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

Editor’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 painful 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 important 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 bone bruise treatment process 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 injuries 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 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.