Bone Marrow Edema HELP!!

Morning,

 I was looking for some help and advice.  8 weeks ago I got a pain on the outside of my ankle!  I rested it for 8 weeks and still didn't improve so last week I went to Bupa and got an X-Ray and MRI scan.  It showed up that I have Bone Marrow Edema and they can't really help me.

 Has anyone ever had this and can recommned any stretches etc?

Any help would be greatly recevied.

 Regards

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Comments

  • From a quick google

    Not sure how stretching will help the inside of your bones, But there you go....

    A qucik google gave pages and pages of stuff..... If BUPA said there was nothing they could do, I'd ask for my money back !

  • Thank you Dave.

     I've googled it and looked at everything.

    Just hoping someone hear had the same issue and got it sorted.

  • Hi

    I had it in my medial malleous, inner ankle bone after marathon training and had
    To pull out of my marathon at last minute image
    I took 3 to 4 months off, the more you can keep off the leg the quicker it will heal
    the time just depends on severity and individual

    The doctor did think it was a stress fracture so he'd already put me in an air cast boot
    And crutches so I used that for about a month

    If you haven't done loads of miles or ramp up miles too quickly (ie training errors )
    it might be worth seeing a podiatrist to look at your gait in case that is causing it?

    It's a year on and my odema is gone but I'm still having ankle issues
    so back to docs again for me! Sigh

    Hope this helps, I do sympathise

    Oh you should be able to swim and try biking before you start running
    Basically none impact exercises

  • Excellent - thank you Laura.
  • Think of it as a precursor to a stress fracture...

    You need to rest it and do non impact exercise

  • Thanks OW.

     I am going to take a week off work and completely rest it.

    Did you have the same injury?

  • So frustrating that it is still present after your 8 week lay off.

    Marrow oedema is the stage prior to bone stress (prior to stress fracture). There is not a whole lot you can do about it other than give it rest, keep cardio fit in a non or very low impact manner - cycle, deep water run.

    Do you have pain on walking? if so going onto crutches for a few weeks may give it a bit more rest.

    The body will slowly resolve the swelling, the aching and pain will start to settle and then you can increase to X-trainer and stepper and then as it recovers further you will be able to start with light pool run and then jogging.

    It usually settles in about 8 weeks (depending on what you have been doing), unfortunately in some cases it can take quite a bit longer.

    You want to feel that the symptoms are slowly settling. My test for runners is to get them to hop x 10 on the affected leg with no reaction, then hop x 50 and look for any sign of a reaction. If that is ok they can start a light jog looking for symptoms over a 24 hour period.

    Depending on male/female there may be issues related specifically to the female athlete - you can look up a thing called the female athlete triad.

    Hope this helps your understanding unfortunately it is not going to make it get better any quicker.

    Stay sane

    Greg
  • Thank you Greg I really appreciate your advice.

    I have pain walking - Hopefully my full week off will help the issue.

    Any thoughts on the cause of the injury?

    Thanks

  • I assume you are a runner?
    You would have to look firstly to your training program - most bone stress injuries are as a result of over training / high impact.
    You also need to look into your biomechanics - poor bios can place extra stress on parts of the body and sooner or later trouble will strike especially as one increases the miles or increases the speed.

    If you can go and see a running physio - need to have it looked at and discuss the issues around the area and how to protect it. As Laura mentioned earlier "the more you can keep off the leg the quicker it will heal the time just depends on severity and individual.
    The doctor did think it was a stress fracture so he'd already put me in an air cast boot and crutches so I used that for about a month"

    Greg
  • Great thank you.

     When I do heel drops the pain seems to go - which doesn't seem right.  Any ideas?

    Many Thanks

  • Probably because at that moment you are not loading the fibula / lateral malleolus (ankle region) as when you are flat footed.

  • Great - thanks once again
  • Great advice from Greg!

    Good luck Supersonic.

  • Greg - would ice and ibuprofen speed up my recovery?

     Thanks

  • We prefer not to use Anti-inflammatory medication as this reduces the signal for the body to heal the area.
    Ice can help - i am a big fan - see how it feels.

    Unfortunately there are no short cuts.

    Try to keep fit so that your return to activity is not delayed more than necessary.

    Greg
  • Excellent - thanks again
  • Aqua running?    the first week of my injury (full stress fracture) even that hurt. I had night time bone pain (kept me awake)

    I'd really caution pushing it too soon.

  • Thanks OW.  Any tips you can pass on?
  • Hi All,

    Bupa got back in touch and have given me a zoledronic acid infusion. He is 100% sure this will sort the issue. Got this on Thursday, however one of the side affects is the Flu so I am not able to go out for a run.

    Has anyone heard of this as a cure?

     

    Thanks

  • Hi



    So is this to cure your Odema?

    I've never heard of this I'm intrigued?



    I thought you just had to rest and get your biomechanics looked at?



    Laura
  • Yes it is.  He said he had use this 44 times and it worked 42.  I went out for a run this morning and to be honest I don't think it has worked.  He said if this didn't work I would have to let it sorted itself out which can take 12 months.  I've been 4 months now and going out of my mind!

    Laura - where abouts is your odema?

  • Hi Supersonic,

    When was your infusion?

    Zoledronic Acid is a biphosphonate that is more commonly used in treatment of cancer patients and osteoporosis. I've looked for research in it's usage for stress fractures and didn't find very much. What I did find suggested It "significantly improved the strength of the healed fracture" and led to "stronger callus formation" (bony callus is the new tissue the body uses to heal a fracture). But this research was on rats! There may be better research out there but I haven't been able to find it for you yet!

    Bony healing is a balance of building new bone (anabolic activity) and breaking it down (catabolic activity). Zoledronic Acid is described as an anti-catabolic drug - that means it helps ensure more new bone is made than is broken down. So in theory it should aid healing but I'd imagine it's not an immediate affect or an over night cure - the bone will still need time to heal.

    Where is the problem? The bone involved and location of the issue makes a huge difference.

    Thanks

    Tom
  • Hi Tom,

    Thank you for the message.  It is located on the outside of my left ankle just at the heel (sorry not sure the name!). I got the infusion on Thursday and was told by the Doctor it would work straight away if it was going to work.  Have you had the same issue?

    Any advise would be great.  Not run for 4 months and going crazy!!

  • I've written an article on bony shin pain if you fancy a read;



    http://runningphysio.wordpress.com/shin-pain-part-one-2/
  • Great will read it now.

    What do you suggest to get me back running?

  • tricialitttricialitt ✭✭✭

    I can't see how the infusion could possibly work right away, but I'm intruiged by the thought of using it to help heal a fracture- yes, it's used in metabolic bone disorders, but surely if it worked in fracture healing, it would be standard practice to use it in all broken limbs! ( although, of course , cost is an issue there, whereas not so much in the privalte sector)

  • I asked the same question and was told it is at a very early stage and once they have tried it out more they will launch it to everyone. He said it would reduce the swealing rather than the fracture. 

  • I agree with Tricialitt, can't see how it would work straight away.

    So is it a heel fracture? Or is it the fibula?

    Did your consultant say you can return to running on it?
  • No mention of fracture at all.  Said it was Bone Marrow Edema after the MRI.  The first consultant said he couldn't do anything and referred me to the Dr who made the infusion.  Told me if this didn't work I would just have to live with it!!

    I have attached a picture to show you were the pain is.

    /members/images/470391/Gallery/untitled_0.png

     

     

  • Have you had a second MRI to see if the oedema has settled?

    I wouldn't recommend a return to running until

    A) the oedema has settled

    B) you can hop repeatedly on that leg painfree (as I think Greg mentioned in his post)

    Really I'd want the go ahead from your consultant. Not all stress reactions (like marrow oedema) will heal in 4 months I'm afraid.
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