A bone bruise, also called subchondral bone marrow edema, is detected only by MRI. A bone bruise is less severe than a fracture, but sometimes it occurs with other serious injuries, such as ligamentous or bone fractures.

What is a bone bruise?

There are various types of bruises. A bone bruise means that the bone had a traumatic injury and is damaged.

A bone bruise is less severe than a bone fracture. However, a bone bruise means that micro-fractures happened in the bone. Unfortunately, bone bruises cannot be detected by x-ray. The only sensitive examination that can detect bone bruises is MRI.

The appearance of bone bruises looks similar to subcutaneous bruises, however, the period of healing is much longer. For example, if the subcutaneous bruise can heal in two weeks, for a bone bruise the healing takes about a month or even more.

Interestingly, that bone bruise often goes with other types of injury, such as serious ligament injuries. Moreover, bone bruises can happen at any type of age to the general population and occur frequently in athletes.

Bone bruise on the knee

Your knee is most susceptible to bone bruises when compared with other bones.

About 80 to 99% of patients that had anterior cruciate ligament injury have bone bruises too. The strong compression force between the femur and tibia during ACL injury cause inflammation, edema, hemorrhage, and micro fractures in the bone. That is why bone bruise is frequently found in the lateral femoral condyle and sometimes both in the lateral femoral condyle and tibial plateau bones. Interestingly, sometimes it is called a “kissing lesion” because of the strong knee valgus position during injury when thigh and shin bones get direct impact.

Moreover, bone bruises can be seen during other knee ligament injuries: lateral collateral ligaments, medial collateral ligaments, and posterior cruciate ligaments.

Bone bruise symptoms

The symptoms that can be felt during bone bruise injury include the following:

Pain in the injured area

Swelling around the soft tissues and joint

Change in color on the injured area

Bone bruise recovery time

The recovery time that is needed to heal bone bruises varies. It depends on the injury that you experienced.

If you have an injury and damaged collateral ligaments of the knee but surgical intervention is not needed, then the bone bruise can heal in 6 to 12 weeks. However, if there is an ACL injury, and it is necessary to do a surgical intervention then the healing time lengthens.

When you have an ankle injury, then bone bruises heal in 6 to 8 weeks. However, a study showed that bone bruises during ankle injury took longer to recover than knee bone bruises. This is related to re-injury and trauma mechanisms that can prolong healing time.

Bone bruise treatment

During the acute phase of a bone bruise, apply ice and elevate the injured area to reduce swelling. Moreover, nonsteroidal anti-inflammatory drugs can be taken during the acute phase to reduce pain. It is also important to refrain from weight-bearing on the injured area.

Exercises can improve the healing process, range of motion, and muscle strength. A physical therapist will prescribe individualized exercises that mostly depend on the injured area and type of trauma.

Closed kinetic chain exercises that do not require weight bearing and open kinetic chain exercises can be performed during rehabilitation. Small equipment, such as gym balls, can be very good additional tools to create closed kinetic chain exercises where the injured leg can be positioned without full weight bearing. Gym balls not only help to reduce weight bearing on injured legs but also increase proprioception in the joint to increase joint stability and reduce re-injury after the healing process.

However, all rehabilitation must be prescribed individually, because many bone bruises go with additional injuries, such as ligaments or fractures.

How to heal a bone bruise fast

The fastest way to heal bone bruises is:

Ice. Apply the ice on the injured area, which helps to reduce swelling and bleeding of the injured area. Repeat this for a few times per day.

Rest. The injured area needs rest so be patient and do not disturb the healing process.

Elevate. Elevating the injured area this also helps to reduce swelling.

Other bone bruise treatment depends on the situation and severity of the injury. Make sure you follow any treatment plan prescribed by your doctor.