How dangerous is a Bone Bruise?

As a rule, a Bone Bruise heals by itself by sparing and cooling the affected areas, does not cause any consequential damage and is not very dangerous. Complications such as bone marrow edema with long-term damage to the bone usually only occur in the case of very severe bruising.

Localizations

Particularly at risk are body parts that lie directly under the skin without a protective soft tissue mantle of muscle or fatty tissue. As a result, the pressure of an injury is distributed over a small area only and the bone is directly affected. These regions are usually the shin (tibia) and knee, but also the hip, ankle, shoulder and skull.

A bone bruise in the area of the foot, especially the metatarsal, is mostly found in athletes in the area of martial arts, especially Taekwondo. The symptoms are similar to bone bruises in other parts of the body, especially pain under stress and swelling. As a consequence, after a fracture has been ruled out, the injury should be cooled and immobilized.

The metatarsals are a rare location for a bone bruise. Usually, metatarsal injuries occur when heavy objects fall on the foot or after kicking. A common cause for bone bruises in this area are martial arts like Taekwondo.

The kicks can quickly cause small bruises of the superficial bones on the back of the foot. Depending on the severity of the bone bruise, movements and the appearance can be painful afterwards. Cooling and protection should be maintained until the bruise heals itself.

The heel and also the ankle joint are bone regions that often suffer bruises, especially during sports. A typical development of a bone bruise at this point is the collision or sliding in football. The heel then swells up and is very painful under pressure.

If the heel bone is bruised to a high degree, there is little restriction on the occurrence and running. However, if the bruise is deep in the heel, pain occurs with every step. Unfortunately, in order to allow a quick healing, only a protection of the heel helps.

The talus, i.e. the anklebone, is a bone of the tarsal and is located directly above the heel bone. As such it is an important part of the ankle joint. A bone bruise of the talus or other bones of the ankle joint occurs mainly during sports activities.

It is often described as the result of a foul, e.g. in football or basketball. This is usually accompanied by severe pain and a clearly visible bruise under the ankles. Since the ankle joint is a heavily loaded and much used part of our body, an injury in this area is associated with considerable restrictions in everyday life.

To treat the bone contusion, a splint can initially be applied for a few weeks. Later, crutches should at least be used to provide relief for the ankle joint or talus. Pain as a result of the bone bruise can last for a very long time, complaints of up to a year or more are not uncommon.

After a few weeks or months, when the most severe pain has subsided, it is possible to resume sports as long as the pain does not worsen significantly. Sports such as cycling or swimming are preferable to sports with a strong foot joint, such as jogging or playing football. A migration of pain is also frequently observed and is related to a pain-induced change in gait pattern and the associated unusual stress on the joints.

Since the tibia (shinbone) is only slightly covered by padding muscles and fat over its entire length, it is often affected by bone bruises. This is often the case, especially in football, as a result of fouls. If this happens in the area of the head of the tibia/tibial plateau, joint effusions can occur at the same time, which manifest themselves as pain in the area of the patella.

If the pain is severe, clinical examinations show a “dancing patella”, i.e. a kneecap that floats on the effusion. Initially, this is mainly seen in the ultrasound examination. The treatment of a bone bruise of the tibial head is the same as for other bone contusions.

Since an injury in the area of the head of the tibia can also result in rupture of the ligaments, pain in the knee should always be clarified. A bone bruise on the kneecap is not a rare occurrence. The kneecap has a prominent position in the body and is therefore affected by abrasions, fractures or bruises in many falls and impact injuries.

Here too, it is important to first rule out whether any structures have been injured before the entire knee is cooled and protected. At the kneecap and the soft tissue under the kneecap, small micro-traumas can lead to the typical bruising. These can lead to considerable pain at the patella.

As this is a bone marrow injury, the blood enters between the bones and the periosteum of the patella. Since the patella is easily visible as a superficial bone under the skin, the bruises can often be seen externally. It is also important to distinguish whether the kneecap itself or the head of the tibia is affected.

In this case, too, slight microfractures may occur, with similar bruising. In addition, haematomas (bruises) can develop in the knee joint, which restrict movement and are very painful. If the effusion spreads into the joint cavities, the body may not be able to absorb the blood itself.

In these cases, a doctor may need to initiate punctures to draw the blood out of the joint with a needle. If the bruise spreads over a large area under the kneecap, the phenomenon of the “dancing patella” occurs. The kneecap floats and “dances” on the effusion.

In these cases, the diagnosis can easily be made by an ultrasound examination. Bone bruises of the wrist are usually the result of falls where the fall is caught by the hand. Pain and significant swelling are usually the result.

Once a fracture has been ruled out, the most important measure is to immobilize the wrist and cool it. A support bandage is ideally suited for this purpose. Since the wrist is used very often and heavily, a bone contusion in this area is often associated with severe restrictions in everyday life and a lengthy healing process.

Pain often occurs many months after the injury itself. The elbow also has an increased risk of bruising due to its superficial position. Especially in the case of falls, rapid rotations or jerky movements of the arm, the elbow can quickly suffer a bone bruise when the arm is bent.

In this case, the bone marrow edema causes more or less severe swelling. On the one hand, this can be very painful, but on the other hand it can also considerably restrict movement. As an important joint in everyday life, mobility in the elbow should be restored as quickly as possible.

However, the healing process is primarily helped by sparing the joint so that the blood can be absorbed. Under certain circumstances, the joint may have to be punctured if the effusion is too large to resorb itself. In the shoulder area, a so-called bone bruise usually only occurs if there have been severe injuries in this area.

In high speed trauma, such as in a car accident, the very strong forces exerted on the shoulder can lead to a bone bruise. If such bruising of the bones has occurred in the shoulder area, we speak of a bone bruise phenomenon. A Bone Bruise causes severe pain and rarely occurs in isolation.

In most cases, there are still haematomas, other bruising marks etc. somewhere in the shoulder area. A Bone Bruise usually leads to severe pain, which can last for weeks or months. By definition, a Bone Bruise of the shoulder must not be detected by imaging. A Bone Bruise is a bruise or contusion of the bone in the shoulder area.