Bone Up On Bone Bruises

Some of us have experienced a bruised ego. And most of us have had a bruise on our skin — probably many.

But did you know you can also bruise your bones? These injuries, also known as bone contusions, can be very painful. And if you don’t treat them appropriately, they can lead to bone fractures.

How A Bone Bruise Occurs

The bruises that most of us are familiar with occur when a blood vessel breaks and blood pools under your skin. This may cause swelling and discoloration. But usually, these bruises don’t require treatment.

Bone bruises are similar. They cause bleeding and swelling inside your bone. The skin around the injury may become discolored, as well.

“When I describe a bone bruise to people, I tell them to think of a steel can,” said Matthew J. Rachwalski, DO, a Michigan City sports medicine specialist with Franciscan Health Sports Medicine.

The outer part of the can is hard, just like the outer part of a bone. If you think of a can of meat, what’s inside the can is soft. That’s similar to the marrow inside your bones. Just as something hitting the can may move the contents inside without breaking the can, something hitting your bone can displace the soft, spongy marrow inside your bone.

“The force results in an energy transfer into the inner part of the bone that causes the trauma,” Dr. Rachwalski said.

Common Causes Of Bone Bruises

Bones are deep inside your body. So, it usually takes a high-velocity event for a bone bruise to occur. According to Thomas Schmittdiel, MD, a Michigan City primary care sports medicine physician with Franciscan Health, common causes of bone bruises include:

• Athletes colliding with one another while running at full speed
• Car or machinery accidents
• Falls
• High-impact injuries from baseballs, softballs or other sports equipment

Because bones weaken over time, the risk of getting one of these injuries increases as you age.

“Older people can get bone bruises from less trauma than someone in their 20s or 30s,” said Dr. Schmittdiel.

How Doctors Diagnose A Bone Bruise

A bone bruise and a fracture can have similar symptoms. So, it can be hard to recognize a bruise on a bone yourself.

“The diagnosis is typically a diagnosis of exclusion,” said Dr. Rachwalski.

If you’ve had a high-impact injury and bruising on the skin with pain that doesn’t get better after a few days, you should see a doctor.

“We start with a basic X-ray just to make sure we don’t see an obvious fracture,” said Dr. Rachwalski.

If necessary, doctors may then order an MRI. It’s usually the best imaging test to confirm a diagnosis because it can show soft tissue and swelling. To some degree, ultrasound may be helpful, as well.

Treatment For Bone Bruises

Once doctors make a diagnosis, attention shifts to treatment. As with many musculoskeletal injuries, the RICE method is often key. It includes:

Rest. It’s best to use the injured part of your body sparingly to give your bone time to heal. Your doctor may recommend that you avoid intense activity and use tools to take stress off your bones. “If the bone can be braced or immobilized for a brief period of time, that’s often helpful,” said Dr. Rachwalski. For a bone bruise on the leg, an assistive device such as a walker, crutches or cane may also help rest the bone.

Ice. A cold compress applied to the bruised area several times a day may help reduce inflammation and pain. However, be sure not to apply it directly to your skin. Wrap it in a towel. Sometimes doctors recommend anti-inflammatory medicines or steroids to reduce discomfort, as well. In very rare cases, they may prescribe pain medication.

Compression. Doctors may recommend that you wrap an elastic bandage around your bone. “Compression is a great way to reduce swelling that can occur outside the bone in soft tissues,” said Dr. Schmittdiel. “Swelling can definitely cause discomfort. It can push on the nerves in the area and on ligaments.”

Elevation. If you keep your injured bone above the level of your heart, it may also help reduce swelling.

Bone Bruise Recovery

Time is essential to help a bone bruise heal. Depending on the severity of your bruise, it may take several weeks to six months for symptoms to resolve.

Take your injury seriously. And don’t rush your recovery. Continued stress on a bone bruise may ultimately cause your bone to crack or break. That may create a whole new set of problems. But with adequate time, your bruise should heal and you can get back to your regular activities.

If you need an expert to evaluate your symptoms or guide your recovery, our sports medicine specialists are here to help you.