Taping alleviates pain and facilitates lymphatic drainage by lifting the skin. The taped portion forms convolutions in the skin, thus increasing interstatial space. The result is that pressure and irritation are taken off the neural/sensory receptors. Then, slowly, pressure is taken off the lymphatic system, allowing the edema to drain more freely.

And finally, remember to be patient. Bone bruises can take a few months to heal.

Disclaimer: This article is the opinion of the Mountain View Pain Center, for this particular type of injury. If you feel you have had a similar type of injury please contact your primary care physcian and do not attempt to perform any of these treatments without the approval and supervision of your doctor.

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The Trainer’s Room is written exclusively for Midwest Sports Fans by Denver chiropractors Dr. Niall McNally and Dr. Ihsan Erhuy of the Maintain View Pain Center in Denver, CO. You can contact them by leaving a comment below or sending an email to info@mountainviewpaincenter.com. Click on the image below to visit their website.


Dr. Niall McNally is certified in chiropractic neurology and has a strong background in sports iDr. Niall McNally - Pain and Rehabilitation, Denvernjuries and in the rehabilitation of common nagging athletic problems. Dr. McNally also is trained in pediatrics, orthopedics, and nutrition. He graduated from the University of Central Oklahoma and successfully completed his Doctor of Chiropractic degree at the Parker College of Chiropractic in Dallas, TX.

A very active athlete, Dr. McNally played hockey up into the junior level. In fact, it was his love for hockey, and the Colorado Avalanche, that originally gave him the idea to one day practice sports medicine and chiropractics in the area.

Dr. Ihsan Erhuy - Pain and Rehabilitation, DenverDr. Ihsan Erhuy specializes in motor vehicle accident injures, back, neck, and extremity problems, as well as treating pregnant patients and children. He is certified in the Diversified, Gonstead, Thompson, Upper Cervical, Activator, Sacral Occipital, Applied Kinesiology, Soft Tissue techniques.

Originally from Adana, Turkey, Dr. Erhuy graduated from the University of Arizona and also susuccessfully completed his Doctor of Chiropractic degree, along with his bachelor of science in health and wellness, at the Parker College of Chiropractic in Dallas, TX.



About Mountain View Pain Center

At Mountain View Pain Center we are committed to relieving your pain and restoring you to good health and wellness. We are able to do this by combining expert advice, the highest quality chiropractic care currently available, advanced soft tissue work and state-of-the-art rehabilitation programs. At our office you will experience the benefits of a dynamic team approach and receive a level of care which is virtually unmatched elsewhere. With this powerful combination our chiropractors can dramatically improve your life and the lives of your friends and family. The Mountain View Pain Center is located in Centennial, CO which allows us to provide convenient chiropractic care and rehabilitation treatment to Aurora, Centennial, Denver, Lakewood, Parker, Littleton, Highlands Ranch, Cherry Hills, Lone Tree, and Green Wood Village.

Comments

  1. Hi, Dr. McNally

    Is there a chance a bone bruise would not show up on an MRI? Because I had an MRI and it showed nothing. The doctor only told me to wear a brace. That was the only information I got, besides he thinks it will heal, and I will be able to run again. He told me to come back in a month.

    My knee injury seems to fit a bone bruise, which is very disheartening, since I want to run, badly. I fell 2 days before running a half marathon. I did not think my fall was serious, even though it was a bit sore. The outside of my knee was swollen after I ran, and bruised, only after the run.

    I thought it was getting better, until Thursday, when the pain became much worse, and I started limping. I fell on a Friday, ran on Sunday, and the pain became intense on Thursday. It has been a week now, and it does not seem to be getting better.

    Walking up/down stairs is painful, so I have to protect it as much as I can. My house has steps going up to it, so I have to use stairs daily. And I walk with a limp, almost to the point that I can't remember how to walk normally. Much less if this goes on for weeks/months. Any pressure to my knee, when attempting to walk normally, makes my knee buckle. Or if I trip a bit, it brings the pain on.

    My knee is also sore to the touch where I fell, in addition to when I walk — feeling like it's not superficial. And it hurts to straighten it.

    If this is a bone bruise, will I be able to run again? (I know it may not be, or it could be a bruise and something else?) But, again, would a bone bruise always show up on an MRI?

    Thank you!

    • Dr. McNally says:

      Amy I have replied to your comment in depth in an email, I sent to you. Please let me know if you recieved it. For anyone else interested in commenting or has a question feel free to comment. If the answer is short and sweet, I can put it in the comment section. If not I will do my best to get you a more in depth response and email it directly to you. Thanks for your interest

      • emmanuel says:

        @Dr. McNally,

        i hyperextended my knee a about 4 months ago..they said i had small injuries including a bone bruise…its been 4 and half months and i was on crutches for about a month after i hurt my knee…im trying to be patient and its hard because i miss playing basketball and sitting is tough…but i want to get back to playing the way i was again. what should i do? the ortho. thinks it could cartilage but i can move my knee, it hurts going up stairs, putting pressure on it as if im about to do a squat (i feel pain as i come up from the squat position), obviously running and when i stretch my quads and release my leg i feel as if my bones are rubbing together..so im going to see the doctor again in a few weeks and see what i need to do…please help doc. i just want to play basketball again

        • Dr. McNally says:

          emmanuel,

          You injury sounds pretty substantial and would lead to me to believe you have another injury along with the bone bruise. It is not uncommon to have meniscal tears as well as ligamentour injuries accompanying bone bruises. Has your ortho taken xray, or MRI?

      • emmanuel says:

        @Dr. McNally,

        ive taken both of those things twice…and the ortho said, they dont show anything major, and that i need to make my quads stronger (which i have been doing)…he said if it still hurts after that, then they will have to do arthroscopic surgery and find out what is wrong…but i know there is something wrong

        • Dr. McNally says:

          @emmanuel,

          You have take the correct steps so far contacting the ortho and having the xray and MRI. It is possible that the MRI may not show the damage to the softtissue so thats why the ortho may want to go take a look around. It is also possible you have a muscle imbalance causing additional pain, unless properly rehabed, it will continue to give you problems. Where are you located maybe I can recommend a good sports doctor that works with these kind of issues regularly.

          Dr. McNally

      • emmanuel says:

        @Dr. McNally,

        i am doing rehab right now, and my quads are gettin stronger, but the pain is still there..i have an appointment with my ortho on the 26 of march and so i will tell him that the rehab is not helping…

        but im hoping i will be able to have the surgury and be back to playing basketball soon

      • Malcolm says:

        @Dr. McNally,

        Would you please forward me your reply/diagnosis of Amy's

        condition (omitting personal info obviously). My condition's nearly identical – I will explain…

        I play both rugby and soccer – for the last few weeks many games/practices have overlapped – so I am unsure of an exact event that was the obvious cause of my pain.

        Symptoms are:

        First occurrence was mid-May 2009. Rehabbed myself via rest, brace, walking stairs, unweighed squats…then running..then returned to sports after 6 weeks.

        Then after a rugby scrimmage it came back, but worse. (~Jun 30th 2009)

        My knee was at first very sore and swollen. Subsided after ~one week.

        I started limping

        Walking up/down stairs is painful

        I walk with a limp

        Any pressure to my knee, when attempting to walk normally, makes my knee buckle – feels wobbly (However, MRI indicated ligaments intact)

        Any knee buckle or misstep results in intense stabbing pain in my knee.

        Hurts to straighten knee, unable to "flex quad muscles" while leg straightened.

        MRI also showed some signs of possible edema (cloudy white near tibia).

        Any help and treatment suggestion would be greatly appreciated! I want to get back to my sports!

        Thnkx, Malcolm

        • Dr. McNally, D.C. says:

          @Malcolm,

          I am sorry I did not get you a reply sooner, this comment got lost in my email. How is the knee do you still need me to send you anymore info?

          Dr. McNally

  2. Alex Potter says:

    Hello! I have a similar situation – and am interested in what you think. I have been to two doctors and two chiropractors. No one seems to know what is going on and the only advice I have been given: rest. That is extremely hard for me.

    Seven months ago I had a road bike accident where I landed on my right knee; I had bruising on the inside of my patella. I was training for a triathlon at the time so I continued running. About a week later, the pain in my knee was severe. Since then, as I mentioned, I have seen several professionals and had taken about 4 months off (which was absolutely terrible being non-active). Now seven months later with absolutely zero pain for the last three months, I began training for a marathon. No issues until a 10 mile run.. felt like the 'bone bruise' which I believe it to be was back. Few days later it was better.. and no more pain until my next long run (12 miles). Since then my 'bone bruise' area has been very painful on and off and I have cut back my mileage greatly. Some days I can run 5 miles with no pain.. other days I might run a half mile before I HAVE to stop because of the pain. What is going on? If this is a bone bruise – can I rest easy knowing that I WILL marathons again.. or should I be worried? Also what CAN I do as far as exercise and recovery. I have sort of been trying to run or bike as long as there is no pain. The last seven months have been the most frustrating, confusing in my life. Running is so important to me. Any help would be greatly appreciated. Thank you so much! Take care.

    • Dr. McNally says:

      Alex,

      I have sent you an email requesting some further information on your situation, so I may further assist you. Again thanks for the comment, let me know if you recieved the email.

      Dr. McNally

  3. Alex Potter says:

    Dr. McNally, I have not received your e-mail. Please try again or post it on here. Thank you for your speedy response. I am anxious to hear back about my situation! -Alex-

  4. Joey cueroni says:

    I suffered a bone bruise during my basketball game on Sunday February 22nd and I was wondering what, if any, damage it would cause if I was to play in my next game on Sunday march 8th. I have been resting it since the incident and the swelling has gone completely away. There is also very limited pain. Would there be any consiquences if I played?

    • @Joey cueroni, thanks for your question Joey. Dr. McNally is actually out of the country until next week, but he will be back answering questions once he returns. I'll be sure that he sees your question. I know that does not help you for Sunday, but I'm sure if you call a local doctor in your area they would be willing to give you a quick consultation. At least, I would hope they would!

      Best of luck finding out more info. I'd suggest something but, of course, I'm not a doctor. Dr. McNally will get back to you soon.

    • Hey Joey,

      I am sorry to hear about your knee. Without really looking at your knee it would be really hard for us tell you if you should play or not. But if you’re having pain when walking or running I would advise you to stay off your knee and ice it (20 mins on and 1 hour off throughout the day). Even if the swelling as gone down your knee hasn’t had enough time to recover from your pervious injury. What we would advise you to do is see your primary care physician so he can look at your knee. He would give you a better idea after examination and tell you if you should play or not. If you must play I would advise you to have a brace on your knee while you play and ice right after the game 20 mins on and 1 hr off (but again I would not advise this if you are having any pain at all). I hope this helps with your problem please keep in touch to let us know how you are doing.

      Thank you

      Dr. Erhuy, DC

      • Faruk Akagun says:

        Mr Erhuy hi
        This is Faruk Akagun,former Coach ..l am Turkısh and since 2001 workıng for the Pistons as their International scout..l live in ıstanbul ..l have a 225 Russian young athlete whom l am coaching privately basketball with..2 months ago doctors diagnosed he had bone edema -kemik ödemi-near the knee on the femur bone..after quitting all lower body exercises for 3 weeks he started easy jogging and some sea walk psractises but never jumped or squat ..the pain is stil there and never decreasing after 8 weeks ..l would like to hear your thoughts.. if pour paths cross l would like to meet you personally when l come for NBA draft in June to Detroit..thanks ..
        Faruk Akagun
        loyaltyforever@gmail.com

  5. Hi doctor, I had a partial menisectomy in the lateral menisecus, and after 2 months of wrong Physical theraby my muscles got too weak. At that time I fall in home accidently. Ofcourse my knee was hurting me and I completed the Physical theraby for further 2 months, then my doctor advised me to begin a slight running. This was a begining of a big problem, I had a severe pain directly under the knee (the upper portion of tibia at THE MEDIAL PORTION) I had MRI done that cleared that I have a bone bruise and edema at site of pain, it cleared also some tears in the medial mensicus and partial MCL tears, and my muscles still very weak. What I have to do now?, and thanks.

    • Hi Bondok,

      Once again with this type of injury it’s going to take time to heal. If you are having pain while running let your doctor know this most like means that you are not ready to start running yet. I would start with non-weight baring exercises such as a stationary bike or swimming. You must let your doctor know that you are in pain so he can properly treat you. I hope this helps please keep us posted with how you are doing.

      Thank you

      Dr. Erhuy, DC

      • @Dr. Ihsan Erhuy, Hi doctor, I've done both x-ray and MRI. Regarding x-ray it has pionted out that I've a bone bruise but it has been nonaccurate, and regarding the MRI it pointed out clearly the bruise involving the medial tibial plateau in the T2 WS, and hasn't clearly clarified some other items because of the inflammation and edema.

        These items were:-Some tears in the medial mensicus.

        -Partial tears in MCL.

        -Disrupted Hoffa's pad of fat.

        N.B: All this happened after the sliding at home that was 2 months after the operation of partial menisectomy in lateral mensicus.

        • Dr. McNally says:

          @Bondok,

          It will be important to get the swelling (edema) out of the area to help release some of the pain. You have to take it easy since you have the damage to the meniscus and MCL. With these tears, you have an unstable knee, and are at risk of tearing it further, and making things worse. Are you currently seeking treatment. If not let me know where you are located and hopefully I can point you in the right direction.

          Dr. McNally D.C

        • @Bondok,

          Dear Doctor, I've been taking (Aesin) for 2weeks. Also I've been taking (Glucose amine, Diclofenac, chemotrypsin) for nearly 2 months. But the edema is still present or it decreased slightly (the edema is in my knee with no edema on tibia). I don't know wether the exercises increase the edema or not. As I said before my muscles are too weak and the range of motion decreases every day and the bruise hurts me in any motion. Would I do a slight exersie for range of motion or not? and is the ice useful in edema? Many thanks

        • Dr. McNally says:

          @Bondok,

          It is important to do excerises for range of motion. Remember to do these to your tolerance, if an excerise causing pain then do not do that excercise and move on to one you can. If you find you can only do one excercise for example a knee extension, then start with that and build up until you can add more. Single leg excercises are better when you are trying to rehab. It is important to listen to your body, do not push it to pain, or you will prolong the healing process. As for the ice yes it is helpfu moving out edema. There are many therapies as well that can help with this as well, we put some examples in the article, have you tried any of these?

      • @Dr. Ihsan Erhuy,

        Hi doctor, I've tried all methods except the microcurrent theraby. I want to ask you doctor, is it so bad that edema is still present from the surgery (16/10/2008) till now? what is its significance? as for ice what is the duration of putting the ice? and should I put it on my knee (site of edema) only or on the tibia (site of the bruise) as well. Nearly, what is the average duration of healing of the bruise? I've MRI done recently can you see it, if yes plz tell me how to sent it. Many thanks.

  6. caroline says:

    my son hurt his knee playing football, took him to see the doctor and he said he had inflammation of the knee bone. they also said i had to keep an i on the swelling as it could be a fluid build up, my son is only 11.his knee isn't bruise but swollen, could you please explain or help with the problem thank you.

    • Dr. McNally says:

      @caroline,

      How long ago did he do this? If it was a few days ago keep an eye on it, he is in the acute phase and the swelling is a normal process after and injury. Swellling can occur without a bruise, or sometimes the bruise is not visible ie. bone bruise. Keep ice on the knee, not directlym and try to have him stay off it, which I realize is hard for an 11 year old. This does not mean he can not walk around, but if he is wanting to get back on the field, then he should avoid any aggrevating factors that can increase swelling.

  7. James Ferioli says:

    About a week and a half ago I was experiencing knee discomfort, I could feel something off but it wasn't painful. I figured I had just tweaked it and that it would be better overnight with rest. The next day however it was worse and hurting, after limping to class and back the pain was unbearable so I went to the hospital. The doctor gave me crutches and painkillers and said I had a knee effusion. I went to the orthopedist, who initially thought I tore a meniscus, however after and MRI, could not find anything significant to cause a knee effusion except for bone bruising. As of now, the pain is completely gone and swelling is starting to go down, and I can put some weight on the leg, but I am still stuck on crutches. I was wondering, how much longer until I will be able to fully straighten and bend my knee again?

    • Dr. McNally says:

      @James Ferioli,

      Unfortunately there is no easy answer to that question, especially since I have not seen you and can not gauge your progress, some people can get over this injury very quickly and others can take months. For now start with very small fluid excercises, trying to go to full range of motion, or as far as you can go without pain. Do you feel like your knee is locking up when you try to bend it? That can often lead a doctor to belive there is a problem with the meniscus or something floating around the joint.

      • James Ferioli says:

        @Dr. McNally,

        I saw the orthopedist again today and he said I just had to wait and that it was a matter of time, i can almost fully straighten my knee now, and bend to about 110 degrees, which is improvement. I can't bend farther because of the pressure and pain in the knee, orthopedist says it is due to the fluid still being there. Crutches are just annoying, was hoping to be able to at least walk by now. Seems I need to be patient though. Ice, elevation, rest, and ibuprofin.

        Thank you

        • Dr. McNally says:

          @James Ferioli,

          Hello again James thanks for the update. I am glad to hear you are improving, however as a fellow athlete I realize the worst news you can hear is to wait it out. The last thing we want to hear is to step back and wait till it heals, however if you want to fully recover that is the smart thing to do. Have you tried any other therapies to move out the swelling? We mentioned a few in the article, and if you are interested in trying to speed up the healing, I could possibly recommend someone in your area. If not I will certainly help you find someone suitable for your needs.

          Dr. McNally, D.C.

        • James Ferioli says:

          @James Ferioli,

          Thank you, but I think I will be fine. I actually can walk as of today, even if it is short distances with a limp, so I know I am getting better! Also, spring break starts tomorrow, so I have a week to get better. I don't mind taking a break from sports for a little bit, the grades were taking a hit.

  8. Ben Curtis says:

    Hello, In october 08 i was injured in a football tackle and was on crutches for about a month and then had an mri, i got the results back jan 09 and the doc said i had quite bad bone bruising and but my ligaments etc looked ok. I've been going to pyhsio and even been having massages on my knee but it's still really painful all along the front of my knee. I can cycle and swin ok but i cannot run as the pain along the front of my knee is so bad. I've even tried wearing a patella band as some of the pain was coming from my knee cap, but this made no difference. The pain is like a crunching pain all along the front of my knee. Could you give me any advice on this as it's been six months and desperate to start even light running again. I've been building up my quads as advised and stretching etc, but nothing seems to be working. Many thanks

    • Dr. McNally says:

      @Ben Curtis,

      Sounds like you are doing the right thing with the cycling and swimming. As for the patella band that usually only helps when you are experiencing patella tracking (or the patella moving around) which can often be attributted to an injury or muscle weakness. If you are experiencing a crunching or grinding it is possible you have something floating in the joint or on the back of the patella. Have you had an xray, there is also an xray methond where you bend the knee and the xray is shot down the patell so you can see the back of it and the space between the patella and the rest of the knee joint. This view may gie you some insist or help gather more information that can be missed on a straight AP knee view (front to back essentially)

  9. Hi knee gods… I hope you are out there!

    I injured my knee in nov 08 following a simple jump. That night I went to ER and had X-ray, was told noting was wrong and it was my inability to bend my leg and massive swelling that pushed for a referal to hospital fracture clinic. I had an MRI 3 months later and was initially told a minor menical tear, nothing to get excited about. 6 wks later it was revealed that I had the following:

    Torn posterolateral meniscus (1cm)

    Damaged ACL (still dont know excactly)

    Bone bruising to femur in several places, and approx 15 cm down my tibia all the way through

    Lots of oedema to right leg.

    Bearing in mind that it took 3 months to get an MRI and to see this damage at this stage, is this a window into a horrid picture? Can I expect to stop getting aching in my tibia anytime soon…

    I have been doing hydro therapy and ice packs. I have a post op hinged brace which is from ankle to hip as well as a crutch. Kind of terrified this may lead to OA.

    oh, I need a Knee Fairy!

    Happy to supply MRI images!

    • Dr. Erhuy, DC says:

      Sorry it took so long for us to get back to you. We hope you’re feeling a little better. It sounds like your "simple jump" caused a lot of damage. Do you still have edema in your knee? If there is still edema there after this long; we would advise you to see your doctor and let him know what’s going on. From what it sounds like you had a weak knee to start with and the jump was the last straw. If the knee swelling as gone down and you have good range of motion we would recommend starting with non-weight bearing exercises just as a stationary bike or swimming. The most important thing right now is to strengthen the muscles around the knee to stabilize your knee. If you want you can send the MRI report and we can take a look at it. I hope this helps let us know if we can help in any other way.

      Thanks

      Dr. McNally, DC and Dr. Erhuy, DC

      • @Dr. Erhuy, DC, Hi Again!

        Thank you for you comments, I know its been a while, but A) wanted to give feedback and also ask a supplementary question if I may…

        After 9 months I have learned to walk again and am beginning to rebuild muscle that as wasted to nothing. I am also waiting on a ALC Hamstring reconstruction as it was revealed to me that I had a dislocated patella for about 8 of those 9 months!

        My query is as I can stand on my leg, I can pop my tibia out of the socket as I walk, not causing any pain but have to ensure that I plant my foot correctly to ensure I don't do something silly… I am noticing that due to the extended time for bone bruising to heal and my 'dicky knee' that I no longer feel the constant ache, but if I don't keep my mind on something else, the aching in the head of my tibia right about where the patella anchors in aches like hell! I'm pretty sure it is the bone as it feels different to the muscle aching I get…

        Could this be due to the bone or the soft tissue?… should I be concerned or do you think I will be fine once the tibia is secured back into position again?

        Thanks again for your time!

  10. Terry Little says:

    Hi Dr, I received a kick to the side of my right knee cap last thursday the 12th of March during a training session. I thought nothing of it until near the end of the session when i could hardly move my knee. I iced my knee after training and felt quite good, however i played on saturday and am now experiencing pain almost constantly. There is no swelling and no bruising and the pain shoots straight across my whole kneecap. I was wondering if there is anything i can do to speed up recovery other than anti inflammatory medicine and ice etc.

    Thanks heaps.

    Regards, Terry

    • Dr. Erhuy, DC says:

      @Terry Little,

      Thanks, for the post sorry it took so long to get back to you. First have you been to a doctor yet? If not you might want to think about going. There could be some damage done to your knee at does not produce swelling. But it sounds like your doing the right thing with ice (remember only 20 mins on and 1 hr off). If you can't find a doctor please let us know and we can point one out for you. I hope this helps and I hope your feeling better.

      Thanks,

      Dr. Erhuy, DC

  11. Hi Dr. McNally

    I injured my knee in Jnauary '09 while playing tennis. I did not fall but had a sudden jerking movement. I had swelling and severe pain for a rew days. I saw a doctor about a week later when the pain became unbearable and I had difficulty walking and extending the knee. I had an MRI a few days ago, which showed bone bruising and early subchondralsclerosis. for thepast several weeks taking the stairs has proven to very challenging and I have moderate to severe burning throughout the knee. I am not taking any medication at present.

    Should I be using crutches at this time and what else do you recommend at this point.

    Thanks

    Lisa

    • Dr. Erhuy, DC says:

      @Lisa,

      Thanks for the post; sorry it took so long for us to get back to you. As your doctor already may have told you; subchondral sclerosis is an early sign of Degenerative Joint Disease (DJD). The good news is you know about this now and you can start doing something about it before it gets any worse. What we would advise is start non-weight bearing exercises such as a stationary bike or swimming. This will help you strengthen the knee joint and slow down the progression of DJD. As for the crutches use them only if you’re in pain and can't stand or move your knee. The reason we don't advise you to use crutches all the time is because your knee will only become weaker the more you don't use it. We also advise you to talk with your doctor before starting a workout program and make sure he/she is okay with it. I hope this helps please keep us updated on how you’re doing.

      Thanks,

      Dr. Erhuy, DC

  12. Thank you SO MUCH for the information about bone bruising. It is way more than my doctor even provided me with. She just told me to take painkillers and not to use a brace or crutches. Your advice was just what I needed. Keep up the great work!

  13. Ooops! I almost forgot to ask…

    An MRI has shown that I have bone bruising and contusions in my knee area. I have been injured for four weeks. It still hurts to walk. I am going to Hawaii in 3 weeks. I would love to go SCUBA diving. Do you think it would be okay on my knee?

    Thanks again for all your help!!!

  14. Dr. McNally says:

    I am glad we could help you. I think scuba diving will be fine for you. In fact swimming is a nice alternative excercise when you have a this type of injury. Obviously do this in moderation, don't go for a three hour dive. After you swim stretch out the leg and get some ice on the knee. If you find the knee is bothering you then slow down. Thanks

    Dr. McNally, D.C.

  15. Ben Curtis says:

    Hello,

    I previously left comments regarding my bone brusising on my knee thanks for the response.

    My knee is actually now feeling quite good after treatment and so i'm looking to start running/football (soccer) again but am unsure whether i should wear a knee brace and if i should which one as there are so many and none seem to detail bone brusing.

    Should i wear a knee brace for stability as obviously my knee is weak with being out for 6 months and if so can you recommend any? All i know is that i should not wear one with exposed metal parts.

    Thanks

    Ben

    • Dr. Erhuy, DC says:

      @Ben Curtis,

      Glad to hear that your knee is improving and we are more then happy to help in anyway that we can. As far as the brace goes it is important to find one that fits your knee properly. You might want to ask a trainer at the gym you workout at to look at your brace. It is hard to recommend which is best for you without seeing you first. Obviously you do not want exposed metal, to protect the other players as well. I would recommend wearing one at first because your knee more than likely is still unstable and player soccer involves alot of quick cuts, and stops and starts which can be hard on the knee. Do not forget to properly rehab, continue to excercise the leg, you can even do single leg weightbearing excercises as you feel it begins to heal, and gain stability

      Dr. Erhuy D.C.

  16. Ms. Corazon Manaloto says:

    Dear Dr.,

    Greetings! Last November 26, 2008, as I was walking along the road, I tripped and fell on both knees on great impact. My right knee hit the cemented pavement so hard that it was really sooooo painful that I nearly blacked out. Now, almost 4 months later, my right knee is still painful, specially when kneeling ( in church services ) and when sitting down when pants are stretched towards the knee. I had done already warm and cold compresses but the pain is still there. Do I need an MRI? Is this knee bruise am having not going to heal soon?

    Thanks. I appreciate your advise. Thanks so much for your article. Am sharing it with friends.

    Ms. C.M.

    • Dr. Erhuy, DC says:

      @Ms. Corazon Manaloto,

      Thanks for the post, sounds like you hurt your knee pretty bad. As you read above without a MRI bone bruise's can't be seen so it would be hard for us to tell if this is a bone bruise or something else. Have you been to a doctor yet? If you have what did they say? If your still having pain we would advise you to see a doctor. If you can't find a doctor let us know where your from and we can point one out for you. I know your going through a lot of pain and if this is a bone bruise don't forget this is going to take a lot of time to heal. Please let keep us up dated with how your doing

      Dr. Erhuy, DC

  17. Hello,

    First of all let me say how great it is that you all take time to answer all of these questions.

    I skate for a roller derby team and took a really hard fall on my left knee on Feb. 28th. About a week later after massive, from above the knee to the ankle, swelling and bruising I went to get x-rays. (I know, I know, I should have gone earlier. I just thought it was a bruise.) Good news, no fracture. Bad news, severe bone bruise. The external bruising is almost completely gone now, still some swelling on the right side of the knee, below the knee cap. But really, what I want to know is when I'll be able to put pressure on my knee. Right now any pressure at all is too much to handle, and obviously I can't skate with the team as falling is a regular occurance while bouting. Any information you can provide would be wonderful.

    It may be pertinant to tell you that there is a weird ridge that has developed underneath the swollen area. Not sure what that's all about. And I should mention that I RICE'd my knee to death.

  18. Dr. McNally, D.C. says:

    Andi,

    Thanks for the response. We are happy to answer any questions as they come. First off I hope playing a rough sport like you are, that you are wearing appropriate knee guards, to help prevent this type of injury. How long have you been icing the knee, and are you using direct ice. It is possible if you ice to much that you can actually create a larger problem. Ice is extremely effective in the initial stages, because it decreases blood flow to the area, thus producing less swellling. However using ice for to long a period of ime can actually then reverse rools and rush more blood to the area, to protect the body from what it thinks is hypothermia, there are research articles explaining this in depth, if you want search for the hunting reaction, or check out this link http://www.springerlink.com/content/mcy724j7w5wtb… . Also I would recommend having a doctor check it out, as another form of therapy may help move the swelling away from the joint. Your specfic injury sounds pretty significant so I would not, think you will be out on the roller derby track anytime soon. Of course it is hard to judge your progress without seeing you. Have you done any other therapies besides the ice?

    Dr. McNally, D.C.

  19. a. john says:

    Hi I've had knee soreness for almost a year now.I'll give you some background info.while playin basketball I jumped off my left foot and felt a pain.I continued playing for months as it was just a little sore but bearable.I finally went to physio where they thought it was tendinitis.I did rehab and leg strengthening exercises with no basketball for 3 months with no significant progress.it is now another 5 months later and it is still very sore.I don't believe its tendinitis as the pain/sorness feels like its on the kneecap itself just to the inside.the tip of the kneecap also feels like there's a chip or something on it.I've had an xray and ultrasound done and the doctors said nothings come up.any ideas or suggestions?this injury has affected my explosiveness and quickness in basketball.while also taking a couple inches of my vertical jump.

    • Dr. McNally, D.C. says:

      @a. john,

      Hi a. John, it would be unlikely to get a bone nuise from a regular jump in a basketball game, unless of course you landed funny or previously bumped or jammed it. It sounds like a soft tissue injury, are you currently under the care of a doctor, have they mentioned maybe and MRI to see the soft tissue. Where are you located maybe I can recommend a sports physician in your area.

      Dr. McNally

  20. Hello Doctor,

    Your amazing, how Much information you gave me&Taking time for me.

    My daughter is a soccer player and got Injured about a week ago in an Indoor soccer game. We went to the doctor& He said there was bleeding underneath&Bone bruise. It was very swelled up. Now, It's about a week later&The swelling is gone, but it Is yellow&Blue&Black&Purple.

    She has played soccer, But it has hurt her&She couldn't move or barely kick the ball. Does she need time off? It' getting better… Can you please help! When do you think she will be 100%? She is getting much better. Is there anything I should no?

    Thankyou So very very much,

    Serena

    • Dr. McNally, D.C. says:

      @Serena,

      Well thank you for the compliments. As for your daughter it is difficul to say if she will cover soon or not without actually seeing her. Yes I do think res will help her. If you want to take a more proactive approach try to find a doctor, chiropractor, or PT that specializes in sports injuries around your area. If you have trouble finding one let me know your location, and I will try to find one in your area.

      Dr. McNally

  21. Dee ann says:

    My daughter was doing conditioning for highschool basketball running the stadium stairs. She missed the last step and hyper extended her knee. We went to the doctor and he wanted to do a MRI since it was still swollen after 5 days. We just got the results and she has a bone bruise to her tibila bone in the knee. The doctor said nothing but basid walking on her knee for 4 weeks because she could break the bone if she does anything else. Is this correct?

    • Dr. McNally says:

      @Dee ann,

      I is difficult ot tell if she would actually break the bone with out having seen here MRI report. I would find it unlkiely the bone would actually break, unless there is an underlying weakness or hairline fracture. With a bone bruise it will be difficult for her to do any sports activities unless you seek some conservative care. Also with any hyperextension there can be damage to ligaments or tendons so be sure to properly support the area, and seek some sort of rehab program. If you need a referral let us know.

  22. Hi Dr. McNally-

    About 5 weeks ago I completely ruptured my ACL, have a small tear in my mensicus and a massive bone bruise on the tibia and femur as confirmed by MRI (it is a non-contact, running at full speed-then-stopping-suddenly injury). In preparation for surgery in 4 weeks, I've been going to rehab and they keep telling me to work on full extension and flexion. Extension isn't too bad (although painful to go past 180), but flexion past 90 degrees is excruciatingly painful when the bones come together. If I push too far with my rehab one day, for 2 days after my knee gets very stiff and sore to where I can only bend it slightly. After 2 days is back to where it was before at 90 degrees. My question is, am I doing more harm than good by pushing through the pain like the PT and my doc want me to do (they are stressing getting complete ROM)? I.e., am I making the bone bruise worse and/or hindering the healing process? Should I be waiting for the bone bruise to heal more before working on my flexion past 90 degrees, or is my ROM more important? It seems like all I'm doing is making my knee sore and stiff without actually gaining flexion.

    • Dr. McNally, D.C. says:

      @becky,

      It is hard to say exactly, as your doctor and PT have seen your MRI, and done an exam on you and I have not. During my treatment with patients who have similar injuries, we take the leg through the ranges of motion to the point just before pain. Each day we do this and try to progress further. If it causes pain then we usually do not do it, as the pain can bring in more inflammation to the area, makes more swelling and in turn decreases the range of motion as you are experiencing after. We go up in steps and provide stretches to move past each point. Remember though some treatment does hurt and their specific method may work for them. Let me know how things go. If you have a torn ACL, surgery is really the only option to get it repaired, and rehabbing before the surgery is a great idea. Make sure to stay on top of the rehab after as well.

  23. Krista says:

    Doctor,

    About four months ago I fell about 3 feet directly onto my left knee. There was swelling and a lot of bruising. It has since (appeared) to heal.

    I cannot apply any sort of pressure onto my knee. I can run, jump, snowboard; everything. The only problem is the area is extremley sensitive to direct pressure.

    Also, this may sound exremley odd. I also have what feels like a small pebble moving around the inside of the sensitive area. I can pinpoint it and when I touch it it moves all over my knee (only in the sensitive area).

    I have not been to a doctor. I will make an appointment, but would greatly appreciate a suspected diagnosis. A serious injury to my knee may disqualify me from some promising opportunities in my near future.

    Thank you.

    • Dr.McNally, D.C. says:

      @Krista,

      Thanks for the response sorry it has taken me a few days to get to you. Sounds like you have a bone bruise in the area if it has been sensitive for that long. If there is something floating around in the knee then it is possible that you have chipped the bone, or have some sort of avulsion of the area. It is also possible there is some scar tissue build up in the area. it is impossible for me to give you a diagnosis, without actuall seeing you myself. I do hoever recommend you see a doctor and have it checked out. If you can run and play sports now then I would not be to concerned that the diagnosis will keep you out of activity. The concern is that if something is floating around in your knee then, it could get into the joint space and cause the knee to lock up which could cause further problems for you in the future.

      Dr. McNally

  24. Mardell says:

    Dear Dr. McNally:

    I was training for a half-marathon when 7 weeks ago I was running 9.5 miles and at 9 miles had some pretty severe knee pain. I have ran for 15 years, just started doing longer distances in the last two years and have never suffered any knee pain/injury. I overpronate and had scoliosis corrected by a brace t 26 degrees as a teenager [I am 40 – but no reference to my age would be appreciated :). At first the Chiro and sports trainer thought it was my ITBand. So I received some therapies and still ran the half marathon on April 11th. Things were not improving and saw an orthopedist and MRI revealed a deep bone bruise of the lateral tibula. I haven't ran since April 29th. I have been able to elliptical without pain, but seem to have pain later in the day – each day regardless if I elliptical or not. The doctor told me no walking/running/etc. for 2-1/2 weeks then start with light walking and progress from there. My question is this… what other things can I be doing besides icing and your other website suggestions to enhance healing? What other restrictions, if any, should I be following. I have recently gotten custom orthotics and I am also not doing squats, lunges, plank etc in pilates. Lastly, how long does it REALLY take to be able to heal? I was hoping to begin training for my first marathon in October but an very discouraged. I want to be smart about this but with every passing day fear I am losing my established fitness/running level. Thanks in advance for your help!

    Mardell

    • Dr.Erhuy, D.C. says:

      @Mardell,

      First I want to apologize for not getting back to you faster. After reading your comment it sounds like you’re taking the right steps by taking your time. Remember this type of injury REALLY does take a long time to come back from. Especially if your doctor told you it was a deep bone bruise. The reason for that is because of the decreased blood supply to the bones in general. I can’t stress the importance of icing your knee after you workout (remember 20 mins on and 1 hour off); as you read above we use Kinesio tape and it has helped with the inflammation that is produced from the bruise. If you want to stay active start with non-weight bearing exercises such as swimming or a stationary bike. Also, when exercising remember that if something you’re doing produces pain it’s generally not a good idea to continue. With the right training hopefully you should be able to get back into top form again. If there are any other questions you please let us know.

      Thanks

      Dr. Erhuy, DC

  25. Mardell says:

    CORRECTION

    lateral tibia not lateral tibula :)

  26. In June 08 during a self defense class, I was demonstrating a move and twisted to the left first then fell very hard directly onto the knee. Within a few hours my whole leg was swollen and red. I put ice on it. The next day it was black and blue from my knee all the way to my big toe. I went to the doctor he took an xray of my knee. It was not broken. He prescribed pain and aniti-inflamatory medications crutches a brace and rest. It took about 8 weeks for the bruising to go away. Since then I have been through 3 courses of physical therapy. The last one was conditioning to build me back up to normal functioning. I can walk on my leg with no limping. It is still sore all the time and gets much worse if I stand on it for any length of time. It sometimes locks when I stand. If I sit for a long time it is stiff and sore. Extending walking causes pain and swelling which lasts for several days. I cannot run without pain. A few weeks after I hurt my knee I noticed that I was walking sideways off balance. One leg feels longer than the other. My back feels crooked. I have been taking naproxen sodium for pain and swelling. I have had shots to relieve the swelling which helps for a few days but as soon as I do any activity I get swelling and pain. The Dr. says there is nothing else he can do. Would a chiropractor help? Will my knee ever get better?

    • Dr.Erhuy, D.C. says:

      @Connie,

      It sounds like you’re going through a lot of pain. Have you had a MRI done? If so, what did the MRI report say? From just reading your brief history it sounds like you might have a meniscus injury but this is hard to tell without doing a proper examination. As for your back pain there is a good chance that your knee problem is the cause of your pain. I would recommend seeing a chiropractor he/she can help you restore your curve and help with your knee pain. If you need help finding one let me know where you live and I can help you find the right doctor for you.

      Thanks

      Dr. Erhuy, DC

      • @Dr.Erhuy, D.C.,

        Thank you very much for your reply. I have had Xray and MRI and after seeing the Ortho Surgeon a few weeks ago had another MRI both MRI's came back negative. I am advised to continue cortisone and Naproxen. But no recommendation for Chiro.

        Thanks for your reply it was a big help.

  27. John Jones says:

    Hi,

    Back in September I had a football game, cant remeber getting a big knock and didnt feel any pain during game. Next day I couldnt put any weight on my right knee, severe pain to the inner side. I went to physio which said he thinks I damaged the cartilige. Went to the dr to get referel to get MRI scan. Didnt get appointment for scan under NHS until March. (During this time I can run, carry things without any pain at all, I only get pain when I twist suddenly when I attempt football. kicking a ball in a certain direction also hurts). When I turned up for the scan the Dr sayd that the scan is'nt that accurate and said that I should have key hole surgery. Received surgery yesterday and surgen said that they could see anything wrong, he said the pain could be from a brused bone. Is it possible that a brused bone could last eight months?

    Please give me advice

    John

    • Dr. Erhuy, DC says:

      @John Jones,

      It is possible that a bone bruise could last 8 months especially if you didn’t know you have one. Most bone bruises show up on MRI you should be able to get access to your MRI report if you ask your doctor for a copy of it. Let us know what it says the report may clear the air with what’s going on. Then we can take the appropriate steps to get you out of pain.

      Thanks

      Dr. Erhuy, DC

      • John Jones says:

        @Dr. Erhuy, DC,

        They didn't give me a MRI Scan as they said it wasn't as accurate as keyhole surgery. But after surgery they said they didn't see anything wrong. I only had the surgery yesterday but the surgen said that the pain could have been from bruised bone. Cant belive they have put me through keyhole surgery when there is nothing wrong. Cant belive they didnt give me MRI Scan 1st.

        • Dr.Erhuy, D.C. says:

          @John Jones,

          I am just guessing but I think they thought you had micro-trauma to you ligaments/meniscus and it is true they are hard to detect on MRI but an experienced radiologist should be able to pick them up. So I guess I am not sure why they didn’t start with the MRI. Let us know what they find on the MRI and maybe we can help.

          Thanks

          Dr. Erhuy, DC

  28. Jutta Braun says:

    Hi –

    My 13-year old son was diagnosed with a bruised bone in his knee, after performing the high jump during a track meet. This has not improved in 3 weeks, despite rest and ibuprofen, and someone else mentioned that it might be something called osteochondritis dissecans. What is the difference between a bruised bone and this condition?

    (PS – My son will be having an MRI in 5 days.)

    Thanks!

    Jutta

    • Dr.Erhuy, D.C. says:

      @Jutta Braun,

      I would like to apologize for not getting back to you on time but osteochondrtis dissecans is a condition of unknown origin which occurs in children and adolescents. It’s characterized by a small area bone that is eaten away. This could heal spontaneously or it may separate and become displaced into the joint cavity causing a joint mouse. Joint mice cause the knee to lock out on extension. The MRI should show you if it is a bone bruise or an osteochondrtis dissecans. I hope this helps you understand what’s going on. If you have any other questions please feel free to contact us.

      Thanks

      Dr. Erhuy, DC

  29. Hi,

    I have had a football injury to the knee 6 months ago that was first diagnosed as a strained ACL, but the doctor then told me it was bone bruise and that I should be patient (performed MRI). 6 months have now passed and there has been little improvements but I am still in pain – I just can't flex the knee when pressure is applied (stairs, going up and down and even discomfort when walking). I do some physiotherapy, but am not very disciplined. Can a bone bruise possibly take that long to heal or this must be something else?

    Thanks a lot!

    Toni

    • Dr.Erhuy, D.C. says:

      @Toni,

      Once again I am really sorry it took so long to reply back but yes, bone bruises in general take a long time to heal especially on a weight baring joint like the knee. I would recommend sticking with the physiotherapy and try some of the stuff we have recommended in the article it has helped our patients’ heal faster.

      Thanks

      Dr. Erhuy, DC

  30. Hi-

    hurt my knee during a basketball game. fell hard on my wright knee, and it was really painful. I kept on playing, and i didn't contact a doctor for a long time. I kept up playing basketball 5 times a week, but the pain just got worse. I also felt that muscles seemed to decrease in my wright thigh (quads)..When I finally went to have a MRI and Xray of my knee it shoved a bone bruise..

    I went to a specialist who could also inform me that I, as a result of the bonebruise, was loosing musclestrenght and therefore misusing my knee- and that had resulted in Hoffas (Hoff's syndrome). After this I have tried to take it easy and to rest, (and RICEd alot!) but it doesn't seem to help.

    So.. I am terrified of loosing more musclestrenght, but I cannot use my knee without pain. Because of Hoffas, I must stay away from everything that makes it irritated- wich is everything basically. Even the easiest quads-exercises makes the hoffas fat pad irritated. What can I do?? I sooo want to be in 100% shape for next season! How long will this take? Is it normal to have a bonebruise and then hoffas? What are the consequences of having both?

    I really hope you can help me with some answers, I am so frustrated.

    Thank you for an exellent webpage, and really good responses!!

    • Dr.Erhuy, D.C. says:

      @Ellen, It sounds like you’re in a lot of pain and I am sorry to hear that, but like we have said before bone bruises do take a long time to heal. The worse the injury is the longer it takes to heal. I am sure you already know this about Hoffa’s Syndrome but the main reason the fat pad gets inflamed is because of damage to the meniscus or ligament. So, your injury could involve a menisus/ligament and bone bruise this is hard to determine over email without seeing you but your injury sounds like it’s going to take a while to heal. It’s hard to give you a time frame to when you will heal because of the extent of the injury. We would recommend doing non-weight baring exercises such as swimming or riding a bike (but if any of this cuase’s pain do not do them). Also, make sure you ice (20 mins on and 20 mins off) after any workout you do so the swelling can decrease. I hope this helps if you have any other questions please feel free to contact us.

      Thanks

      Dr. Erhuy, DC

  31. Hi–My son is 15 years old and was diagnosed with mild bone contusions of his femur and tibia. He is scheduled to fly to another state for a select baseball camp in two days. He says it's not that bad and that he wants to go to the camp. But, from everything I'm reading, it seems that the more you push it–the worse it gets. What should I tell my son? Thanks, Tammy

    • Dr.Erhuy, D.C. says:

      @Tammy, Thanks, for the post. If your son is having pain I would not recommend letting him do the camp only reason for that is because this could get worse down the line. It’s best to let the knee heal that way there is no future problems. If you have any other questions please feel free to contact us.

      Thank you,

      Dr. Erhuy, DC

  32. Annie Mitchell says:

    Hi,

    Thanks for such a great, informative site. I was diagnosed by my doctor with a femur bone bruise almost 3 weeks ago, after being kicked by a horse whilst I was riding (so my knee was at a right angle position when kicked). I haven't had an MRI to confirm. It is already so much better than it was (and from your site I understand it may take some time to heal) – I can walk slowly for about 1/3 a mile now before it weakens and have more movement ie gentle squatting (with my other leg bearing weight) and moving my leg unsupported with my knee at a right angle.

    Could you give me some further advice on on physio? I can straighten my leg fine when I'm standing, and gently with support, but I cannot stretch it out unsupported. Going downstairs with my good leg leading, my injured knee buckles and is very painful if weight bearing, and if I walk for more than about 3/4 a mile the knee starts to buckle again. I'm noticing its feeling increasingly stiff and tight, and I'm worried that I'm not moving it enough. Could you advise any physio exercises I can do to help recovery? I'm can currently do pilates(adapted for the knee) and plan to start swimming in the next few days, but no weight bearing exercise as yet.

    Thanks very much,

    Annie

    • Dr. McNally, D.C. says:

      @Annie Mitchell,

      It is great that you have started to rehab your knee already. However my advice would be to see a doctor about the knee. A kick from a horse is an incredible amount of pressure and force on the knee joint, and there is a risk of a fracture or soft tissue damage. At this point is difficult to say what type of rehab you should be doing, because we are not sure of the type or extent of your injury. With the knee constantly giving way it would indicate some sort of weakness or instability in the area. I would suggest seeing your doctor first before continuing with your home rehab as you could run the risk of further damaging the area. If you are not sure of one in your area please let me know, and I will find one for you.

      Dr. McNally, D.C.

  33. Annie Mitchell says:

    Dear Dr. McNally,

    Thank you for your advice – I'll get it checked out by my doctor again and take it from there.

    Many thanks again,

    Annie

  34. David Connolly says:

    My daughter has been doing off ice workout for hockey for the last 4 weeks ( she is 14 and this is the first time she has worked like this). She said she gets a bone on bone sensation in one leg(just started last week)when she does one legged squats. Doctor thought it might be tendinitis? We are going to an orthopedic this week. She has skated basically 6 months a year for the last 6 years but these exercises are different. I have read orthotics might be the answer but have not set her up to see a foot doctor?

    • Dr. McNally says:

      @David Connolly,

      Where in the leg does she feel she is having the bone on bone sensation? I am assuming the knee if this is the case it is always a good idea to have an xray take to asses joint function and she a sports doctor in your area. Do you have any other information that may help point us in the right direction?

      Dr. McNally

  35. Heather says:

    I dislocated my kneecap and tore my miniscus 2.5 yrs ago and had surgery to repair it. A couple weeks ago I fell on the same knee cap and suffered a bone bruise – I just got my MRI results back today. I'm wondering if you see any potential issues/injuries in the future, to be clear I mean does this make me prone to hurting my knee again? If so, what do you think I can do prevention-wise if anything?

    • Dr. McNally says:

      @Heather,

      What were the results of the MRI you had? If you previously have had an injury to the knee then the knee will be slightly unstable which can result in further injuries down the road if not properly rehabbed. To start do body weight exercises on both legs, such as squats, lunges, and other leg exercises. Also do single leg workouts with very low weight such as extensions and leg curls. Let me know the results from MRI.

      Dr. McNally

  36. Firstly, thank you so much for a wonderful and informative site. It is comforting to know that you take your precious time to answer all of our questions and concerns. So many of us out there who have suffered injuries are just looking for straight answers (which we dont seem to able to get in many cases)

    I suffered a serious knee injury whilst snowboarding in Feb this year. Within 20 mins my knee had swollen up to the size of a small melon. Whilst in the resort, I had a rather large amount of blood withdrawn from my knee in which there were lipids present, and I then had a full leg cast put on. Upon returning home, I went to the A&E who referred me to an OS. I had 2 sets of Xrays which diud not reflect any fractures.

    I received a different "diagnosis" each time I went to see the OS (I always saw an associate rather than the OS himself) and finally after about 8 weeks I was sent for an MRI. I was on crutches for almost 4 months (pretty much until end May) and have been doing physio and hydrotherapy once a week. My movement has improved but the pain is still quite severe.

    The MRI report was quite vague, though apparently indicated that I had done quite extensive damage. I know that there was quite a lot of bone bruising – talk of a torn ACL, MCL and damage to the cartilage. (I alledgedly dislocated the kneecap too which was put back by the first doc I saw in the resort – which may have explained part of the agony) I have been doing everything possible (R.I.C.E, all my physio exercises etc) but I still cant walk very far, my knee is grating badly and has "locked" a few times, albeit for only about 20 seconds each time. I saw a different surgeon a few weeks ago (who does not specialise in knees) who recommended that I have the MRI scans re-read as he felt that the initial report was too vague and that he did not feel that the full extent of injuries were picked up. I still cant kneel (or put any pressure on knee at all without excruciating pain and going up and down the stairs is still very difficult (almost 6 months later) At no point did OS associate recommend surgery (in fact he only properly examined me the first 2 visits (out of about 6)

    Can you offer any advice or suggestions? (Will happily post up MRI Images if necessary)

    Thank you so much in advance and apologies for the long post…

    • Dr. McNally says:

      @Simmi,

      It sounds like you have bone bruise for sure plus other injuries as well. If you are still having constant pain especially upon pressure such as kneeling then a bone bruise could be part of the problem. If there really is a torn ACL, MCL and cartilage then you are looking at surgery. The fact that your doctor let it go this long without getting you a second opinion or changing treatment plans seems a little odd. You should not have had to suffer this long, and for that I am sorry. Are you going back for another MRI, or having the original re-read? Please let me know what your plans are or tell me your location and maybe I can send you to someone who specializes in these types of injuries. The reason you may need surgery is that with all three of those injuries it basically makes rehab pointless, and your knee will be incredibly unstable and you will have difficulty doing anything. Again this is just my opinion and it is hard to give you a definitive answer without having actually seen you myself.

      Dr. McNally

  37. Melissa says:

    Hi-

    Last summmer (a year ago) I did a flip in gymnastics and i felt a terrible pain, so my mom took me to the orthropedist. They said i had bruised my knee cap and my fat pad. I was in a knee brace for 2 weeks and could not run, jump, or tumble. Then this year in February I was getting knee pains again and my mom decide to take me back to the ortho. They said i had pattello femoral syndrome. My orthopedisits said it will heal when i stop growing.

    Is that true though? Will it really heal when i stop growing? I also have tendonitis in my ankle but im 13 and i would really like it to heal soon. I get knee pains sometimes but i dont usually where my knee brace while im doing cheerleading.

    Thanks,

    Melissa

    • Dr. McNally, D.C. says:

      @Melissa,

      It will not necessarily heal when you stop growing because you are active. Patella femoral syndrome is very common in athletes especially cheerleaders. Generally speaking cheerleaders have very strong hamstrings due to the tumbling. When you have tight hamstrings the quads become weaker which causes a muscle imbalance, thus leading to the tracking of the patella which causes some of your pain. You should not have to wait to stop growing which can be several years to feel better. If you would like I can find a sports doctor in your area that should be able to take care of this without much problem.

      Dr. McNally

  38. Dr. McNally,

    Thank you for all the guidance you have provided people on this forum.

    While training for an upcoming Ironman I experienced pain in my lower anterior quad / patella area while biking. I attempted to rest/ice the injury for a couple of weeks but still experienced some of the pain. I can run/swim without pain, but in any heavy gears in the bike I start to experience knee pain.

    After a recent ortho consult with xray and mri I was diagnosed as having a bruised patella with damage to some of the tissue underlying the patella. He said the damaged cartilage was getting into the joint space most likely during the recent bike rides inducing the pain. I dont remember any trauma to the patella other than hitting it on a recent boat ride after striking a large wave but there was no bruising or pain after the initial jolt.

    The ortho doc stated that long term I would have to have microfracture surgery, resurface the underside of the patella, and get new tissue transplanted. He stated short-term we could try a cortisone shot several weeks prior to the Ironman and see if that gets me through the race.

    Without seeing the MRI images do you know of any other treatment options i.e. scoping the knee and only removed the offending tissue? Also, he stated that I probably couldn't hurt the knee worse and for pain to be my guide through subsequent training. Any thoughts would be extremely helpful as my first Ironman is only 12 weeks away. Thanks in advance,

    Brad

    • Dr. McNally, D.C. says:

      @Brad,

      Thanks for the comment. First of all can you get a copy of the MRI report and email it to me so I can read it and go from there. If that is not possible, then I will try my best to help out. There is a syndrome called patellofemoral syndrome that affects many riders and is similar to this condition. I would always advise going the conservative route first before surgery if possible. As for cortisone shots you have to pick your poison with that. The shot will decrease pain as you train, however if you cannot feel the pain it is possible to injury the area worse. one or two shots will probably be fine however cortisone shots do weaken bone, tendons, and tissues therefore making the already weakened knee even worse. Try to send me the results and we will see if there is anything else we can recommend. Also if you want to let me know where you are located I may be able to send you to someone who specializes in the rehab of such injuries.

      Dr. McNally

      • @Dr. McNally, D.C.,

        Dr. I was able to get a hardcopy of my MRI report. It says: There is a well circumscribed bony defect within the lateral facet of the patella measuring 6x6x5 millimeters. This is located in the superolateral aspect of the patella. Overlying this is a linear, full thickness cartilage defect which measures only 1-2 millimeters in diameter. Its appearance is consistant with cartilage fissuring. No displaced flap is observed. Mild degree of surrounding marrow edema in the region of the defect. In addition, there is a less well defined subchondral marrow edema overlying the medial facet and patella. There is a linear, near full thickness cartilage defect within the medial facet, in close proximity to the odd facet. No enlarged plicae.ACL, LCL, MCL AND LCL unremarkable. Small ganglion cyst arising from tibiofibular joint. IMPRESSION: Full thickness cartilage fissuring overlying the lateral facet of the patella, at the site of a well defined bony defect. Mild degree of surrounding medullary edema. This could represent a dorsal patellar defect, a normal variant. Nonetheless, there is a overlying articular cartilage abnormality and edema, suggesting it may be related to an osteochondral injury. additional findings of patellar chondralmalacia between the medial and odd facets of the patella. Thanks in advance, Brad

        • Dr. McNally, D.C. says:

          @Brad,

          Thanks for bearing with me on this I just wnated to make sure I got all the facts before I gave any advice. From your MRI reports basically there is a little bit of cartilage damage, some bone bruising (marrow edema), and the chondromalcia patella. Chonromalcia Patella basically is the term for getting pain and crepitus (clicking, popping, and stiffness) in the knee joint. The main criteria for this diagnosis is anteromedial knee joint pain accompanied with stiffness and tenderness of this area. Do you have any pain after long periods of sitting, or getting up from a seated position? Generally this can cause pain and stiffness, does it require surgery. Well that is always between you and the surgeon. If you can rehab the area appropriately and continue without pain, then it is likely that you can continue without too much risk for further injury. However there is always a risk of further injury, it sounds like you had some cartilage issues so you could tear that further, or there is the risk of some of the pieces to break off and lock the knee joint. Try to do some exercises that do not cause any pain in the knee for you to start billing up the area. Also try to do some training on the elliptical as this will take out some of the pounding pressures of running. I hope this helps, if I have left anything out let me know.

          Dr. McNally

  39. ssingleton says:

    MRI – Knee Injury Partial Tears and Bone Bruising

    I just returned from the ortho surgeon and received the results of my MRI. My symptoms include severe pain in the inside of my knee, knee cap, shin and upper thigh along with the feeling that something is ripping in my knee. I'm also experiencing spasms in the area as well as swelling of the feet on ocassion when standing or sitting for long periods. I started with pain in the knee, limping then finally needing crutches. The initial visit prior to the MRI resulted in the Ortho diagnosing preliminarily a Meniscal Tear. Upon reviewing the MRI report which states signal intensity of the ACL and PCL related to chronic partial tears. Edema of the bone marrow related to early osteonecrosis or possibly contusion. small chronic partial tears of the cruciate ligaments, a mild intra-articular effusion. The Ortho's diagnosis after reading the report is that I have bone bruising. Are my symptoms indicitive of a bone bruising in the knee? He says that the partial tears are not what is causing me the pain that I am in and my inability to put any pressure on my leg. I am currently still on crutches and he has put out of work from August 3 – October 1st. He says to go to physical therapy and see if it helps. He also said that the bone could be dead. This sounds so scary. How do I recover from this?

    • Dr. McNally, D.C. says:

      @ssingleton,

      Sorry it has taken me so long to get back to you. When did this injury occur? Was this something recent, if so that could explain the swelling. It is quite common to have similar symptoms with an ACL tear, especially accompanied with a PCL tear. If these are recent injuries or there is instability in the knee causing chronic inflammation that is also a probability. Without seeing you myself it is very hard to say. I have seen people on crutches from bone bruises as well though. When he says the bone is dead he is referring to the part in the MRI report where it says osteonecrosis, this does not mean your entire bone is dead. What happens sometimes in an injury is the blood vessels stop flowing to a certain area in the bone causing that small area to "die" since there is no more blood or nerves that area would show up whiter on an x-ray. I would get another opinion on this, just to be on the safe side. Also find a good sports therapist, chiropractor, or sports ortho. If you would like me to find a good one in your area, just let me know. thanks

      Dr. McNally

      • ssingleton says:

        @Dr. McNally, D.C.,

        Thank you so much for responding. To answer your questions, the injury occurred sometime in late July I believe after repeated stretching excersises that I had been doing for a month to relieve spasms brought on from a prior back injury. I have two herniated discs one in my upper back and lower back areas and also some scoliosis. I did have a second opinion yesterday and this doctor says after viewing my MRI that I have no tears and that I do have bone bruising. He instructed me to use one crutch and to add knee bends to my phsycial thereapy that I started less than a week ago. The knee bends are excruciating which is surprising since straightening my knee was the most painful to date. I still have significant pain on the inside of my knee my knee cap, outer knee and my shin. When I put any pressure on my leg it feels as though something is ripping in my knee accompanied by very sharp pains. I also get uncontrollable spasms in my knee and upper and lower leg. Are all of these symptoms of bone bruising? What is the healing time for this injury? When the firsts doctor I visited thought it was a meniscal tear he put me out of work from July 31 – Sep 14. Once he found out what it was, he put me out of work until Oct 6. This has me confused since I thought bone bruising was much less significant than a meniscal tear that would have required surgery. Both Doctors insist the partial tears are not what is causing me this pain with the second doctor even saying that he doesn't see any tears which the MRI showed as chronic partial tears. How significant are chronic partial tears in the ACL and PCL? I would appreciate your feedback and also your recommendation for treatment facilities in the Bronx, New York 10462. Thank you so very much for your time.

  40. Luke Prangle says:

    Hi,

    I have been out of soccer for sometime and have attempted after months of rehab to start up again and failed due to my left knee giving way. An MRI scan has shown no cartilage or ligament damage just bruised bone. Any advice on wether or not a bit of keyhole may help? i lasted only 44 minutes in my comeback game when the knee just gave way and caused more pain then ever before.

    any help will be very much appreciated

    Luke

    • Dr. McNally, D.C. says:

      @Luke Prangle,

      I would always recommend rehab before surgery as you have tried. I usually would not recommend a surgery however for a bone bruise. There is really not much that can be done, beside letting the body heal itself and use rehab to speed up the process. The fact that your knee gives way would indicate some sort of ligament or cartilage damage. It is also possible your knee is just giving way from the pain. Sometimes a follow up MRI would reveal something originally missed. If you do opt for keyhole surgery that is usually less invasive, less expensive, and easier to recover from than traditional surgery. As for the comeback game, how much running did you do before, did you only rehab and then go into the game. When our patients go back into games we have them try some moves in the rehab process building up to the game. For example if you only rode a bike in rehab then went into a game using stops, starts, and cuts then you are moving the knee in a totally different fashion. We usually try to limit the first game or two to lower minutes as well as you want to see how your body reacts initial to see if you can step it up or need to hold back.

      Dr. McNally

  41. I am a volleyball player and my season is just beginning so rest really is not an option for me…in June of this year i was participating in our volleyball teams annual pre-season camp and fell on my knee a few times…at the time it did not hurt, in fact, the knee pain did not start becoming noticable until a couple weeks later during a "backyard" volleyball game…the pain does not throb until after physical activity…it is a constant pain whenever it is bent and not active which is surprising to me. tonight i applied a paper towel, ice and a considerable amount of pressure to it, i have created a constant pressure around the top portion of the shin and the bottom of my thigh with the ice directly on top of the knee cap…will this work and is it okay to fall asleep with it on

    • Dr. McNally, D.C. says:

      @MIKE,

      It is not okay to fall asleep with the ice on the leg. The reason for this is extended use of ice on the skin, anything over 20 minutes can have the reverse effect. The body will think that area is undergoing some form of hypothermia, and send more blood to the area, causing it to swell and be more painful with less range of motion in the morning. It sounds like you could have bruised the knee cap which I have seen in volleyball players before. It would also be a good idea to get a quick x-ray of the knee, it is a relatively cheap way to look at the area, the doctor would be checking for a hairline fracture or displacement of the patella, as you will see no soft tissue on x-ray.

      Dr. McNally

  42. Hi Dr. McNally,

    I stumbled across your site looking for answers with my own injury and was hoping you could help. I got into a collision while playing ultimate frisbee about 3 weeks ago. His knee collided with mine on the medial side (just next to the patella). Initially it felt like I got hit in the funny-bone, and my entire leg was throbbing, but I thought it would subside after a few hours (It swelled up a bit and I iced it and the swelling went away). Today I still have full range of motion and don't feel any instability, although the joint feels much stiffer than normal. Furthermore, I can still press on the area that got hit and feel a sharp pain in it. Does this sound like symptoms of a bone bruise? Is it just going to take a while to heal or should i definitely go get an xray / mri done? Thanks so much!!

    -Ezra

    • Dr. McNally, D.C. says:

      @Ezra,

      Sorry about taking so long to get back to you. Those symptoms do sound similar to a bone bruise, especially after three weeks of discomfort. Go see a local orthopedist or sports doctor to help you out, they will more than likely shoot an x-ray first, but generally speaking one bruises do not show up on x-ray. If the determine there may be an underlying injury such as a bone bruise, meniscus or ligament damage then they will order an MRI.

      Thanks

      Dr. McNally

  43. Hi Dr McNally,

    My daughter, Shannon, is a High School mid/long distance runner. She is in the top 25 in the Country for 2mile and longer distances. Mid April, her right knee started to have pain (no known incident. it just starting hurting severely). She had been seeing a sports chiro as a preventative measure as she had an aducter muscle pull 3 years ago. (She does over pronate and has custom inserts). He then started kinsio taping and lasaring her knee with slight success. He did encourage her to continue to run. In early June, she had to stop running due to the pain (she has a high pain threshold, so when she complains, it must really hurt). She took the rest of the season off.

    We also took her to an Ortho who then started her on PT in late June. In early July, he had an MRI done:

    The Orthopedic MRI reading of her right knee: "Findings consistent with focal osteochondritis involving the lateral femoral condyle. Patella and associated tendons normal. No other abnormal signal from soft tissues"

    In mid August, the Ortho suggested "exploratory" arthroscopic surgery since her condition was going on "too" long. We decided against that at that point since she would miss her Fall and Indoor season (plus seemed too soon… we wanted to give her more rest and a chance for her PT to work)

    Today (Sept 3), she "finished" her last PT session. The PT said her had built up her muscles (doing VOM exercises) and doing stim to promote healing. All along she has been icing several times a day, doing stretching etc. The PT will continue to work with her at school as he is the PT assigned to her school. She can now run up to an hour but still has some pain at the end of her runs (albeit less pain than a few months ago). The pain in on the outer right knee. She is running every other day and using the elliptical/water exercises the other days. Her PT is encouraging her to not only run but to start racing. I'm not so sure. He said at this point, there can be no more damage and as she continues to build up her muscles, the "bone rubbing" which he thinks occurs when her form starts to break down at the end of a long run, will lessen.

    Would like your take on her case at this point. I do have an appointment set up with a Boston Mass General doctor who is the team doctor for the Boston Bruins at the end of Sept for a second opinion (earliest he was available).

    Thanks!!!

    • Dr. McNally, D.C. says:

      @Jerry,

      I apologize about the lateness of my reply. As for your daughter, if she is having pain during her sporting activities then the PT or any other treatments for that matter have not been completed and there is still a chance of injury. I have obviously not seen her, it is just my opinion if the problem still clearly is there through the pain, then it will probably not just go away with further activity. Osteochondritis is basically a part of the bone that stopped receiving blood, and can break of with it covering cartilage, causing further problems. The cartilage does not always break off however there is that possibility. In cases like this early treatment can generally take care of the problem without further issues. Going to the doctor for the Boston Bruins is a good move, they should be able to either handle the situation or refer to someone they think can best treat the area. I am curious if the kinesio-tape helped her? I use it a lot in my office and get good results, so if you could keep me updated with the progress. How is she feeling now, and also let me know what the doctors say at the end of the month.

      Dr. McNally

  44. Dr. McNally,

    I recently suffered a bone bruise to my left knee and was wondering the average healing time and if there was any way I could still play football with it?

    Thanks,

    Lane

    • Dr. McNally, D.C. says:

      @Lane,

      That is a tough question to answer depending on the severity of the injury. Some bone bruises will only slightly affect the person and can just be tender to the touch. Some make it difficult to walk and cannot play. It depends on you really if you can play or not. How much is the pain affecting you? Where exactly is the injury? How long have you had it? If you do decide to continue to play I would seek some sort of treatment for the pain, to make it easier and less painful to play. I personally had a bone bruise on my knee and continued to play. The pain was there but it was bearable so I continued to play, this does however make the healing process take longer so I stuck with the treatment while playing.

      Dr. McNally

    • crystal says:

      depends on the bruise i had a massive knee bone bruise its taken almost 9 months to heal with alot of physical theropy I would defenetly not play football on it unless you want to end up having surgery one bad move could be it

  45. Dr. McNally,

    The pain doesn't effect my playing other than when I come off I occasionally limp, but playing a WR and DB/Safety position I do a lot of running which was the main concern. I've had it for about a week and a half and haven't been playing since then. It's on the outside of my left knee. I've been seeing our Athletic Trainer and doing some PT exercises with him, and then of course icing it after any activity.

    • Dr. McNally, D.C. says:

      @Lane,

      Has the pain been constant since the injury, or has it gone down at all? It is possible since the injury is only a week and a half old that it may start to heal soon. However with some bone bruises it can take months to heal, especially if you continue to play. If you do continue to play and notice pain and swelling afterwards, have your trainer perform ice massage on the area. Also if he/she needs any treatment advice have them email or call us we would be happy to help. Also keep icing the area yourself.

      Dr. McNally

      • @Dr. McNally,

        I have began to practice again this week and so far it hasn't had any affect on my playing. It does ocassionally swell afterwards depending on how long and the drills practiced, but our trainer seems to know what he is doing as far as icing it and such. Thank you for your help and letting me know that it was afterall okay to play, just glad I don't have to sit during scouting season.

        Thanks again,

        Lane

        • Dr. McNally, D.C. says:

          @Lane,

          Not a problem at al,l we are happy to help. Have the trainer keep a close eye on the knee and don't push it to hard if it begins to cause too much pain while playing. Good luck with the ffotball season and in scouting. Which school do you play for? If there is anything else we can do just let me know.

          Dr. McNally

        • Thanks again and I will definitly be careful with it. It's just small town friday night high school football really, our school got a team my freshman year and that's the first time I ever played. The only college that I've talked to about football is Lane College (ironicly enough). Though I've talked to Harding University and West Point Military Academy for baseball and I tend to take that sport a little bit more seriously.

          ~Lane

  46. hey. i play soccer and i have to deal with os-goods or whatever its called and i was kicked directly on my knee the other day and th pain is unbareable. I went to my school trainer and she said its probably a bruise… but i cant climb stairs or walk with the feeling my knee is going to give out at any moment. ive been iceing for a week and no break through.

    PLEASE HELP!

    • Dr. McNally, D.C. says:

      @Austin,

      If you can go take an x-ray of the knee. They are relatively cheap as long as you don't go to the emergency room for it. The problem with Os-goods is there is already a weakness of that area, from the patellar tendon, basically tearing away the bone. You want to see if there is any further damage done to the area. If there is not similar treatments can be follwed. Get some interferential done on the knee which will help with the pain and swelling. If you need a recommendation in your area let me know where you are located and I will find a good sports doc for you.

      Dr. McNally

  47. Hello! I'm a dancer and just recently received my MRI results, which showed my left knee as having bone bruising and some fluid. It's been difficult to execute extensions of my leg, leap, and turn… :( However, I've been trying to rest my knee as much as possible without much strain. My concern is whether physical therapy will help relieve the pain and am wondering what is my next step in helping the healing process. This is part of my career so taking every measure correctly is important to me, so I appreciate any advice that comes my way!
    thanks!

  48. hannah070104 says:

    Hi
    05/09/2009 went off motorcycle landing on left foot, leg straight, knee "gave out". Hospital x-rays showed nothing.
    05/13/2009 diagnosed lower leg blood clot approx dia of quarter, length of calf 2cm below knee to ankle. On warfarin, blood work weekly. Did physio, ultrasound, manual massage & lymphatic drainage.
    06/25/2009 MRI done. Results-disconnected ACL, torn MCL, tear to LCL, damaged lateral meniscus, subluxated patella, significant tibular bruising. Rehab Jun-Aug, stopped as physio on vaca. On crutches 10 wks & cane since. Meds – Tramacet (37.5mg tramadol & 325mg Tylenol) + 500mg of Tylenol morning & bed but this week greater than normal pain now taking every 4 hours. Use ice pack, try to keep leg elevated at work, but today hurt so bad couldn't bear weight part of day. Since injury almost 6 mo. ago, wondering if pain due to bone bruise. What do you think?
    Surgery needed, knee "loose" just standing, 1st ortho stated knee is "wonky". In Canada, things move a little slowly, awaiting consult w/ 2nd dr. who does ACL repair.
    Any info appreciated.
    Hannah

  49. Dr. McNally, This site has been a great resource for investigating my recent knee injury. I took a hard hit on my bike in September (I can crack 30 mph on a flat surface and 45 mph downhill). Prior to this fall, I twice bent a fork and once bent in a frame in bike wrecks and never had any pain last more than three days. This injury is still there front and center. I take gym yoga to keep limber, and can still outlast people 10 years younger than me, but now my knee pays for it the next day. I've seen a specialist twice, and he only took x-rays, saying it is a bruise on the patella. At this point, the surface of the patella is fine to the touch (used to hurt like mad), but there is still pain down around the area. I also get a clicking sound bending the knee after sitting still. I am going nuts having been laid up this long. Would you advise that I push my specialist for an MRI to rule out anything in addition to a bone bruise? Thanks again, as your comments are appreciated.

  50. Andrew Blau says:

    i have a grade one tear of my mcl and severe bone bruise to my inner knee… its been 5 weeks and it still hurts. will my knee ever be 100% and be able to handle me jumping 13 stairs?

  51. Andrew Blau says:

    I have a grade 1 tear of my mcl and severe bone bruise to my inner knee.. its been 5 weeks and it still hurts. Will my knee ever be 100% and will it be able to handle jumping 13 stairs?

  52. Snowboarding Knee Injury Question:

    Hello, I went snowboarding yesterday and fell and twisted my knee. Basically what happened was my board stuck into the snow and my body twisted around, twisting my knee. When the fall occured the pain was pretty severe..7/10 I didnt think I was going to be able to finish the run. I also thought I heard a "pop" sound. However, after a minute or two of rest I was able to finish the run. I snowboarded the rest of the day with little to no problem and no recognizable pain. However, when I got home that night the knee began to swell a bit and the motion became limited…I was able to jump and jog.

    Today I woke up and the pain was a bit worse maybe a 3/10 and the motion was more limited then the night before. I was not longer able to jump straight up normally and when I jog I had a small limp to it. I have been applying RICE all day but I wanted to know if you had any insight to the injury.

    The pain is on my left knee on the interior..I am able to walk fairly normally with no pain. But the motion laterally is limited some…Any idea what I did?

    • John Paul says:

      i have just had the same sort of injury and know the inscruciating pain it is. it has happened twice now … no idea the teatment tho soz :(

      • Dr. McNally says:

        I have replied to the first comment. Let me know if this covers you as well or if you need any further advice.
        Dr. McNally

    • Dr. McNally says:

      What portion of the knee is sore? You said the anterior portion, but is it more on the inside, outside, or the whole front. Without seeing you and from your description it leaves me to believe you have some possible damage to the ACL or anterior cruciate ligament. This does not necessarily mean surgery, however it would be in your best interest to get this checked out before hitting the slopes again. If there is any instability in the knee, then the possibility for further injury is pretty high. The way you describe the injury as well as describing hearing a pop is basically the most common way to injure this ligament. There is also a possibility you injured the MCL, however the pain and tenderness would be more isolated to the inside of the knee. I am actually in the process of writing a paper on these types of injuries. I hope to have it posted in the next few days. Let me know if there is anything else I can do.
      Dr. McNally

      • Thanks for the help Dr.

        To further update you on the injury, now a couple of days later…The pain has gone down a bit and i able to now jump and run on the knee. I played basketball for the other day and had no problems what so ever. The injury is on my left knee and the pain is on the inside of my knee when there is some. It is weird because at times the pain is essentially gone and then at other times it comes back. I find that moving the knee around makes the pain lessen a lot. Almost as if the blood circulation makes the pain go away…but I am no doctor. To best describe this injury its almost like I need to warm up the knee and then the discomfort goes away. But, when I am just sitting around it gets stiff and the most uncomfortable movement is just moving my leg closer to my body then flexing it back out straight again. The pain is not severe, but just stiff and about a 2-3/10 pain at most.

        Any ideas?

        • I had a very similar experience years ago – foot got caught, body twisted around at the knee and the popping sound. It was so bad I couldn't stand up; had a couple of friends carry me out. As it turned out, I didn't tear or break anything, but I did 'stretch' (in a very bad way) a ligament in the knee (it was so long ago that I forget exactly which one – I think it attaches to the patella). My knee cap slides so easily in and out of place now that I have to wear a brace in almost any sport. For the first year or so after the injury, it would randomly pop out of place every once in awhile and swell like a balloon. It took three visits with MRI scans (over a period of 5 months) to detect the injury. I was given the option of surgery (detaching the ligament and reattaching it in another place to make it taunt again, but I've learned to live with it.
          Hope that helps.

          • John,
            Usually when you twist the knee and hear a pop, it means you have torn or stretched the ACL. The symptoms are very similar, however it would have no affect on the patella. If the patella was free sliding like that you probably stretched the patellar tendon, you lucky you did not tear this. A similar injury was a few years ago when Cadillac Williams tore his patellar tendon, it almost ended his career. If you still are wearing the brace, then when you go to the gym do single leg extensions at low weight with the foot pointed out. This will strengthen the vastus medialis which can help hold the patella in place.
            Dr. McNally

        • Still tough to tell without getting a look at it myself. When you saying you're bringing the knee in towards the body, are you bringing the knees together? If there is pain doing this and on extension then it is possible you have strain the adductor ligament on the inside of the leg. This muscle attaches below the knee joint on the inside. Several muscles attach here and you can get bursitis in this area. It's not uncommon for this to happen in athletes, and many time muscle strains can be warmed up with exercise and you kind of forget about it, until after. Once you are resting or sitting with the joint contracted the muscle will tighten up again. I would continue to ice, and go see your sports therapist or chiropractor this should be a relatively short treatment, if it is a muscle strain. again I cannot tell for sure, this is just an opinion of what this may be since I have not checked you out myself.
          Dr. McNally

  53. I have been having some knee pain lately especially during and after running. It has been so painful at times that it hurts to walk, even if i am just trying to get out of my bed in the morning. In the past few weeks i have not practiced as much and the pain does not occur as often.I have seen my trainer and a doctor to find out what might be wrong but after an X-ray and an MRI I still have nothing to show for it. The trainer at my school told me to go ahead and get back to training. However, I would like to know what I can do for my knee while I get back to running. I don't know if it is just a mental block that makes the pain so intense or if there may be some type of injury. I only want to get back to running especially now that track season is here. I just want to run!

    • get Walk Fit inserts. U may be flat footed and if so this insert is the best choice for you!

    • crystal says:

      it sounds like runners knee and you should always wear a knee support when running or doing any strenious activity and always use the term rice after activity rest ice compression and elevation.

  54. Hi Doctor,

    I'm 44 year old woman. I had lateral knee ligament damage 6 years back while playing tennis. After physical therapy I was able to walk fine. My Doc did say that the joint might not heal completely and will stay a little loose.
    2008 Dec I slipped on wet marble floor.Since the joint was loose the same knee twisted again. This time the MRI report says contrusion of the bones. Agin after taking physical therapy and going to gym regularly I am able to walk.
    Doc has adviced me to make my muscles strong so that they support knee well.

    I currently do excercise bike and elliptical at the gym along with other strength building excercises. I was advised not to do treadmill.
    Would it be OK for me to do kick boxing (step excercises), jogging for cardio etc. and to loose weight?

    • Hi Singh thanks for the post I'm really sorry that it has taken me so long to reply back to you about your knee pain. I'm glad to hear that your doing better I hope things improve as you do more strength building excercises. As far as doing kick boxing goes for my patients I tend to tell them to stay away from this if your having pain at all but if you are not having any pain when doing your excercises. I would tell you to try it out if it causes you to have pain then that will tell you that your not ready for that type of excercise. Remember this injury takes along time to heal and taking your time to recover is very important. I hope that helps good luck and please keep us updated.
      Thank you,
      Dr.Erhuy

  55. Dear Doctor,
    I had an ACL reconstruction 14 months ago due to a wrestling injury and at the time was told I had a compression fracure and bone bruise to the lateral condyle of the femur. I have never completely got rid of the pain that I have associated wth that bone bruising and I have just recently (less than a week ago) twisted my knee during wrestling and it feels like that same pain has returned the same as before. Is it possible that the bone bruising could take greater then 14 months to heal completely and is a previously bruised bone area more easily bruised a second time?

    I really look forward to hearing back from you – I just need some clarification that bone bruising could potentially be causing me this pain all this time later?

    Thank you greatly.

    • 14 months is a long time for a bone bruise to heal, so it is possible but unlikely that the original bruise is still there. How old are you? With a compression fracture in someone that has not had all of their growth plates fused there is a risk of damaging a growth plate which can create a problem is not addressed. If the area in general did not heal properly, such as remaining weakness or scar tissue then that area is more susceptible to injury, and it is possible you have reinjured the area. Have you had a recent MRI or x-ray after the ACL reconstruction?
      Dr. McNally

      • Thanks for your reply. I'm 25 years old. I had an MRI just a week ago to determine what I had done this time but they havent been able to tell me anything except for that the existing compression fracture is still there and that there is water retention in the bone along with a bursitis behind the knee. I strengthened the area really well afte the ACL surgery , I had returned to wrestling 100% with mild discomfort on rotational moves but everything else was fine; squats, dead lifts etc etc.

        my acl injury was an avulsion fracturs of the tibia so they screwed the tibial bone attachment back in.

        I would really appreciate any other thoughts you could give me or any ideas of what I should get checked out. The pain really exists towards the posterior – lateral part of the knee.

        Thank you again. I had national trials for wrestling approaching and It's not looking promising.

        Dave

        • Would it be possible for you to email the MRI report, so I can see what they have said. Many times doctors do not do a very good job relaying to the patient what the findings are in English. What I would do for now if you are going to continue wrestling is to see a doctor who specializes in sports rehab or physical therapy. There is an electric treatment called Interferential that I think you would benefit from, the doctor would put the pads around the knee. This will get the current deep into the knee joint and help alleviate pain and also reduce the swelling and pump out some of the excess water remaining. Also getting someone proficient in kinesio tape would be great for when you are training. If you need any recommendations let me know I will find someone in your area that will best suit you.
          Dr. McNally

          • MRI report;
            -metallic screws within the intercondylar region create considerable susceptibilty artefact and loss of information at the level of th eintercondylar notch and as a consequence the ACL is not visible. The PCL appears intact and the collateral ligaments of the knee joint are intact.

            -old impaction fracturing of the cetrolateral aspect of the lateral femoral condyle is again shown, the overlying catilage is thin and oedematous and there is a little degenerative oedema within the subcortical bone. However, no acute fracture is identified.

            – a small to moderate volume effusion is present within the joint but no loose body is detected and no new osteochondral injury is identified.

            -the menisci are normal size and signal intnsity appear normal.

            -moderate volume synovial bursa is associated with the origin of the medial head of gastrocnemius muscle. There is post therapeutic scarring within the infra patellar fatty tissues. The ligamentum patellae and quadriceps insertions are intact.

  56. Hope there is something here that can explain the pain I'm experiencing. Although they say they cannot see the ACL im reasonably confident that the ACL is tact just because the injury did not feel as severe as last time and I"m not experiencing any instability. Hope you can help/

    Thank you.

    • Ok, the sub cortical edema means the bone bruise is still there. The edema and effusion basically means there is still swelling in the knee. Not being able to see the ACL does not necessarily mean there is still damage there. If the doctor can feel the instability they may take another, if they were concerned with the ACL. It seems your pain is mostly coming from the bone bruise and the edema still in the knee. Now I have not seen you so this is all hypothetical unless I was able to perform an exam of my own. My suggestion is to go see a sports rehab doctor that works in physical therapy to get the swelling out of the knee. If you want let me know where you are located and I can try to recommend someone.
      Dr. McNally

      • Thank you. I feel strongly that the ACL is intact, It feels very stable and my physio says that he can feel it there when he does some tests. It's good to narrow it down to the bone bruising.

        I live in Brisbane, Australia. Thank you for your help so far.

  57. alena Kazlauskas says:

    hi my name is alena and i hurt my knee like 4 days ago by my friend sat on my knee and i heard a load pop coming from my knee cap. I have been iceing it and it hasn't gotten better it is pain full to put any pressure on my knee and i don't have much motion in it so i went to the Illinois bone and joint and saw dr.hunt and he said that it was nothing took x-rays and he said that they were fine but he said that me not being to but WIGHT on it and he said that it was nothing he didn't even think to give me an MRI witch i think would help but he didn't think it was necessary so now im in a lot of pain and don't now what to do about it? I am in evolved in swimming and gymnastics so i wonder does anyone have any clue on what i should do about this ?

    • Usually when you hear a pop in the knee means you have eiher torn a ligmaent or possibly the meniscus. If the knee was ebnt back and you hyperextended it then you could have torn a few ligaments or sprain them. See if you can get an MRI to see if there is any soft tissue damage. An x-ray will only show bones and joint space so an MRI is what is needed for the ligaments and meniscus.
      Dr. McNally

    • crystal says:

      I had a massive knee bone bruise x ray showed nothing however MRI showed the bone bruise and its taken me 9 months to heal with theropy xrays are not useful in certain knee injuries and you need to demand an MRi before further damage presents itself good luck! And my knee cap popped also when I landed and i was in severe pain with swelling for months could be a bone bruise or torn cartilage

  58. Cassandra says:

    Dear Doctor,
    I am a dancer.Last month i did a dance proformance in a school gym and i slipped and broke my nose and i smashed my knee. My knee was badly brusied for a few weeks but now the bruise (colour) has gone away completly but the pain is still there. When i touch my knee i can feel a small ball and i am able to push it around :S is that normal?? should i go get it checked out or will it heal?

    • It is never normal to feel a lump under the tissue. Go have it checked out just to be safe. The doctor will more than likely take an x-ray and run some simple orthopedic test to determie whats going on in there. Is there a lot of pain as well or just the lump.
      Dr. McNally

    • i really would see a docter

  59. Harry_Baxter says:

    Dear Doctor,__A couple weeks ago i hurt my knee playing rugby. I went to the doctor and had an MRI done and the report said that I had bruised my medial femoral condyle. It has been about two and a half weeks and my knee still hurts. I have tried running and I can jog slowly but the afterwards it gets sore. I also feel pain when I move my knee laterally. I was wondering how long will there be pain and if I should quit jogging on it?

  60. Slightly overweight 50 year old woman who had a patella injury about 15 years ago to the left knee. No surgery but was told it would always be a bit unstable. Stupid thing, but recently jumped out of the back of a pick-up instead of sitting down and easily getting on the ground. I immediately felt great pain in the knee and assumed at first that it was the same thing. Ortho dr. drew fluid off and said if it was bloody that it was a torn ligament but if not it was just strained. Bloody. So, he scheduled an MRI. Preliminary report came back as a bone bruise with fluid accumulation. Only treatment recommended so far is a full leg knee immobilizer. Knee still hyper-extends, even with brace. Worst pain seems to be cause BY the brace – seeming to put an unnatural backwards pressure on the knee. Any thoughts?

  61. Hi. My name is Hannah and I need some advice. I bruised the front of my knee a few weeks ago during volleyball practice. I put ice on it and kept it rested. It was always tender to touch and I couldn't kneel down, and after a couple weeks of ice it didn't bother me quite as much. About two weeks ago I went for a ball and somehow my knee was re-bruised. It was swollen on the out side of my knee so much I could barely make out my patella, and it was very hard to put weight on it. I iced it and i was able to walk without a limp in three days. It has just begun bruising and it is blue. It keeps giving me trouble and somehow keep re-bruising. What do you think is the problem? What should I do to help it heal faster?

    Please help me. I need some advice.

    Thanks

  62. Hi. My name is Hannah and I need some advice. I bruised the front of my knee a few weeks ago during volleyball practice. I put ice on it and kept it rested. It was always tender to touch and I couldn't kneel down, and after a couple weeks of ice it didn't bother me quite as much. About two weeks ago I went for a ball and somehow my knee was re-bruised. It was swollen on the out side of my knee so much I could barely make out my patella, and it was very hard to put weight on it. I iced it and i was able to walk without a limp in three days. It has just begun bruising and it is blue. It keeps giving me trouble and somehow keep re-bruising. What do you think is the problem? What should I do to help it heal faster?

  63. Kresimir says:

    Hi my name is Kresimir 17 year old male, elite soccer athlete (goalkeeper).
    I injured my KNEE on May 10th had X-Ray& MRI. The MRI Report is as follows as 28th MAY : There is minor intrasubstance degeneration involving the posterior horn of the medial meniscus and further minor change involving the posterior horn of the lateral meniscus, without tear.

    There is a vague area of bone marrow oedema in the anterior aspect of the medial femoral condyle, possibly an area of bone bruising. There is some synovitis in the posterior recess.

    Can you please reply back to me as soon as possible, i can only jog on my right knee and feel slight pain/aggravation when passing a ball. Also when kneeling and trying to put my bottom down onto my heels i feel pain behind the knee when doing so.

    Thank you

    • cassy h m says:

      u may not jog or jump, (for a few weeks)
      u need to increase the strength ( u mite be wiht a good strength, but pain and injury would tend to decrease strength, which will decrease even more over time) u may not even realize it, but there are several sets of muscles around the knee which are pretty strong and adapted according to the game/event an athlete plays, they support the joint and specific injury may weaken them (due to pain) bcuz these muscles are reluctant to work,.
      do not excercise vigorously and apply ice to the area of pain / swelling, give some time to recover. u may also tape ur knee,
      hope this helps
      cassy
      physical therapist
      california

    • Kresimir says:

      Cassy thank you very much,
      ive been doing the physio stretches and getting treatment on a weekly basis, when u said may not jog or jump for a few weeks is that from now? or the original injury when it occurred nearly 2 months ago.
      So the more i strengthen the muscles around it the faster it heals?
      thanks

  64. Hi.

    8 weeks ago I had a 60% left meniscus removed as a result of age related degeneration. I'm 38 and used to run 30 miles a week. I'm active on the bike and swimming too.

    All was healing great however then I went swimming and hyper extended my knee when trying to stand up (I lost on balance after finishing a length). I heard a loud 'Bang' inside my knee and immediate felt I damaged it again. No immediate pain or discomfort. 2 weeks on my knee cap on the outside edge is very sore and I can't walk more than 10 minutes without feeling real discomfort. The knee cap is now sore to touch and though I can't feel any break it is dis-coloured (red).

    Could the hyper extension just have bruised the bone or is the remaining meniscus likely to have been affected by the hyper extension?

    • cassy h m says:

      the bang may or may not be a bone bruise , only mri or superficial discoloration can say that , but looks like u have a torn ligament /menisci.. see a physical therapist or orthopedician for tests and investigations
      cassy
      physcial therapist
      california

  65. I live and work in small town in South Korea. The doctors in this area are not particularly good and speak little English. All the good doctors flock to Seoul, Daejon and Busan. I'm currently having a terrible time here getting answers. I had a motorcycle accident seven weeks ago. I used it to get back and forth to the country school where I teach. I was driving home at about 65 kph on a beautiful May afternoon and a bee flew in my helmet and I slammed on the brakes, which destabilized the bike. I crashed, sliding across the road. I laid on the roadside for some time and after the pain subsided, I road it in first gear (the pedal was crushed) to the nearest doctor who cleaned and bandaged the wounds.

  66. I found that I had a broken collar bone, three broken ribs and they told me only bruises and scrapes, although my knee was swelling badly. I had x-rays that said there was no break. They told me to wait and it would get better. But over the weeks it still remained swelled and wouldn't bend. I eventually went to the local hospital to have an MRI. I was told I had a HEAVILY contused knee cap. Looked like a screen door. I also had a 50% torn ACL, large pool of hardened blood benind the knee, bone loss on the femur and the knee is numb. The third doctor consulted said no surgery. He said I should have been in a cast for the last 6 weeks. He prescribed a knee brace, had to wait one more week for that since there was no available size for me in Korea. He also recommended physical therapy, but nothing else but the brace and to visit again in 3 weeks. These doctors are terrible I think. (continued)

  67. I suppose it could be worse, I could be in the USA with no insurance, rather than the national care here, in which, as I diabetic, I wouldn't have been able to afford the daily wound cleanings and dressings that I got for $4 a day here. Even with that it took 5 weeks for the scrapes to heal into horrible scars. I suppose I'm thankful for those good things or I might have gotten an infection and lost the leg completely. Anyway, I am having trouble bending my leg more than 60 degrees without great resistance and pain. The thing that is most disturbing is that the knee is numb and it feels as if the tendon is not responding to stimuli. I tell it to move and it's as if the muscles in the thigh flex and the muscles in the shin move, but the tendon across the knee doesn't respond. It feels as if it is stretched so tight it's pushing the knee cap too far in with each movement, like someone has attached a immovable, inflexible strap there. I think the longer I wait the worse it will get. What do you think it could be?

    • Hi
      the movement that u are talking about ( I tell it to move and it's as if the muscles in the thigh flex and the muscles in the shin move, but the tendon across the knee doesn't respond) is called "substitution which happens when muscles are generally weak, it happens to all who are in pain /weakness.
      have u been doing quadriceps and hamstring stretching and strengthening? if not then u need to, ask ur physcial therapist for VMO and vastus lasteralis strengthening. u need to add this to your excercises. about your 60 deg immobility , it is ofcoourse bcuz of stifness whn u were immobilized in the cast, so u need knee mobilization which has to be very gentle to begin wiht , u can ask any one to do it for you after u have learnt it from a physical therapist .
      hope this helps

    • The doctors are bad there BECAUSE of a national health care system! Maybe you should have been working instead of riding your bike. Then you might be able to afford health care instead of expecting other people's money to take care of you. Of course, had you been working at the time to support yourself, you would not have been injured by a bumble bee.

      • Bryan. A little out of line don’t you think? He was working there, teaching. If you would of read his post you would of comprehended that he was driving his motorcycle from work. Reading comprehension is a GOOD thing. I recommend you learn it.

  68. Licia Phillips says:

    My son is sixteen and he injured his right knee two days ago. His injuries consist of ACL tear, PCL tear, osteochondral fractureof anterior aspect of the femoral condyle which is partially detatched, tear in the posterior horn of the medial meniscus, lateral collateral ligament partial tear/strain. He was released from hospital yesturday and Needs follow up, but the doctor that he was recommended to cant see him for 10-14 days, I'm asking if anyone can help me get my son seen by someone who specializes in these areas. My son plays varcity basketball for his high school, I dont want to wait and let scar tissue or shrinkage take away from his recovery. Someone please help us

    • Stephanie Tiner says:

      I completely feel your pain. My son tore his ACL in December of his JR year playing basketball. Now that we have 8 months of surgery/rehab/therapy behind us, he has now bruised his knee bone in his first day back at practice. It is so frustrating wanting to help your son and knowing that there is nothing you can do. I'll keep you both in my prayers, I know it's a long road ahead of you both.

  69. Dear Doctor,

    About three weeks ago, I had a knee injury in a softball game and wasn't able to finish out the season. I had an x-ray and an MRI done and the dr. or specialist I saw confirmed it as a bone contusion. The healing process hasn't gone so well. The pain level is about the same and my knee is still swollen. Is there by chance it could be worse or is it just taking time to heal?

    Thanks,
    Trisha

  70. hello doctor.In the middle of fall and summer of this year i was training for mma.i attempted to judo flip someone and kept my foot planted while i twisted my knee to the left. i heard a pop at the time of the incident.so i stopped for a min.than i ran with a punching bag for about a half mile.after i walked home and was limping abd had swelling.rested with ice for two weeks went to get an mri and they said my acl and ligaments were intact but i had severe bruising of my knee,femur and along my tibia.for a while i rested using epsom salt and ice. i was able to attend school with little pain.now its october 1 of 2010 and i still get some pain.and at times when i bend my leg it pops.i occasionally smoke marijuana and when im under the influence i get severe twitching which i think could be fibromyalgia due to the trauma.im also getting twitches in my right foot.my left leg that got injured twitched really severe at times and it feels like electricity runs down my calfs and quad at times.help me doctor!!!!!!!!!!!!!!!

  71. mri said i have severe bone edema after injury from fall on bicycle in NYC sidewalk pavement 2 months ago..had posterior tibia fracture on crutches 5 weeks now cane. knee still has severe bone edema after 8 weeks???? i was taking systemic high grade enzymes to dissolve possible fibrin build up i think i am a scar tissue maker… what is the best was to get rid of the edema and scar tissue?? at this point? saw your comment about interferential..hope i can afford that with no insurance how many times does one need to get this done before it works? also have a feeling on and off (everyday) intermittently of something getting stuck and then a stabbing pain..mri's said some age related cartlage degeneration and very small ter of miniscus. but this getting stuck and stabbing feeling is driving me crazy two top ortho docs here in NYC said they didnt knw what was causing it but to do phys therapy and possibly it would go away…what do you think please?? crashed bad on sidewalk think i bruied the bone sick of this want to get back to my life.

    • Doctor please reply…there is very little info on bone edema after a fracture i cannot find much on how to get rid of it and only saw one thing that said it takes a very long time…i cannot believe there are nothing one can do to speed the water retention out of the bone what do you think please

      Lisa

  72. Doctor please i need a reply.i want to continue mma training but i want to know what you think of my condition.ive been stretching and doing some knee transmission exercises which has lessened my twitching and pain and cracks i just want a valid response please

  73. carol griffin says:

    i fell and brused my right knee on Monday and on thursday my right foot and ankle was all brused and swelled can you tell me what going on. thankscarol

  74. Dr, I had a car accident almost seven months ago now. I didn't break anything, but hurt my hip and had terrible bruising on my knees (One from hitting the gear shift, and the other from hitting the opposite knee) and ankles. I went to a chiropractor for two months until my hip got better and he also did a cool laser treatment on my knees and ankles. All the coloration of the bruises on my knees is gone, and they do not hurt to move them. However, when I touch the spot it is still tender and a little painful. Of course it's much better than it was, but it has felt the same now for several months. Will this eventually go away or is it a sign of a bone bruise that takes this long to heal?

  75. Jay Williamson Jr. says:

    Hello Dr. i hurt my knee over 3 years ago in a baseball game at third base. A ball was hit to my left and when i shuffled to get it my right knee caved in and popped really hard. I couldn't move and the pain kept throbbing for a while. I had bad bone bruise that took months to heal properly and it still isnt 100%. after baseball my dumbass dad made me do football and i hurt it again similarily a month later. After 2 weeks (and still no rehabilitation) i came back and started kicking footballs experiencing a lot of pain in my thigh and knee. I hung with it for a while but eventually quit after the pain became unbearable. Now my knee still isnt 100% and I have a big lump of scar tissue in my thigh where i partially tore my rectus femoris. Ive been to therapy a few times but it still isn't that good. Is there ANYTHING u can suggest to me? I also love weightlifting and have been doing a lot over the years. Is that really bad for my leg? Please reply if u have the time. Thanx.

    • Hi, Jay
      Sorry it took so long for me to reply. First have you had any imaging done on your knee such as a MRI or X-ray? If so what did the report say? How do you know you partially tore your rectus femoris please let me know and I’ll be able to point you in the right direction.

      Thanks
      Dr.Ihsan Erhuy, DC

  76. kimberly Greer says:

    i hurt my knee years ago when a SUV sun roof fell and landed on my knee. After two surgeries I ended up having a lateral release done because my knee cap was twisted and sitting on the side of my knee. I constantly have knee pain but they say there is nothing that can be done about that. I fall all the time because this knee just gives out. I don't fall as much as I used to but I still do. Which brings me to my current problem, I fell and landed straight on my knee cap. Oh my goodness, the pein was excruiating. I have landed on it two more times since and I cry evertime the pain is so bad. My knee is not swollen and I can walk ok. Should I go to the dr. or just try to stay off my knee? Thanks

    • Hi, Kimberly

      Thanks for posting your question; I am sorry to hear that you having this issue with your knee. One of the most important things that we need to look at here is the fact that your knee keeps giving out. As you know this is not normal. Have you seen anyone for this problem? What did they say? Even if the knee is not swollen the best recommendation I can give you is ice for 20 min (no more than 20 mins) because even though you don't see inflammation that doesn't mean there isn't there. If you looking for help let me know where you live and I can recommend a doctor for you to go and see.

      Thanks for the post let me know if you have any other questions

      Dr.Ihsan Erhuy, DC

  77. on Oct.27,2010 I tripped and fell on left knee. I have alot of swelling.I saw a Dr. and x-rays were done and it saide bruised knee. The swelling is gone now,still some pain some days worse than others. My knee never did show bruising on outside of it.I can't see visible signs of swelling ,but it feels like it gets tight above the knee injury. The reg. medical dr. just wrapped my injury with ace bandage, no kind of therapy. Told me to walk,sit stand as needed. Went back to work and had it easy for 2 days after injury,was allowed sitting on another job. Then back to standing and walking alot as usual, which is what my job requires. I still have pain mostly walking, and some while standing. I can almost extend the leg all the way but not completly. I can bend it all the way. I am just now seeing an ortho dr. had an MRI done. Haven't seen ortho Dr yet. He told me be fore it could be a tore meniscal and surgery would take place. Another possiblitly would be an injection and therapy if no tears are present. I am just wondering what to expect recovery wise for either scenario. Thanks for the info.

  78. Dear Doctor,
    I was originally diagnosed with a bucket handle tear in my meniscus. The MRI came back clean for tears. It showed a lot of bone bruising, swelling, and a sprained ligament. It has been four four weeks and I still have no extension with my right knee. I can flex it backwards to a point before pain kicks in. I am now trying physical therapy to get full use of my knee. My orthopedic had no idea why I haven't gained full use of my knee. Could the bone bruising be the reason why my knee will not extend out. How long can I expect to be stuck with a locked knee?

    • I have exactly the same situation, will follow closely.

    • The knee should not lock with mild swelling, however it can cause pain on range of motion. If you have continued physical therapy for a full 4 weeks and you have not had results yet then it is time, to either try a different therapy technique or get another image of the knee. Generally speaking the meniscus tear and cause locking of the knee, or there could be a loose body in the joint as well. How long have you been in therapy and what have you been doing there?

  79. I just got my MRI ………….And it showed a bruise bone…..I hurt my self trying to snow bored! It has been 3 weeks i still hurt mostly at NIGHTS and after showers ugggggg I hate this I only hope it will get better before summer comes. :(

    • Bone bruises can be painful for quite a long period of time. The reason it is hurting after the showers is the increased heat on the knee, causes more inflammation. Use ice every time after you snowboard whether it hurts or not for about 20 minutes. Don't go over 20 minutes per session.

      • I partially tore my ACL skiing 6 months ago, I got an MRI and the surgeon said my tibia and fibia were very bruised. He said it could take 4 months to heal but its been 6 months and I am wondering if this is ever going to heal? Thanks

  80. Barry Nelson says:

    I have a right medial knee bone bruise and it has become a nuisance type injury. I think what initially started it was doing a inverted hurdlers stretch which puts alot of pressure/torque on the knee. Then I fell on this same knee while running in a Tough Mudder event. I can still do my daily runs anywhere between 5-12 miles which doesn't affect it or my gait. It feels stiff getting up after sitting for long periods and also tight after waking up in the morning. Also, I can't crouch like a baseball catcher completely. MRI showed slightly torn medial meniscus, some edema. Orthopedic surgeon thought, after looking at MRI, that it was non-surgical and that the bone was bruised and meniscus not bad enough to surgically repair. He said to run on grass for the time being. I am running the Boston Marathon on 4/18 and would love to have to full range of motion of my knee without this stiffness. Thank you.

    • Best bet here is to get into some type of physical therapy on the knee. Edema in the knee is going to be your primary source of pain and decrease range of motion. Also if the meniscus tear gets worse it can lock up the knee. I would try to get into therapy to remove swelling and increase ROM. Also ty to find someone good with kinesiotape. This technique works great on the knees.
      Dr. McNally

  81. I bruised my knee in a basketball collision. It immediately swelled and showed signs of bruising. After a week, lots of bruising has shown up and it is still somewhat swollen. But the only pain is from lack of range of movement. I even tested it with some light jumping and jogging exercises. It doesn't hurt during any of that. It hurts the worst in the mornings when I first wake up. When is it ok to try and resume a normal amount of activity and running?

  82. hi! looking for a little advice/information on the length of time it takes a bone bruise to heal & what happens to my knee when i try to run and i hit the 'spot' of the bone bruise. i'm a 44-year old female who's been active whole life (swimming, running, team sports). mri has shown a bone bruise on the end of my left femur. i hurt it while running, which was over 6 weeks ago. prior to that i had been trying to recover from a heel stress fracture/no heel fat pad in the same foot. in my attempt to get that injury to heal, i think i compensated in my running gait & put more pressure on my knee. this resulted in the knee bruise 6 weeks ago. i have tried running periodically for minutes at a time during the 6 weeks, but this is small in comparison to what i used to do (45-50 miles/week). these attempts at running are pathetic – eventually i hit the bone bruise spot & it stops me immediately from running any more. during this recovery time, i've been swimming & tried spin classes, but the spinning seems to put pressure on the point of the bone bruise at times. i've been icing, increased intake of vit. D, calcium, vit. K. currently not doing any physical therapy. i know i compensate the way i go up & down stairs to avoid pain. i'm worried i'm going to injure my right knee or right leg in compensating for left knee. should i be lifting weights, going to physical therapy or doing something to avoid injuring my right side? & how long will it take for this bone bruise to heal?

  83. Jasmine says:

    Hi Dr.

    I fell about a month and a half ago. I was sitting on my knees and fell backward from a very short distance but while falling, i heard something in my knee pop. I was in so much pain but there was no bruising. Xrays showed no fracture and i got an MRI done which showed a bone contusion. I was limping up to about a week ago. Now i can walk normally. However, my knee doesnt straighten out fully and it is still obviously swollen on the inside part. When i stand or walk for long periods of time, it starts hurting and gets more swollen. I have been gone to physical therapy and it has somewhat helped. Is it possible that i have fluid in my knee and this is why it is still swollen? Please advise me.
    Thank you.

  84. I got my knee bannged about two months ago. I just got my result of X-ray. The doctor said there is bruise in the bone. I am waiting to get my MRI done. In the mean time, what can I do? the pain is subtle and random. the the knee is popped (the sound). I am planning to do some knee related stretching and strengtheing exercise. Can I go to play badminton?

    Thanks

  85. Hi my name is Ryan. Last summer I was playing basketball outside and got tripped. I fell on both knees evenly on the tibia bone. I landed right on the part of the tibia that sticks out a little bit, just below the knee. Stupid me, I thought I could tough it out and continued to play through it. Actually, I continued to run and play basketball and soccer all summer. The bone hurt but not enough to make me quit running and playing. I eventually got tired of it hurting and decided to try resting my knees, which I did for about a month. Afterward my knees felt better and I did not feel any pain when running or jumping. About a week later, when I came back from Thanksgiving break (which I did not do any form of exercise) I stretched and my knees began hurting again. After that it was been the same thing over and over. If I stay off my knees and do not put pressure on them very much, they begin to feel better. But then if I try to run or jump they hurt again. The pain feels like it is coming from the tibia, where it sticks out just below the knee. I have been icing here and there but it does not seem to help. I cannot stand to not be able to run and play sports and I do not know what to do. Any help will be greatly appreciated. Please tell me I will be able to run again!

    Thank you,

    Ryan

  86. Hi my name is Brian on saturday i landed on my left leg while being tackled in a rugby game. When i landed on this leg my knee became hyper extended i can already almost fully walk on it i was wondering how long it would typically take for me to be able to play again It has been 4 days since injury

    • Hi Brian I know it has been 20 weeks since you posted but funnily enough the very same thing happened to me while playing rugby and I just got it checked on MRI and its a bone bruising. I hope your knee is fully recovered now, and now I know what's wrong with my knee hopefully I'll soon be out on the field again. Thought I'd just share that with you, have a good one!

  87. Take this article with a grain of salt! The are not real doctors….

  88. Four days ago my 82 yr. old mom was racing to stop her dog from getting into the trash and he slammed into the inside of her knee. She was unable to sleep the entire night due to "intense, burning pain". Her knee has a huge lump and is extremely painful to the touch. When she called the dr. the nurse said it sounded like a fracture but when she saw the doc he said since she could walk on it there was no break but he thought she had an infection and put her on a sulfa medication. Does this sound feasible that with no break in the skin she could have an infection?

  89. ali b b says:

    I got hit side-on by a car three weeks ago, whilst cycling, and have now been told i have a tibia bone-bruise. I am pain free free if i use a full leg 'cricket' brace, but any twisting or bending is either very painful or just to stiff to move it. should i be resting/ weight bearing, or just getting on with things and ignoring the pain just to get mobile again?

  90. I had the same problem with having a bruised tibia. I had an MRI and they said to be on crutches for a month even though I was able to cycle on it just fine like you. It is taking way longer to heal since I never used crutches. I still have pain and its been over 3 months

  91. I play volleyball and and about 3 weeks ago we had our first game! I fell on my inner knee very hard to the point where I almost couldn't walk. I iced it when I got home and went on with my same routine of games and practices. I fell on it several times in the next game and iced it again! I just had practice and I fell on it so hard that it felt like blood was just rushing through my knee… yes I was wearing knee pads. I could walk on it but I couldn't bend and I still can't with out it hurting. Now practice has been over for just about 2 hours and I still can't bend it comfortably what should I do ?

    • My daughter has done the same thing….banged knee on floor twice during volleyball practice. We went to the doctor after no apparent progress and she said it was just bruised tendons. Put her on crutches and Naproxen. After two weeks no practice and doing what dr said, she has full range of motion back without pain but when she tries to put pressure on it, it still hurts. How are you progressing? Thanks

  92. I am a cross country runner. One night I bashed my knee really hard into the dull corner of my desk(note: not the sharp point corner, more of like hitting it on the side of an iphone) so it only hurt for a little bit. The next day I ran a 5 mile recovery, that was when I started to feel the pain. Its been a day and now its just tender. Im sure if I ran on it I would experience the pain over again. What could it be? Thank you

  93. Hi , iv had bruising on my knee for about 3 months and worried went for ultra sound and X-ray and recently wen to knee specilost but he saidnothing major but the knee is still blue where I fell which was off a motor bike on. A dirt track onto a rock any ideas?

  94. Hi,I fell heavily on my knee's and my left kneecap is swollen and bruised,I am really struggling to bend it without severe pain and cannot walk up or downstairs as cannot bend knee properly,do I need to have an x-ray or is it just the swelling and bruising that is preventing me from walking/bending it properly.

    • you should see an Orthopedic… could be like the above, bone bruise, but could also be worse, and you may have injured ACL or MCL…or the ligaments. The swelling is putting pressure on your ligaments that run down your leg to the ankle, so this why range of motion is being lost. Also your upper leg & other muscle are shutting down. body is protecting itself from aggravating the knee. Def go see the doctor

  95. Lisa Thomas says:

    I recently was diagnosed with a knee bone bruise on my left knee. I did not do anything to cause it, like have a fall. My doctor believes the way I run may be the cause. I am a toe runner and supinate on both feet. I wear light neutral cushioned running shoes but my right shoe always has the most wear. I have had wear and tear knee problems in the past but only in the right knee. The MRI specifically says "could represent tiny (less than 5mm) focal bone contusion in the lateral femoral condyle, minimal reactive bone marrow edema or early cystic degenerative change". I have taken 3 weeks off running, only cycling, spinning and elliptical. Walking at a 13mph produces the same dull pain that the running does. I'm also starting PT to have ultra sound, e-stem, icing done 3 times a week. They will also apply Kinesio Tape. I am scheduled to run as a pacer on Feb 12 for a marathon, and I am also registered for Boston in April. Is it safe to run just the races and train on the bike? How long will this take to heal? Do you think that my way of running is the cause and if so will the bruising return once I resume running? I appreciate any information you may have and your website has been helpful.

    Sincerely, Lisa

    • Lisa I just wanted to apologize for not getting back to you, for some reason I was not receiving notification of posts for a while. As I can see you posted about a year ago so I doubt any of this is still relevant. I just wanted to apologize for not getting back to you. How are the knees know? Any current problems?

  96. Hi So I was playing baseball yesterday and dove for a ball and landed on my right need right on the patella. I got up and was in soo much pain 7/10 I couldnt bend my knee much or put weight on it at the time. I slowly started to wake on it and it got better but still had pain in the back of the knee radiating pain going down the back of my leg to my heal. Finished the night and got home and iced the knee for about 20mins on and off for 2hrs and went to bed. The next morning I could bend my knee or strighten it much. I wraped my knee, elevated and iced for 20 mins all day on and off and if i need to get somewhere im useing crustches. what am i looking at here

    • Joe sorry about the delayed response. How are you now. Sounds like a bone bruise to the knee cap or patella. It is possible to fracture the patella, but not a very common thing to do. How is it now and we can go from there. If it is still bothering you almost 2 weeks later I would definately recommend getting to a doctor and having some imaging done

  97. Hey, i jsut got my MRI results back. I have a brused medial femoral condyle, knee effusion, chondromalacia petella, and possible meniclsal brusing. I have had pain for about 2 months, and only recently have noticed improvement (off and on). I would advice to not run/job (as that is what my doc said). Please let me know how your knee is doing and how long it took to heal if it did in fact heal. My e mail is jaggy7@hotmail.com
    Jordan

    • Jordan sorry about the late reply, for some reason I was not getting notification of posts. How are you currently doing? Any residual problems from the injury and how did your recovery process go.
      Dr. McNally

  98. my dauaghter was complaining of knee pain so we took her off the soccer team to rest her knee and took her to the doctor where the MRI showed a brused bone and no other injuries.
    my question is how long should she rest it for? and what is the best quick treatment she can do on her own so she can go back to playing soccer since her team depends on her returning soon.
    thanks
    will

    • Hi Will and thanks for the reply. Its difficult to say when she can return as with a bone bruise it really depends on when the pain and swelling have gone down. This is not really the type of injury that if she plays she has the ability to blow her knee out or anything, the main problem is the prolonged swelling and pain the more she uses it. The absolute best thing she can do is ice the area, the more the better just no longer than 20 minutes at a time. Where on the knee is the injury? Does it say on the MRI report? What we typically do with someone who wants to continue to play is make sure the pain and swelling are manageable or gone first, however continued treatment when returning is advised to keep the pain down.

  99. wayne van sickle says:

    DOCTORS, I HAVE HAD TOTAL REPLACEMENT OF BOTH KNEES. ABOUT 4-5 MONTHS AFTER SURGERY I FELL AND HIT BOTHKNEE CAPS ON THE FLOOR. I STILL HAVE GOOD BEND AND EXTENSION. BOTH KNEES ARE STILL REALLY SORE. MY ORTHO SAID TO KEEP DOING EXERCISES, ICE AND TYLANOL. HE SAID IT MAY TAKE 6-9 MONTHS TO SEE IMPROVEMENT. YOUR OPINION PLEASE. THANK YOU, WAYNE

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  102. I have a bruised tibia just below the knee on inside of leg at the top of my tibia,mri shows bruise about the size of a quarter. I think i got the bruise from jumping but am not entirely sure how i got it,but its going on 4 months now and when i think its better and am on my feet for a few hours i have severe pain and when i step just right the pain is extreme and stops me in my tracks. My question is if i keep walking on it and just tough out the pain will it still heal eventually or will it cause a permenant problem

  103. Hi Dr. McNally, Not sure if you are still responding to these.

    I took a hard fall on my right knee about 3 weeks ago, there was a lot of swelling and pain when bending. I went to the doctor he and he said I had severe knee contusions and it would take 3 months to heal…does this sound right? I really would like to run the Nike Women’s Half Marathon in late October (4.5 months away). Would you advise not to?

    Thanks!

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  105. Dr. McNally, I notice you haven’t responded to these in quite awhile, but I thought I’d try anyway.

    I suffered a bone bruise to the tip of my femur (just on the inside of the knee) when playing basket ball on Dec. 1, 2014. I had an MRI and there was no ligament or tissue damage. I was on crutches for a month and avoided running or doing high impact exercises until mid-April (I mostly biked and lifted weights). From April until the end of June, I gradually returned to running and got back to where I was running ~35mi/week (I was a cross country runner in high school). I also started playing basketball and tennis again starting in May. I was feeling fine until around the 4th of July when my knee began to hurt again, in the same way/place as before.

    I haven’t run for two weeks now (admittedly, I still play tennis once a week) but the pain in my knee has been getting worse. Do I just need to cut back even more on the activity? Should I be more concerned since the pain returned so long after the original injury? I am very discouraged by my knee and am worried that even if I rest, the pain will go away and comeback again for the rest of my life (I’m only 20!!). Any advice?

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  230. What university do you go to? write an essay about your future career Asked how much he was focused on winning the FedExCup title, Stenson replied: “First of all, I’m interested in winning the tournament, and I know, if I do that, then I’m going to win the FedExCup. We’re just trying one more day.”

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