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Athletic Training

Bruised lower fibula treatment/recovery

09/25/2006

Question:

About 2 months ago, I took a puck off the lower fibula playing ice hockey. An x-ray apparently showed no fracturing, so no cast was applied, just crutches for a few days. Stayed off for 3 weeks, then went on an active trip (toughed through the pain, stupid but thats what I did) for two weeks. Returned and have stayed off since (4 weeks). The injury does not seem to be improving now, I can walk without a limp, but cannot run. Long walking periods cause some swelling and pain. But with no fracture, only treatment I`ve been advised of is time. To the touch, feels like a hard bump on the bone. Advice?

Answer:

Thank you for your question.  Based upon your mechanism of injury and current state, I would consider your problem to be either a bone bruise or a possible stress fracture. 

With a bone bruise, the outermost layer of the bone (periosteum) can be lifted off the bone and blood will fill in under the space between the periosteum and the bone.  This blood can then harden and possible calcify into bone over time.  There are a number of treatments you can get at a Sports Medicine Clinic to reverse and/or limit this possibility.

Stress fractures may not show up on an initial x-ray.  With our athletes, we will often obtain a second x-ray one to two weeks after the initial x-ray.  Recurrent swelling in an area is one (of many) signs of a possible stress fracture.  Depending on where the stress fracture is located, treatment can vary from simply modifying activities to using a walking cast.

Although you have been able to tough it out up to this point, I would recommend you follow up with your physician so you can get the proper diagnosis and then begin the best treatment to get you back out on the ice playing hockey.

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Response by:

Vincent J O'Brien, ATC Vincent J O'Brien, ATC
Head Athletic Trainer
Clinical Instructor at the School of Allied Medical Professions
College of Medicine
The Ohio State University