Tom injured his knee while squatting, the Guru explains how bruising is painful and suggests some exercises

June 9, 2015

I injured my knee squatting, and an MRI revealed bruising of the kneecap. I stopped all leg work in the gym, and the specialist advised a 2-3 month recovery time.

I carried on doing upper body work (entails carrying aroung dumbbells etc. on occasion) but no leg work, and my knee as still hardly healed after 6 months.

Is it likely that carrying around heavy loads on a daily basis/leg drive on certain exercises in preventing healing?

The Guru requires more info:

Tell me a little more about the “not healed” bit.

Is this via a new MRI showing ongoing bone bruising or it’s just painful but MRI or painful and MRI showing ongoing bruising?

The Guru

Tom replies:

Hi Guru,

Thanks for getting back to me.

The MRI originally showed bruising; I had a re-scan and it showed bruising once again, although it has improved since December. I have had relatively consistent pain since the injury occurred, although it has improved gradually (but very slowly) with time. Now I get occasional pain almost randomly, especially when walking. The pain is concentrated mainly on the inside and lower portion of my knee, but isn’t especially acute.



June 9, 2015

Bone bruises, like normal bruises are painful.

Bone bruises by their very nature do take longer to feel better. However on MRI scan it may show the bruise is still there but you may actually have very little signs and symptoms coming from the actual structure.

What’s more common, and I’m assuming that you’re a “normal” bloke with no collagenous things happening, is that the pain you feel is coming from what you’re doing with your kneecap ie the function rather than the structure of the bruise.

Have you tried to tape it? Have you seen a Physio to mobilise it? Have you rolled your ITB with a foam roller? Have you done some very nice, control lunge and squat work?

If no to the above, I would. I think you’ve got an issue (and pain) with the way your patella tracks and moves, which was initially caused by a painful bone bruise…..

The Guru

Tom came back with some more information:

No, I’ve done none of those things. My doctor (a knee specialist) advised that it was simply a matter of rest, although he’s now suggested physio. So do you think it’s advisable to limit all heavy lifting that involves my legs (e.g., carrying around dumbbells, leg drive on the bench press, etc.)? That’s what I’ve been attempting to do for the last two weeks, and I feel – although it’s hard to say this early – that it’s helping.

I’m just worried that with lunges/squats (I assume you mean bodyweight) I’ll slow down the healing. Is this incorrect?

And the Guru responded:

…I think your doc would if he didn’t understand why it’s taking this amount of time.

I don’t think the lifting and lugging around of kit has any relevance – your kneecap does not come into contact with your femur until 35-45 worth of knee bend, so unless you’re going up and especially downstairs with the kit, then it pretty irrelevant.

I think your healing rate is so slowed due to what you’re doing (lack of control, timing, balance etc) this is exactly why you need to do FORM squats and lunges etc.

It’s not what you’re doing but how you’re doing it.

Your knee specialist is a great structuralist but he’s probably not too crash hot on function – this is what you need to improve.

Hope that this makes sense.

The Guru

Guru Responded

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