I’ve had a bone bruise for 10 months and I’m still not running. What does that mean? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
Today’s episode actually comes from one of your comments on Doc On The Run YouTube channel and this comes from Colin, and he wrote in saying that he had a bone bruise and he made this comment on one of the videos on the Doc On The Run YouTube channel that was specifically “Bone bruise vs stress reaction in a runner”.
Since he’d been told that he had bone bruise, I guess this video appealed to him and after watching that, he commented and he said, “I’ve got a bone bruise, which he said was a grade 4 Chondromalacia behind the patella, which is of course the kneecap, I’ve had it for ten months, sudden onset. I’m fit, 45 years old and I cannot run since October of 2022. Any ideas to help me please?”
Well, yes, I always have ideas. But the first thing I’ll tell you is I don’t treat knees so I cannot give you medical advice on knees, but that doesn’t matter. I don’t get medical advice through YouTube comments anyway. But no matter what you’re running injury, there are some ideas I have that may help no matter what the situation is if you’re injured and you’re not getting back to running.
In his case, it’s been 10 months since his diagnosis, and he’s still not running. So, what advice would I have? Well, even if this was something that I do treat like a metatarsal stress fracture or a plantar plate injury, or peroneal tendinitis or something like that, what I would say is you really need to do four things specifically right away.
Number one, first and foremost, you need to write down your running goals in clear detail and making the pain go away behind a kneecap is not a goal. That’s an objective. What a goal is like “I want to run the St. George marathon in under four hours” or “I want to run the Houston Marathon in three and a half hours”. You need to have a goal that’s running oriented and not pain or injury oriented. That’s number one.
Number two, what I would do is I would say, “You need to figure out what you can do today, not tomorrow, not after the injury heals but what you can do today to start rebuilding running fitness” and no matter where you are in your phase in your running injury recovery, you can always start regaining and rebuilding some of that running fitness today. And so that’s number two, is figure out how to start doing that immediately.
Number three, I would get a second opinion to confirm the diagnosis. No matter what the injury if you had an injured for ten months and you’re not better, there’s two possibilities. Possibility number one, you’re doing all the wrong stuff. You’re just not following directions. I assume that Colin was following directions and yet he’s frustrated because he’s not getting better after he’s been doing the right things for 10 months. But if you’re doing the right things for the wrong condition, then that means that you got the wrong diagnosis, which is the second reason you should get a second opinion.
You need to figure out, are you really doing what you’re supposed to do? Or are you doing stuff that should help but you are treating the wrong condition. Getting a second opinion is the third thing that I would recommend here for Colin and that can really help you sort out what you can start doing differently so you can start improving differently.
The last thing is that when you go get that second opinion, hopefully you can find somebody that works directly with runners who knows a lot about running. But no matter what, even if you just pick somebody in your neighborhood or who’s on your insurance plan, you need to focus your second opinion doctor’s visit on your running goals and not the injury. So, you don’t want to go in and say “I have knee pain. I’ve had it for ten months I want it to go away”, that’s going to be the focus of the doctor and telling you to do nothing might be their first step.
Instead, you go in and say, “I’m signed up for the Houston Marathon in February, and I want to be ready to run that. I got this little problem with my knee. I need to get that problem out of the way so that I can go run the Houston Marathon.” That’s the way to actually redirect your physician when you walk in, so they really do focus on “Okay, this guy’s fixated on the race, I have to get him through the race. Let’s talk about how to do that.” That is really the four steps that I would recommend for anybody that has an injury that has not been getting better.
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