Bone Bruising in the Knee - Causes, Symptoms, and Treatment

Bone bruising (aka bone oedema or bone marrow oedema) in the knee can sometimes go undetected and heal by itself. However, if you do experience pain, sports physio Maryke Louw is on hand to explain how bone bruises are caused, what the symptoms are, and what to do about them.

📽️ Other videos you may find useful:

📚Chapters in this video:
00:00:00 Introduction
00:00:52 What causes a bone bruise?
00:02:24 Bone bruise symptoms and impact on recovery
00:03:33 How to treat bone bruises
00:06:39 How we can help

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References:

Gage, A., et al. (2019). "Factors Associated With a Delay in Achieving Full Knee Extension Before Anterior Cruciate Ligament Reconstruction." Orthop J Sports Med 7(3): 2325967119829547.

Galloway, C., et al. (2023). "Relationship Between Bone Bruise Volume and Patient Outcomes After ACL Reconstruction." Orthop J Sports Med 11(2): 23259671221146205.

Horga, L. M., et al. (2020). "Is the immediate effect of marathon running on novice runners’ knee joints sustained within 6 months after the run? A follow-up 3.0 T MRI study." Skeletal radiology 49: 1221-1229.

Kompel, A., et al. (2021). "MRI-Detected Knee Ligament Sprains and Associated Internal Derangement in Athletes Competing at the Rio de Janeiro 2016 Summer Olympics." Open Access J Sports Med 12: 23-32.

Mandalia, V., et al. (2020). "Bone marrow oedema in the knees of asymptomatic high-level athletes: prevalence and associated factors." Indian Journal of Orthopaedics 54: 324-331.

Mester, B., et al. (2023). "The influence of distribution, severity and volume of posttraumatic bone bruise on functional outcome after ACL reconstruction for isolated ACL injuries." Arch Orthop Trauma Surg 143(10): 6261-6272.

Villari, E., et al. (2024). "Bone marrow edema of the knee: a narrative review." Archives of Orthopaedic and Trauma Surgery: 1-12.

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[hanzo]

So to sum it up, train with low impact and intensity until the pain fades. Be it weeks, months, push fluid in and out of the area.

[charlesmauldin]

I have a bone bruise in my fibula by my knee and a muscle strain in my calve after a fall. It’s been 2 weeks, just started physical therapy. Just now able to put weight on it.

[lindastamp]

Thank you for this! I needed this a year ago when I had a meniscus tear and bone bruise. For me it was the worst part of the injury. I couldn't find much information out there and my Ortho had no information for me so I felt totally on my own. PT helped!

[jonathangosing]

Thank you very much for this video. I recovered from bone bruise/BME, took me 6-7 months. But thanks to your other videos which I was watching while recovering. You're an angel.

[maricotaeseusvideos]

Very useful. I had a bone bruise on the hip and appeared in marathon training. After the marathon, I stopped completely, and the pain didn't better. I restarted slowly and finally, now the pain stopped (almost 9 months later).

[AlexHils]

Hi there. I got an MRI on my knee and was diagnosed with “small medial tibial plateua bone contusion with adjacent medial joint line soft tissue edema”

I play soccer and this pain initiates whenever I kick the ball with the inside of my foot. It sends a shock up to knee and is immeditately met with nagging pain. is this unusual for the bruise to be caused in such a way or does that make sense to you

[tavusk]

Hi. Thank you for the videos! They’re all very informative and helpful. I had tibial plateau bone edema 3 months ago from running, an orthopedic doctor told me non weight bear for 8-9 weeks, but I did ROM exercises. I was extremely painful in the beginning, now I’m in 13th week, using one crutch (partial weight bearing) for walking in the house. It is still a little painful. When do you think the pain will go away? How long does a tibial plateau edema take to recover? Thank you so much!

[MBL]

I have a bone bruise on the medial femurkondyle. 2 years ago I suffered a cartilage damage for which I underwent surgery approx 1 year ago. My bone bruise has been present during this whole time. It is even bigger now than 1 year ago before the surgery, which I assume is due to my cartilage surgery and the cartilage yet not being able to protect my subchondral knee sufficiently. I am strengthening my muscles, but it is very hard to deload my knee/bone bruise and achieve good overall strength in your leg. I will have to talk to my surgeon for advice. Having seen this video, I will definitely stop going into the pain, which I sometimes did to train my muscles and prevent my brain from further losing neuromuscular connection...

[kazbaz]

I fell over and scabbed my knee badly and bruised my leg and I now have a hard bony bump just under knee. At first I thought I had broken a bone but think its a bruised bone. I can walk fine. I wonder if I should of got it checked? Its been a week

[tsubasaoozora]

Hello doctor I have edema in the hip femur bone, should I exercise?

[promeebarot]

Hi Maryke, 0:43sec the picture this man is holding below his knee, same place below my left knee..the bone is paining and it’s a little swelling over there too. Probably last night it got hit with something (maybe furniture which I didn’t notice on the spot) but in the morning it was hard to walk when I put my first step on the floor. I ignored thinking it a normal bruise. But afternoon passed and it’s evening and weather is getting colder, the pain is getting worse. Please suggest something.

[divorcemediationtips]

Hello, I fell on both knees on cement about 6 weeks ago. The right knee is fine. BH. The left knee is painful while walking mostly up stairs. Downstairs hurts but not as much. What would you recommend?

[wilgr]

I need to get bilateral medial partial knee replacements but the doctor won’t do it until my bone bruise heals…. Help

[borikatrina]

Thank you so much for this video. There is little information on bone bruise and this answered my question. I have bone bruise due to a fall 8 weeks ago, I am feeling better and have been doing ROM exercises for 3 weeks now but was worried I shouldn’t be moving so much in order to allow bone bruise recover. After this video I am at ease in continuing my ROM exercises. Is it ok to walk on a treadmill for 15 mins slow pace with bone bruise?

[flakelife]

Thanks for this video! I have extensive marrow edema in my elbow but ive been so scared to move it, even with the pain is very little. Will try to get more movement in - hopefully this 6 month struggle will end soon :(

[ORIAMMARQUE]

Hello Maryke, I was mountain biking and fell off and got a bone bruise on my knee. I’ve been having a lot of joint pain for 2 weeks, when I walk it is normal but when I play soccer it worsens. The pain toleration has increased every week, but after playing my knee hurts a lot and has a throbbing sensation. Should I stop playing completely for it to recover, or am I able to play and take two days off at a time?

[lucasjay]

I’ve had a bone bruise for 2 years now that hasn’t healed even with taking months off from activity

[craigshorey]

Can anything be done to reduce the likelihood of it returning?

[praveshchauhan]

Hi Doctor, could you please help me by telling me how to recover from knee cap bruise?

[Andres-cdlr]

Currently have marrow edema in the proximal tibia shaft because of a couple muscle strains.

If I can tolerate the pain, can I continue to do high impact activities such as running? Or will it worsen the injury?