Patellar Bone Bruise – What I’ve Learned

My training for Boston was going great.  More than great.  Amazing.  The winter months were brutal but didn’t deter me from getting my workouts and long runs done.  I ran on the treadmill more than ever, but made each run count and nailed my paces and mileage despite polar vortexes, icy trails and huge amounts of snow.  I raced a strong half marathon in March at RnR USA and was feeling so good about my fitness and mental strength.  It was all coming together – one day, one step at a time.

Rocking the Rock n Roll USA 13.1

And then, one cold Sunday morning 4 weeks before Boston, I decided to try out the ElliptiGo with my good friends Jeff and Maddie.  Usually on Sunday mornings I take a yoga class but thought why not switch up my cross training and bring it outside with some non-impact running on this super cool bike?!  I still think that in theory this wasn’t a bad idea, the ElliptiGo is an awesome form of cross-training for runners and I look forward to getting better at using it, but looking back it was a little short-sighted of me not to consider the risk I was taking.  I had never done it before and the feeling was totally new to me, and when I went to get off of it I fell into the pavement and banged my knee right into the asphalt.

I got up and assessed the situation – my knee hurt a little but it really wasn’t bad.  I got back on the ElliptiGo and we hit the trail for a few fun and, honestly, exhilarating miles.  We had a blast!

all of these pics were taken after my fall – it was so fun!

It wasn’t until a few hours later when I was home that I noticed my knee was pretty sore and stiff, especially walking down the stairs.  That week was rough.  It was supposed to be my peak mileage week and I ran a total of 31 miles (as opposed to well over 80), ALL of which hurt me — BADLY.  I saw two doctors who I really trust with my whole heart and they both diagnosed me with a patellar bone bruise. An acute injury to the bone, one that would take TIME to heal and a process that I really couldn’t rush.  It would take anywhere from a few weeks to a few months to feel normal again, and that uncertainty was rattling to me.  I really needed to take it one day at at time, to listen to my body and do all that I could do to help myself heal, while also preventing myself from getting another injury as a result of my form changing or muscles tightening or tendons getting grumpy around the kneecap (this was of more concern to me than the actual bruise itself was, to be honest).

As with any injury, recovering from a bone bruise takes time and the healing process is different for everyone and depends on a lot of factors.  A bone bruise is probably not the most common running injury, though I imagine this kind of thing could happen more frequently to trail runners who may fall on rocks and get pretty banged up.  I thought I would share what I’ve learned from my own experience with this injury though, just in case someone might find it helpful.

Running:  In the first few days following my fall, running HURT.  The pain was constant and didn’t seem to get worse as I ran faster or longer, but it did not subside at all.  Despite assurances from my doctors that it was “safe” to run, I hated it.  I was running in pain and in fear and after a few days of that I decided I needed to rest.  I did not run for the remainder of the week.  In retrospect I really think I should have pulled the brakes on my running right away – no matter what anyone advised me of.  If running through pain to you feels wrong then it probably is.  I think I probably slowed the healing process down a little by running through it.  I don’t think I made it worse, but I probably could have, had I continued to not listen to my body.  I gradually started running more and more as the pain lessened and I did not attempt to push my pace until it just naturally came back to me to do so.  It was more than three weeks before I was running my marathon pace again.

Pain Management: LOTS of icing, especially after a run.  I would typically massage the painful spots on my knee cap with ice cubes until they melted, or wrap an ice pack around my knee and elevate it.  I applied Arnica gel to it throughout the day.  After doing some research on anti-inflammatory supplements and foods, I started taking Vitamin D, Bilberry, Bromelain, Glucosamine with MSM (vegan), a vegan Omega (similar to fish oil but I am allergic to shellfish and eat a mostly vegan diet so found one I could take), Calcium and Vitamin C.  I also started taking Arnica homeopathically as well, a spray bottle I squirt into my mouth a few times a day.  I considered taking Aleve for inflammation but I really have mixed feelings about it.  I tried it for one run and I am not really sure how much it helped, and the worry that it might upset my stomach is pretty major for me since I already deal with GI issues.

Exercises and Physical Therapy:  For the first week following my fall, I was pretty much resting the knee and avoiding any activity that hurt.  I got on an elliptical at the end of the first week, pain free.  It was boring but I was happy to be moving without discomfort!  I stuck to my regular routine of core work and Pilates all week though, and modified the exercises that hurt me (shoulder bridges and certain lunges – basically anything that stretched the muscles that inserted at the top of the patella).  After a week or two though once I was beginning to feel better I did these exercises carefully at the guidance of my physical therapist – I needed to retrain the quad muscles to lengthen properly and these exercises were great for that.

Medical Attention:  I went to see my chiropractor, Dr. Wong, right away the day after the injury and have seen him once a week since.  In addition to his excellent chiropractic care, he has done laser treatments, stim, Graston and ART and has helped me with correcting the imbalances that showed up in my body as a result of the injury.  He examined my knee and made sure the injury was not more serious – all ligaments and tendons in tact.  I also saw my physical therapist, Rich.  He confirmed the same diagnosis as Wong and has helped with mobility and strengthening exercises as well as releasing some of the super-tight muscles around the kneecap with dry needling technique.  Rich also taught me to massage the tendon above my kneecap with a cross-frictional technique for 3-5 minutes before I run.  I think that has been really helpful.

Emotional/Mental State:  An acute injury really knocks you down – literally and figuratively.  I felt like I was on top of the world with my running and then in an instant I was trying to climb up out of a major slump physically and emotionally.  The thing is though, I believe that everything happens for a reason and that our biggest struggles are truly our greatest opportunities for growth and strengthening.  My injury has been no fun on a lot of levels, but at the same time I think it has been an essential part of my story and it is building me up in so many ways.  I have learned how to trust my body in new ways, and I have discovered a determination and strength in my heart that is so unwavering and comforting.  I feel like this experience is making me a stronger runner overall and is also going to enable me help others who I know love, teach and coach.  The road to recovery is a bit of a roller coaster ride emotionally and that is all part of the process.  There will be downs and ups, just like there are in running and like there are in LIFE.  You just have to hang on, listen to your heart and to your body, and BELIEVE that you will get better.  Because you will.

I leave for Boston tomorrow and I am so excited to run on Monday.  With each day I can literally feel myself healing and getting stronger.  I will lace up my shoes on Monday morning, proudly pin my bib to my shirt and run with my HEART.  I feel pretty sure that my legs will come along with me for the ride now!

Have you ever had a patellar bone bruise or a bone bruise of any kind?  Do you have anything to share or add about your experience with the healing process?

Are you running Boston on Monday or will you be there?  My bib number is 9465 and I’m in Wave 2, Corral 1.  You can track me by texting 9465 to 345678!