can you exercise with a bone bruise?

can you exercise with a bone bruise?

(13), Osteonecrosis is another potential risk factor when it comes to bone bruising. A bone bruise is often the stage before a fracture. Return to the starting position. B., Chari, R., Murray, J., Beale, A., & Henson, J. H. L. (2005, June). Please welcome our new Physical Therapist at Best Physical Therapist NYC. If you have, you know A neti pot is used for nasal irrigation. Stand with your feet together. Sitting increases pressure on the tailbone, so avoid exercises like cycling or rowing while you are healing, Instead, try walking for short periods of time, several times per day. Athletes who take part in high-demand sports like soccer, football, and basketball are most likely to injure their ACL. New York, NY 10018 X-rays dont show bone contusions, so it was not until MRIs came about that doctors started to see and discuss the term bone bruise.. Bone contusions may appear along with a bruise on the surface of the skin and be accompanied by symptoms such as stiffness, swelling in the joint, tenderness, and pain that lasts longer than that of a normal bruise. Last medically reviewed on July 30, 2018, Minor bleeding into the skin is common and often the result of an injury. A bursa is a sac of fluid that acts as a cushion at the joints. Bone Bruise of the Knee. If you need to relieve sit bone pain at home, this is a very easy exercise that you can do. MRI studies of acute ACL injury have found bone bruising, contusions, or edema in greater than 80 percent of study participants. In order to do that, you need the best physical therapist. In addition to exercise, other interventions can reduce pain as your bone is healing: If home remedies are not helping, consider seeing a physical therapist for additional interventions such as massage and manual mobilization. Weight-bearing exercises such as walking, jogging, running, stair climbing, skipping rope, skiing and impact-producing sports affect mainly the bones in your legs, hips and lower spine. Remember that time is the biggest remedy in a case like this. Physical therapists can work with you to meet recovery goals that are both realistic and effective. What Exercise Can I Do With Bruised Ribs? If the bone bruise is in your leg or foot, elevate your leg to help ease swelling. Learn more about symptoms and, Bruises happen when an injury causes damage to blood vessels below the skin. Exercise could make a bruise worse. This is when bruising after exercise will most likely be the worst. You may or may not see bruising. For starters, you can try myHomemade Bruise Cream that uses the healing powers arnica, bilberry, comfrey and frankincense. Corticosteroids thin the skin, making it easier to bruise. The foods that can help heal a bone bruise include leafy green vegetables, fruit and cultured dairy. There are three kinds of bone bruises depending on where it occurs on the actual bone. They will also advise you when you are able to begin certain activities again. This MNT, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Bone bruises are among the most serious and painful. Brock, S., What You Need to Know About a Bone Bruise, Livestrong.com, October 21, 2015; Bruised ribs may be an uncommon injury to sustain, but when it happens, it can be very painful, http://www.md-health.com/Bone-Bruise.html, http://www.saintlukeshealthsystem.org/health-library/bone-bruise, http://www.livestrong.com/article/5521-need-bone-bruise/. Gentle movement of the injured area might be encouraged, but formal exercise can make your injury worse. Keeping your head above your heart helps keep blood from pooling around your eye, reducing bruising and swelling. Institute for Orthopaedics and Sports Medicines: What Are Muscle Bruises? Contusion can cause increased pain in a joint that is already inflamed. It is also important to wear the recommended protective equipment while playing sport to help protect the bones from further trauma. There are three types of bone bruises, subperiosteal hematoma, interosseous bruising and subchondral lesion. The exercise (whether it is extensive "pounding the pavement" or "pumping the weights") intensifies over the course of time, leading to a bruise effect. A bone bruise does not automatically necessitate a doctors visit, but you should ideally get seen to rule out the possibility of a fracture. A healthcare provider might also give dietary advice. A foot contusion (bruise) is the result of physical damage to the veins and capillaries (which help move blood back toward the heart). Low-impact yoga poses can help stretch and strengthen your chest during your bruised rib recovery. Well+ Good: How to Relieve Sore Muscles in 5 Easy Steps, According to a Corrective Exercise Specialist, Self & MSN: 14 Ergonomic Office Chairs Recommended by Physical Therapists. The statements herein have not been evaluated by the Foods and Drugs Administration or Health Canada. Osteonecrosis disrupts the blood flow to bones, weakening the integrity of the bone itself, thus leaving it more susceptible to bone marrow edema and bone bruises. Comfrey is calledknit bone for its ability to help fractures heal aidnew cell growth, so its not surprising that it can help a bone bruise heal more quickly. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497019/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445054/, http://www.clinicalradiologyonline.net/article/S0009-9260(05)00042-5/abstract, http://www.ejradiology.com/article/S0720-048X(08)00096-X/abstract, http://www.nhs.uk/chq/Pages/1057.aspx?CategoryID=72. (14). Also, smoking can inhibit the bone healing process and should be avoided, as should heavy or intense pressure on the affected area. Well, 50 percent of those who have sprained ankles have had some type of bone bruise occur. Physical Therapy help in healing a Quadriceps Tear, Get Help for Your Temporomandibular Joint Dysfunction. Physiotherapy is an important treatment for bone bruising of the tibia. A bone bruise is a step before a break and can commonly lead to a fracture. More Information Exercising with osteoporosis of signs you need emergency medical attention or call 911. Most people are familiar with the bruising, discoloration, and swelling that is characteristic after a blow to the muscles and soft tissue. [Abstract]. Like you, walking was ok, stairs were a little painful, and I was raring to resume a vigorous exercise regimen. The area will appear red in color at first, changing to blue or purple, green, yellow-brown, and, finally, a persons normal skin color as the bruise heals. With the approval of your physician, light stretching may be beneficial as well. For each injury, a unique pattern of bone bruising can be found on MR imaging, which results from the acute trauma. do they get our quality seal of approval. [4] An adult human skeleton contains 80% cortical bone and 20% trabecular bone. There does not need to be a visible bruise in order to have a bone bruise. for quality and safety during the production process. Skeletal muscles are made up of bundles of muscle fibres. Swelling is the predominant symptom in bone bruising. The condition may be part of a more serious issue. Treatment of a bruise has to deal with the acute symptoms of pain, swelling and decreased motion. Similar to sprained ankle remedies, bone bruises can be treatedthrough diet, supplementation and rest. The compact bone is the outer portion of the bone. 1202 ). Seated upper-body strength exercises, like dumbbell curls or cycling on an arm ergometer, are excellent exercise options if you have a lower-extremity bruise. Also, if you smoke, it is best to quit as soon as possible as smoking cigarettes can impair your bones ability to heal. using current production and quality control standards. That is usually the journal article where the information was first stated. Disclaimer: Results are not guaranteed*** and may vary from person to person***. Extreme compressive force or rotational mechanism such as testing (shearing force) that literally crushes the cells. Rest is the most important thing in speed of recovery. pain or tenderness that continues after a skin bruise has disappeared, subperiosteal hematoma, in which blood builds up beneath the fibrous membrane that covers the surface of the bone, interosseous bruise, involving bleeding and swelling in the central cavity of the bone, where red and yellow bone marrow is stored, subchondral lesion, where bleeding and swelling occurs between to repair cartilage and the bone underneath, the forces associated with the skin or the muscle being torn away from the bone, two bones striking each other after ligament injuries, do not wear protective equipment for their sport or occupation, reducing swelling by raising the injured area above heart level, applying ice to the injury several times a day, taking analgesic drugs, such as acetaminophen, to reduce pain and inflammation, performing a subchondroplasty, a procedure where a surgeon injects a bone substitute material called. Keep your knees together. A femoral bone contusion is a deep bruise, or hematoma, of the thighbone. New Address & Video Tour, Posture Exercises You Should Add to Your Workout, All You Need to Know About The Graston Technique, Karena Wu on PIX11 NY Living: How to Improve Your Posture, Health.com:Bad Posture Can Be Causing Your Neck and Back Pain and This $19 Posture Corrector Can Help, Womens Health: Lymphatic Drainage Massage- Does It Really Improve Your Health? Bone Bruise, MD-Health web site, http://www.md-health.com/Bone-Bruise.html, last accessed November 30, 2015. You will find that sometimes what you believe to be a simple bump or bruise could actually be quite a bit more serious, and it could be something that would require physical therapy treatment. http://www.livestrong.com/article/5521-need-bone-bruise/, http://bruises.knowingfirstaid.com/permalink.php?article=Bone%20Bruises.txt, https://www.physio-pedia.com/index.php?title=Bone_bruise&oldid=245261. A chest contusion, or bruise, is caused by a fall or direct blow to the chest. Research has shown that bone bruises are associated with ACL tears, patella dislocations, occult fractures and contusions. Read more: Home Remedies to Get Rid of Bruising. Keeping your chest up, slowly shift your weight forward toward the front leg until you feel a stretch in your groin. You will feel much better when you do. This jarring movement can stress muscles and ligaments in your pelvis and delay healing. For starters, bone bruise symptoms typically last much longer than a muscle bruise and result from a more significant trauma than a muscle bruise. Interosseous bruising may result if a person applies extreme pressure to a bone on a regular basis. While these deeper bruises may not show visible signs of bleeding, they can cause pain. Sports participation is growing significantly in high schools in the United States. staff@bestptnyc.com. Most of these injuries occur due to a direct blow to the bone or when two bones smash together. Jungueira and J. Carneiro, Functional Histology 2010; 167, Prof. Dr. S. Van Creveld and Dr. M. Kingma Subperiostal haemorrhage in haemophilia A and B. Ned. New York, NY 10018. The article describes three overlapping phases of healing, including the destruction phase, repair phase and remodeling phase. Trabeculae help provide structure, retain calcium, and other functions related to the bones integrity. Bone bruises are fairly common, so how will you know if youre suffering from one? A bone bruise is differentiated from the alternative fracture types in that only some of the trabeculae are broken. Original Editors - Laurien Henauas part of the Vrije Universiteit Brussel's Evidence-based Practice project. Depending on the size and severity of the bone bruise, it can take several weeks to around four months for one to heal properly. Push your hips upward to work your glutes and hamstrings. Meet ActiveCare PTs New Physical Therapist: Sarah Mostafa PT, PTA, Physical Therapy Case Studies: Chronic Neck Pain & Lower Back Pain, Best Physical Therapist NYC: Recent Press From Dr. Karena Wu PT, DPT, OCS, ActiveCare Physical Therapy Participates in the 2021 NYC Walk to Cure Arthritis, ActiveCare Physical Therapy Treats Patients With Arthritis, 2021 Virtual Walk To Cure Arthritis NYC | A Personal Conversation with Dr. Wu & Jacqueline Cooper Travels, Seneca Women Heres Something Good: How to get back to your pre-Covid workouts, Business Insider India:I Challenged Myself to Stand for 3 Hours a Day for a Week, and my Energy Levels Soared, ActiveCare Physical Therapy NYC | April Newsletter, Why It Is Important to Consult a Physical Therapist for Hip Injuries, Sports Physical Therapy: What Is It and How it Helps Athletes, ActiveCare Physical Therapy joins the Greater New York Chamber of Commerce. [1] In patients with ACL rupture there is an 80% probability of concurrent associated bone bruising at the femoral condyle or tibial plateau. Since the tailbone is located at the bottom of the spine, these exercises focus on stretching.A tailbone bruise is an injury that often occurs from a fall that damages the bottom of the vertebrae in your spine, known as the coccyx. Bone bruise (bone contusion): Symptoms, causes, and treatments. Daily Mail: Jeremy Renners road to recovery explained by doctors: Will he be a Hollywood frontman again? Try Heat Medical conditions such as arthritis may also lead to a bone bruise. Trouble using your joint if the bruise occurs there How to Treat a Bone Bruise A very forceful blow to the chest can injure the heart or blood vessels in the chest, the lungs, the airway, the liver, or the spleen. With an x-ray, it will be possible to diagnose the condition fully. [8] The time for the resolution of a bone bruise is variable. 2 comments. If the bone undergoes avascular necrosis, the resulting damage might be irreversible. Beauty Heaven: Can You Really Spot Target Fat Loss? Yeah, they heal slow, which can be frustrating, but respect the injury and avoid compounding it with further problems. Exercises: Physical therapy including stretching exercises can be started the healing of the shoulder joint bruises. However, once you do begin walking on it again these inserts can be worn inside your shoes to cushion your heel. Reinjury is a real risk for those trying to do too much, too soon. Exercises that involve prolonged sitting or standing can aggravate tailbone pain. The modalities, hands on techniques and exercise prescription that can be utilized by the Physical Therapist can help speed up the healing process. Patients with a bone bruise tend to have protracted clinical recovery, with more effusion and a slower return of motion. The most common cause of bone bruise is trauma however the condition can also be associated with normal stress loading and haemophilia A and B. Then slowly stand back up. Sign Up for the Latest Health News and Tips, Home Pain How to Recognize and Treat a Bone Bruise. Most smallbone bruises heal slowly in two to fourmonths. (11) In fact, a pattern with bone bruises in patients sufferingACL tears is acute and problematic. Medical conditions such as arthritis may also lead to a bone bruise. It is dense, well-organized, and extremely hard. It is important to get the opinion of a medical professional if a person suspects a bone bruise. Avoid smoking, as it can delay bone healing. [1][4] According to Boks et al. ActiveCare Physical Therapy: Nominated for Bethpage Best of The City Award 2021, ActiveCare Physical Therapy Is Practicing Social Distancing, ActiveCare Physical Therapy participates with PT for Heroes, Stretching the Gluteal or Hip Muscles Video, Bustle: The 4 Best Seat Cushions For Back Pain, Good Posture Isnt All About Your Back Heres What Else You Should Pay Attention to, Bustle: The 5 Best Body Pillows for Back Pain. Your doctor may also recommend an anti-inflammatory to help relieve pain and bring down the swelling, and they may recommend the use of a brace to limit movement and allow the joint or bone to heal. Place your back knee on the floor and bend your front knee. A bone bruise is one step below what happens when you have a bone fracture or stress fracture,which is the complete damage and release of the internal trabeculae in a certain bone. A bruised coccyx or tailbone can be painful and can happen for many reasons. [4], The treatment of a bone bruise consists of RICE, pain relief and/or anti-inflammatories as prescribed by a medical practitioner and load restriction dependant on the circumstances of the injury. The physician might request an MRI if symptoms do not improve. Devon is keenly aware of trends and new developments in the area of health and wellness. This type of bruise mainly affects footballers, basketball players, and runners. In most cases Physiopedia articles are a secondary source and so should not be used as references. ActiveCare Physical Therapy Offers ClassPass Sessions! For each injury, a unique pattern of bone bruising can be found on MR imaging, which results from the acute trauma. Batista Bonadio, M., Nogueira Giglio, P., Partezani. Exercises for Bruised Coccyx (Tailbone) bruised coccyx joints pelvic floor pelvic floor physical therapy physical health professional si joint tailbone pain Aug . Hold this stretch for 15 to 30 seconds. (1). Because its not a soft tissue bruise, the pain ismore prominent and lasts longer with a bone bruise. Read more: What Exercise Can I Do With Bruised Ribs? The broken blood vessels leak a small amount of blood into the tissues under the skin. The goal of treatment is to reduce the acute symptoms of pain, swelling, and limited range of motion: Apply an ice pack to the injured area right away to reduce pain and swelling. Returning to an exercise routine too early, or progressing too quickly, can slow the healing process and result in complications such as stress fractures, compartment syndrome and myositis ossificans. What You Must Know , Migraine Relief: 10 Home Remedies for Common Symptoms, Neti Pot: 6 Health Benefits of Nasal Irrigation + How to Use One Safely, Pancreatitis Diet + 5 Tips for Prevention & Management. Bruises can last from days to months and vary from mild to severe. His joint is stiff and swelling. Copyright 2023 Bel Marra Health. A direct hit to your muscle or bone can cause a bruising after exercise, which is bleeding underneath the skin due to tissue damage and broken blood vessels. All our products are backed by a 100% satisfaction guarantee. ACE Physical Therapy and Sports Medicine Institute, Get Back in the Game! Bone marrow edema is now usually referred to as bone bruise to reflect the traumatic nature of the condition. These may be warning signs that the bone bruise is interfering with blood flow, which could result in irreversible damage to that area of the bone. MNT is the registered trade mark of Healthline Media. in government-approved facilities. A bone bruise is characterised by three different kinds of bone injuries including: sub-periosteal hematoma, inter-osseous bruising and a sub-chondral lesion, or a combination of these. Some great choices for a poultice include comfrey, calendula and St. Johns wort. National Library of Medicines list In 1988, a study of ten people with debilitating pain in the hips and knees discovered a condition that the researchers called bone marrow edema. All A butt bruise can be painful, with a black and blue mark that changes color over time. Check out our ActiveCare Physical Therapy YouTube Channel! Simple exercises can provide much needed relief from tailbone pain. Dr. Karena Wu celebrates 5 years at ActiveCare Physical Therapy, Pvt Ltd in India! Brock, S., What You Need to Know About a Bone Bruise, Livestrong.com, October 21, 2015; http://www.livestrong.com/article/5521-need-bone-bruise/. Namely, you can expect to experience pain and tenderness in the affected area, swelling in the surrounding tissue, and a change in color. (, ) In fact, a pattern with bone bruises in patients sufferingACL tears is acute and problematic. The pain doesnt go away. Most bone bruises are caused by direct trauma but repetitive stress, compressive forces, twisting and other health issues can be lead to the condition. Most likely, I presume. Clinical Radiology, 60(6), 627636, Mandalia, V. & Henson, J. H. L. (2008, July). Often, some type of blunt impact causes the bruising. (212) 777-4374 There are three kinds of bone bruises, depending on where it occurs on the actual bone: subperiosteal hematoma, which occurs on the periosteum and is the most painful type; interosseous bruising, which damages the bone marrow and is common in the knee or elbow; and a subchondral bruise, which occurs when the cartilage and the bone separate, causing bleeding within the cartilage. The term 'bone bruise' is actually a misnomer and can sometimes lead people to think it may be a less severe injury than it actually is. The physical therapist has a number of tools at his or her disposal to help you. Related: Top calcium-rich foods for stronger bones (Hint: They arent dairy!). For the all bone injuries, incidence rates tend to be higher amongst professional athletes and those that run and jump frequently on hard surfaces, for example football and basketball players. Mandalia, V., Fogg, A. J. The blood supply within the bone is damaged, and this causes internal bleeding. Bone bruise symptoms include pain and/or tenderness in the affected area, swelling, discoloration, and joint pain near impact zone. The RICE approach may help relieve symptoms and promote healing in knee injuries. specifications following safe manufacturing practices. Be aware of exercises to avoid with tailbone injury. If you are experiencing serious medical symptoms, please see the Don't put ice directly on your skin. http://www.medicalnewstoday.com/articles/314427.php. For instance, have you or anyone you know sprained anankle? Consider using an elliptical or swimming as alternative low-impact activities. The symptoms of bruised bones are similar to other injuries, like regular bruising, sprains, tears or fractures. When it's bruised, just sitting down can shoot a sharp pain right up your spine. Tailbone pain also called coccydynia is most commonly caused by trauma, such as a fall or childbirth. Bone contusions cause deep, achy pain and often . Balance exercises such as tai chi can reduce your risk of falling especially as you get older. It can be a mild injury to the outer cortical layer. Talk with the therapists at ActiveCare about getting the diagnosis and treatment that you need. Apply it to the painful area for about 10-15 minutes, every three or four hours. Literature suggests that the healing time to completely resolve this injury can take anywhere between three weeks to up to two years after the trauma. Your bones are not as solid as the pictures would have you believe. Imaging of Orthopedic Sports Injuries, bruise? Bone bruises can heal in as little as 3 weeks or take as long as 2 years to fully repair. Henson. Femoral Bone Contusions & Stretching. This rise in sports participation has led to an increase in anterior cruciate ligament (ACL) injuries in athletes. 50 Proven Remedies for Fast Pain Relief. Large bruises on your muscles can cause muscle spasms, muscle weakness, swelling and severe pain. Avoid jogging or other high-impact exercises with tailbone pain. A bruised rib can occur due to injury to any area of the rib cage. There are quite a few issues to cause your spine to feel bruised, including: Back injuries are among the most common causes of spinal pain or tenderness. A bone bruise can be extremely painful and limit the functional capabilities of the individual that suffers the injury. MRI Follow-Up of posttraumatic Bone Bruises of the knee in General Practice. You need to set up a consultation with a medical professional. . Avoid placing constant, intense pressure or heavy weight on the affected area to prevent aggravation. Eating a diet rich in calcium, vitamin D, and protein can help the healing process. Bursitis. Most likely, I presume. Treatment of a bone bruise can be conducted at home and normally includes resting the injured area as well as using ice and compression. (. What is the latest research on the form of cancer Jimmy Carter has? Fracture pains tend to feel sharper where bone bruises tend to feel deeper and achier. Sports injuries, motor vehicle accidents, or falls from a height can cause them. Bone bruises can occur after the following forms of trauma: Each of these forms of trauma leads to a unique pattern of bruising the bone. Lie down and place your knee and foot on a pillow so that your entire lower leg is elevated to ease swelling. Devon has written extensively for Bel Marra Health. Note that the numbers in parentheses (1, 2, etc.) Swimming and cycling are two of the main kinds of exercises that will give an athlete a good workout without putting a load on the knee. REQUEST APPOINTMENT, Activecare Physical Therapy | Karena Wus Holistic Method, Activecare Physical Therapy | Dr. Wu: Why I Became A Physical Therapist. Stand with your feet staggered, one in front of the other. 1202 Use an extra pillow to elevate your head when you sleep. In the case of certain types of trauma, this could well be the case, and you may need to have special care. This article is based on scientific evidence, written by experts and fact checked by our trained editorial staff. In patients with ACL rupture there is an 80% probability of concurrent associated bone bruising at the femoral condyle or tibial plateau. Another option is Kinesio taping, which can help promote faster healing and remove all of the excess fluid from the area. Cardiovascular health: Insomnia linked to greater risk of heart attack. Rights Reserved. The ACL runs diagonally across the middle of the knee and provides rotational stability. Hold for 5-10 seconds and lower your buttocks. Bruised heel bone. Of course, using the natural remedies explained here, you can help expedite healing time. If this is the case, you may need additional treatment like physical therapy, or possibly surgery, before you can return to your normal exercise routine. 8 2. With these conditions, the cartilage breaks down, as does part of the bone, which leads the bones to grind againsteach other and be more easily bruised and damaged. If a bone injury is suspected, an X-ray is usually called for. Bone Bruise, Saint Lukes Health System web site, http://www.saintlukeshealthsystem.org/health-library/bone-bruise, last accessed November 30, 2015. A bone bruise can only be seen on an MRI. Bel Marra products are produced Any exercise that is performed prior to the relatively pain-free status should be used to enhance the healing process, increased range of motion and establish normal neuromuscular activity at the injury site. Your bones can also become bruised, a condition which is considered to be a step below a fracture in terms of severity, but this does not make them any less painful or disruptive. Grades of recommendation B, Simone S. Boks, Dammis Vroegindeweij, Bart W. Koes, et al. Topical and systemic corticosteroids can be used to treat various conditions, including allergies, asthma and eczema. A bone bruise is sometimes called bone contusion. The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. A bone bruise happens when some of the fibrous tissues inside the bone, called trabeculae, are damaged. People with hip and knee pain were found to have altered bone marrow density on a magnetic resonance imaging (MRI) scan that was not visible when examined by X-ray. Bone bruises cause damage to the inner layer of bone, which is not as strong as the outer layer of bone. Sincebone bruises are mostly impact-related injuries, its important to wear seat belts, which help reduce injury in car accidents, as well as proper sports protective gear like helmets and padding. However, if there is severe pain and swelling, or. While resting, make sure to properly elevate the bone that has been impacted above your heart to promote circulation and reduce swelling. Bone bruises can be very painful, as the damage and inflammation is in the bone tissue versus the muscle tissue. Certain dietary supplements, such as ginkgo biloba, also can increase bruising risk due to a blood-thinning effect. If you are concerned that you may have a severe bone bruise, it is best to contact your doctor and receive a proper diagnosis so treatment may begin as soon as possible. In one study, 80 percent of those who had an ACL tear experienced bone bruising. In the area around the bone bruise, symptoms may include: Bone bruise pain lasts longer than pain from a soft tissue injury. We avoid using tertiary references. The third kind of bone bruise is known as a subchondral bruise, which occurs when the cartilage and the bone separate, causing bleeding within the cartilage. Injury of any kind can cause a bone bruise.

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can you exercise with a bone bruise?

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