Today, ESPN.com reported Notre Dame coach Mike Brey’s announcement that Luke Harangody might not return this year because of a right knee injury he suffered in a game against Seton Hall on February 11th. The injury, diagnosed as a bone bruise, is one that can take — don’t shoot the messenger, Irish fans — months to heal.
“Bone bruise” sounds like a vague term, but it actually provides a good description of what’s happening in this injury. We associate the word “bruise” with bleeding and leakage of other fluids under the skin that makes that reddish or bluish blotch happen when we bang into something or when something bangs into us. That’s pretty much what’s happening here, but instead of some external force being applied to a part of the body that causes blood vessels under our skin to break — like bumping into a table, or taking a punch with your face — this is happening within the bone itself.
An MRI of the knee (not Harangody's). The white part in the bone? There's your bruise. The bright white stuff in the middle is fluid inside the joint. (image: images.conquestchronicles.com)
When talking about a bone bruise of the knee, you’re usually talking about a force that goes through the joint, meaning along the length of the bone. In other words, there’s been a downward, compressive force that has caused the femur (the big bone in the thigh) to press down on the tibia (the biggest of the two lower leg bones). When that happens, vessels break along the tough, thick outer covering of the bone, leaking blood and other fluid into the bone space. Because of that thick outer covering, that inflammatory fluid tends to build up and stay in that part of the bone — and that’s what causes the pain.
An x-ray (to check for a fracture) and usually an MRI are then done to make sure none of the stuff inside the knee (like ligaments and other stuff not visible on an x-ray) has been screwed up. The ESPN.com report cited above states that there’s nothing structurally wrong with Harangody’s knee, so that’s obviously great news. The problem is that the inflamed area of bone can take months to clear up, and the inflammation makes it very painful to move the knee or put weight on it.
The treatment consists of the usual stuff like ice, rest, and eventually some form of physical therapy to get the knee back to its full range of motion. As I’ve said before, these team trainers and team doctors are an extremely crafty bunch of folks with some really great toys and methods at their disposal, like cold massage and electro-current therapy (those sound fun), that can speed up the healing process.
There’s no doubt Luke Harangody wants to return and hopefully he’ll be pain-free as soon as possible, though he’d probably return even if the pain was at a “tolerable” level. With a bone bruise, though, because of the intensity of the pain, that tends to be later rather than sooner. Harangody, as you know, is on just about everybody’s first- or second-team all-America lists. He’s the second leading scorer in the nation at 24.1 PPG, and pulls down 9.9 boards. The Irish are 2-2 without him, but the two victories have come in their last two games, and at the expense of two ranked teams in Pittsburgh and Georgetown — exactly what the bubble-dwelling Irish need right now.