A bone bruise cannot be trivialized. One cannot just take pain medicine and ignore the symptoms. Despite Roethlisberger’s ironman reputation, he can’t just play through it. Edema or swelling in the bone can lead to complications and articular cartilage loss if not careful. What is a bone bruise? It is not a simple contusion that is treated with ice and managed symptomatically. A deep bone bruise is essentially a microscopic fracture, much like a ligament sprain is a microscopic tear. I am not suggesting it is a true fracture that needs surgery or casting, but there is compromise to the integrity of the bone in order to get the swelling/fluid inside the bone. Think of the bones of the knee being covered by articular cartilage like the dirt of the football field has grass on top. When an elephant stomps on the grass, the dirt underneath can be damaged/compressed. In order to allow the grass (articular cartilage) the best chance to rejuvenate and heal, you can’t keep playing football on it. The “keep off the grass” sign allows a chance to heal. Last year, Broncos LB Danny Trevathan was placed on short-term IR for a bone bruise. As a result of recurrent injury, he needed offseason surgery. I am not suggesting this will happen to Roethlisberger, but the top Steelers medical staff will have this in mind as they allow their QB to return to play
per dr david chao