# Tibial bone bruise



## Earthpig (Jan 23, 2004)

I started feeling intermittant pain this past summer in my left knee during some rides rides, followed by sharper, lingering pain after starting back with running and playing indoor soccer this past November. Deep knee bends and squats would also produce a dull pain through the knee, as would the "resting" yoga position. I finally broke down and went to the doc for a dx in early December after having 24 hours of pain after every run that would start only 2 miles (or less) into the run. Three doctors and four diagnoses, later (including a $1300 MRI), I was diagnosed yesterday with a "trabecular microfracture of the lateral tibial plateau," aka a "bone marrow edema," or a bone bruise, localized on the upper left corner of my tibia. 

Bone bruises are usually only result from traumatic injury - like a hard fall or blow to the knee. What strikes me as odd is that I have no memory of any traumatic event/injury to that leg at any time this past year, and as of last spring, no knee pain at all. But, I really upped my riding days last year, and spent a lot of time on the singlespeed, hammering long hills out of the saddle. My orhtopede, who is a Cat 3 roadie and Expert level mtb racer, opined that all that hammering in a low gear combined with some biomechanical oddities in my left leg (length discrepancy, and I'm horribly pigeon-toed), could have resulted in the bruise.

Apparently, there's no real treatment other than rest and total avoidance of activities that would reinjure the bone and/or prevent healing - no running, soccer, jumping, squats, deep knee bends, snowboarding :sad:, and worst of all, singlespeeding. :cryin: He said riding is fine, but no out of the saddle hammering, no pushing big gears, just lots of in-the-saddle high cadence spinning. He said best case scenario, I'd be better in 6 months to a year. 

Anybody else ever have this diagnosis? What was your recovery period like? Sounds like I'm in for a year of mostly flat land road riding.


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## BoiseBoy (Mar 1, 2006)

*Ep*



Earthpig said:


> I started feeling intermittant pain this past summer in my left knee during some rides rides, followed by sharper, lingering pain after starting back with running and playing indoor soccer this past November. Deep knee bends and squats would also produce a dull pain through the knee, as would the "resting" yoga position. I finally broke down and went to the doc for a dx in early December after having 24 hours of pain after every run that would start only 2 miles (or less) into the run. Three doctors and four diagnoses, later (including a $1300 MRI), I was diagnosed yesterday with a "trabecular microfracture of the lateral tibial plateau," aka a "bone marrow edema," or a bone bruise, localized on the upper left corner of my tibia.
> 
> Bone bruises are usually only result from traumatic injury - like a hard fall or blow to the knee. What strikes me as odd is that I have no memory of any traumatic event/injury to that leg at any time this past year, and as of last spring, no knee pain at all. But, I really upped my riding days last year, and spent a lot of time on the singlespeed, hammering long hills out of the saddle. My orhtopede, who is a Cat 3 roadie and Expert level mtb racer, opined that all that hammering in a low gear combined with some biomechanical oddities in my left leg (length discrepancy, and I'm horribly pigeon-toed), could have resulted in the bruise.
> 
> ...


I am sorry to hear of your bad luck man. So, who did you see for your Ortho, Dr. Shea?
I feel your pain, I have been through two knee surgeries this past Summer and may be looking at another one in the coming months.
I almost get the impression from your Dx and your Hx that it may not be from a single traumatic event, but more from a microtrauma perspective. I would have thought with this repetetive type of injury that you would also have some cartilagenous and/or meniscal pathology as well (degeneration). 
Do you have any other systemic issues or musculoskeletal disorders?
If you do have some biomechanical issues going on, you may benefit from some therapy for corrections and alignment.

Throw me a PM id you have any questions with things.

Happy Trails


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## Earthpig (Jan 23, 2004)

BoiseBoy said:


> I am sorry to hear of your bad luck man. So, who did you see for your Ortho, Dr. Shea?
> I feel your pain, I have been through two knee surgeries this past Summer and may be looking at another one in the coming months.
> I almost get the impression from your Dx and your Hx that it may not be from a single traumatic event, but more from a microtrauma perspective. I would have thought with this repetetive type of injury that you would also have some cartilagenous and/or meniscal pathology as well (degeneration).
> Do you have any other systemic issues or musculoskeletal disorders?
> ...


Thanks for the input. (98 said I should talk to you.) According to Dr. Alex (Intermtn Ortho), the soft tissue (specifically the lateral meniscus) looks A-OK - no degeneration, no evidence whatsoever of cartilage damage. (He initially suspected a lateral meniscus tear.) He did opine that the low RPM, high gear riding, combined with the biomechanical issues, improper bike fit, and then adding the running and soccer in November all combined to make the knee symptomatic.

No other systemic issues or musculoskeletal disorders. (I have to admit feeling a little nervous when he did mention that cancer may be a cause, but then said he had no suspicions of cancer. Whew.)

I've got an appt next week with Corey H. out in Eagle for a "real" bike fit. (I've done Wobblenut for road and mtn.) Dr. A mentioned that I might benefit from a varus wedge set up in my left shoe, a lift, or something similar to equalize the pressure through the knee. Hey, at least I get to avoid the cost of surgery and a sh!tload of PT.

Speaking of, I do remember you mentioning surgery and recovery this past summer. Meniscus tear? Arthroscopy? Were you your own PT?  Hey, that's a good way to avoid those medical bills, right? Are you back in riding shape? (Not that it's rideable out there on anything but skis or a snowboard.)

Thanks again.


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## spongstick (Feb 6, 2004)

*get well*

It could be worse.I lost my left Hip to rheumatoid arthritis at the age of 41,and now my hands are in such bad shape that today i had to have carpal tunnel surgery done on my right
hand.With a release of a tendon in my right elbow to correct the numbness in my hand Thumb fusion is next...As i sit here typing It doesn't seem so long ago that i was a marines a (hard charger) and i was a very good amatuer boxer. 
Now I'm just a broken down 46 year old man who has only stories to tell of what i use to be able to do. I am scared to think that the Pugilism is going to start to effect my brain from all the fights and sparing I did in my career.Maybe it has already and thats why wife says don't you remember what i said.haha

So I want you to Keep your head up because 
6 months to a year is not a lifetime you will get better:thumbsup: .


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## BoiseBoy (Mar 1, 2006)

*Ep*



Earthpig said:


> Thanks for the input. (98 said I should talk to you.) According to Dr. Alex (Intermtn Ortho), the soft tissue (specifically the lateral meniscus) looks A-OK - no degeneration, no evidence whatsoever of cartilage damage. (He initially suspected a lateral meniscus tear.) He did opine that the low RPM, high gear riding, combined with the biomechanical issues, improper bike fit, and then adding the running and soccer in November all combined to make the knee symptomatic.
> 
> No other systemic issues or musculoskeletal disorders. (I have to admit feeling a little nervous when he did mention that cancer may be a cause, but then said he had no suspicions of cancer. Whew.)
> 
> ...


Goot to hear that it is a positive prognosis.
Let me know if you need any help with fit, mechanics, or the rehab process.

My knee is doing much better after two surgeries this past Summer for an ACL and both Medial and Lateral Meniscal repairs. I developed an odd band of scar tissue that had to be removed later on with another scope. All is healing well and I am back to most regular activities, but I have another band of scar tissue that gives me some mechanical symptoms again. 
I have been riding, but with the weather so inconsistant and the trails/roads so poor I have not been doing any consistant riding this Winter. Can't wait for some heat to melt that ice and make things rideable again.

Let me know how things are coming along.


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## Earthpig (Jan 23, 2004)

BoiseBoy said:


> Goot to hear that it is a positive prognosis.
> Let me know if you need any help with fit, mechanics, or the rehab process.
> 
> My knee is doing much better after two surgeries this past Summer for an ACL and both Medial and Lateral Meniscal repairs. I developed an odd band of scar tissue that had to be removed later on with another scope. All is healing well and I am back to most regular activities, but I have another band of scar tissue that gives me some mechanical symptoms again.
> ...


Good to hear the knee is healing up well - man, ACL, medial and lateral menisci? What the heck did you do to yourself?


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