Bone bruises after an ACL injury deserve more respect than they sometimes get.

Not all ACL injuries follow the same rehab trajectory, and bone bruising is one big reason why. A larger bone bruise often reflects a bigger joint insult, which can mean more pain, more irritability, and a slower early recovery.

That matters, because two people can both have an “ACL injury” on paper, but present very differently in the clinic.

Big takeaway: same diagnosis doesn’t always mean same timeline. The bigger the bone bruise, the more likely rehab may need a little more patience, a little more symptom-guided progression, and a little less rushing.

Image Reference: Nakamae et al (2006)

Anyone else see this a lot in ACL rehab?

learn.physio / The ACL Hub