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Author Topic: Another bone contusion recovery question  (Read 8539 times)

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Offline bmcm2girls

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Another bone contusion recovery question
« on: February 08, 2010, 01:01:31 AM »
A little over two months ago, I injured my knee while snowboarding.  I was getting off the lift and my left knee developed a mind of it's own.  I heard/felt a pop but felt no pain.  My leg felt weaker then the other but not painful.  Shortly after I had a collision with another snowboarding in which I felt pain in my pelvis.  I was not able to fully stand for the remainder of my time down the hill.

By that night I had swelling and the pain had increased.  I tried to wait it out thinking it would get better and then it took a while to get an appt (military hospital, not always the greatest for access to care).  By the time I was seen (two weeks) I had classic symptoms of a meniscus tear.  Couldn't turn over in bed, popping/clicking, instability, etc.  I was given a referral for PT and an MRI.  The PT found that I had a lot of laxity in my knee so went easy on PT until results of MRI came in.  It took two months to get the MRI, which I recently had.

At this point, a lot of the symptoms are "better".  I don't have constant popping and my knee feels more stable with walking (still not able to run).  However, it is still fairly painful.  MRI results say that my meniscus and CL's are all normal.  The report says that there is bony edema at hte posteromedial tibial plateau with associated fluid collection consistent with bone contusion.  My PT says she "doesn't buy" that there isn't a meniscal injury, and neither do I.  But that is neither here nor there, I guess, lol.  I figure if it says there is a bone contusion then I should concentrate on recovery from that.

The doctor (family practice doctor, can't get in to see OS unless it is extreme) had no answers for recovery.  All she said was "keep doing what you are doing".  But after two months, what i am doing isn't working so I am frustrated.  At this point, while the popping, etc is better, and I don't get the sharper pains with walking, overall the pain is worse.  I have a constant "ache" in my knee, more generalized then previously.  With a sharp pain down the front of my tibia and an intense (by far the worst) pain in my femur.  It is also an "ache" pain but far stronger.  Everything of course gets worse the more I use it.  The thing is, I spend 13 hours a day (most days) on my feet, constantly moving and putting stress on knees (I am a nurse on a very busy and intense critical unit with constant emergencies, lol).  I asked if I should take time off work to allow it to heal or stop PT for a while but she said that would only allow for my knee to get weaker.  She also couldn't give me a time for it to get better so I have nothing to gauge this by.  Two months with the pain getting worse in some ways seems odd to me.   I can't take the NSAID's she gave and tylenol isn't cutting it either.  At this point I would love at least SOME idea of how this is going to go.  Anyone been there done that?

Offline tez27

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Re: Another bone contusion recovery question
« Reply #1 on: February 08, 2010, 03:44:42 PM »
My experience is that m.r.i's are not completely accurate I was told after  my m.r.i that I had some wear and tear but everything was intact
That was about a year ago, I have spent the last year going  back and forward to my g.p with continued pain and swelling, eventually was rerefered to back o.s who had another look at mri and decided "something did'nt look right" so I had a scope done 4 weeks ago
results were acl rupture and mcl rupture, neither was seen on the m.r.i this was explained by scar tissue making it difficult to see what was going on.
My advice would be if your still in pain then go back to your o.s and ask him to have another  look at the m.r.i just in case somthing was missed
I'm no expert but I wish I had found this site a year ago for someone to encourage me to go back to the o.s sooner cos then I could have been fixed by now   
Take care Tez
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline bmcm2girls

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Re: Another bone contusion recovery question
« Reply #2 on: February 08, 2010, 05:24:01 PM »
Thanks, Tez for sharing your experience.  I know that things can be missed by MRI, especially when the person reading it has little experience (as is the case for mine).  However, when I asked my MD how accurate they are and questioned the results, she said they are more accurate then physical exam and my description of symptoms.  I requested someone else to have a look and was told that they "don't do that".  I haven't seen an OS.  Military health care doesn't work that way, lol.  You get a referral only if the FP physician feels it is something that needs surgery.  So, basically, the diagnosis and evaluation is left entirely up to them to help reduce the number of people who see the OS.  In fact, my daughter broke her wrist in two places (buckle fracture to radius and a chip off of her ulna) and she has yet to even see an MD (only a PA for two seconds who hadn't even looked at her films).

So, a scope is out of the question for now.  Which is why I want to know how long a contusion would take to heal.  MD can't/won't answer but then I will know if it is still hurting after that time, I will push for more.  She also isn't really sure what the proper recovery should be so I am trying to decide if I should be non weight bearing for any length of time.  I would hate to find out later that it would have healed sooner had I tried that.

Offline mmrocker13

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Re: Another bone contusion recovery question
« Reply #3 on: February 08, 2010, 05:39:13 PM »
A bone bruise can be painful for a LONG  time, esp. if you can't get off your feet to let it heal. AND it can be excruciatingly painful. I agree that stopping PT/strength work would be bad...but getting OFF of it, as long as you're keeping up with the other stuff, couldn't hurt.

I have had bone bruises that last for months--and, like you said, the more I tried to do on them, the longer they take to heal. But, sometimes, it's unavoidable. I could always cut back on my running, sure...but you can't necessarily cut back on daily living.
89: Pat. dislocation, lat. meniscus tear, femoral OCD lesion
89: debridement, chondroplasty, lateral partial menisectomy
02: partial lat. menisc., debride
02: mfx
09: subtotal menisc., debride, c'plasty
10: scope/debride
10: varus DFO
13: HWR
15: total menisc., debride, c'plasty, notchplasty

Offline Cosmicsnuffle

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Re: Another bone contusion recovery question
« Reply #4 on: February 09, 2010, 12:14:17 AM »
Hi bmcm...

Oh yes - bone contusions  :(  :(  :(

I have kissing contusions (sounds so romantic  :-\ ) from a bad landing to a great flying kick in September.

The OS I saw has told me to expect a year plus for the bone contusions in my knee to heal. I'm 5 months since injury and still suffer excruciatingly sharp pains at the contusion sites.

I had never heard of bone bruising/contusions before my injury, and certainly had no concept of the timescales involved for healing.... but now I'm beginning to understand!

The PT's advice (and she has my total trust - what a star she is!) was wherever possible to avoid any activity/ action which causes the contusion to hurt, as it is re-bruising the bone, compounding the damage and increasing the healing time.

The information given to me by my PT is that the therapy needs to be structured with the bone bruising in mind so as not to put too much pressure/weight bearing on the bruised areas whilst minimising muscle atrophy during periods of reduced mobility (or rebuilding lost muscle mass/regaining ROM) and aiming to keep all the muscles around the knee strong and supple to support the knee joint.

Keep icing, keep it raised when you can to help any swelling. Ask your PT if you can use shoe wedges/inserts to remove pressure form the damaged compartment when you walk.
Apart from that I don't think there is any magic quick fix, just time, time, time. ...however if you do find one please let me know!

Good luck!

Oct 04 - torn meniscus
Dec 05 meniscal trim and debridement
Sep 09 torn ACL, kissing contusions, knee locked 30-60o
Jan 10 ACL stump debrided, lateral parrot beak meniscal tear trimmed
May 10 ACLr (Hamstring)
Aug 11 mfx (focal lesion lateral femoral condyle)
Jun 14 100k walk London-Brighton 28hrs