Lisfranc Injury | Midfoot Sprain – Causes, Treatment and Prevention
A lisfranc injury/midfoot sprain is not an athletic injury that you hear about all that often. The lisfranc is the midfoot, and it refers to either bones or ligaments in the midfoot being broken or torn. The midfoot is made of many little tiny bones and ligaments. Because of the number of structures in the area, it can be complicated to pinpoint the problem without the help of a medical professional.
The midfoot is critical in stabilizing the arch when doing any walking. If there is an injury to this area, it can cause immense pain when walking nevermind running or jumping.
The injury can be simple and affect one joint, or it can be more complicated and change more than one joint. These injuries include ligament strains, fractures as well as bone dislocations.
Lisfranc injuries tend to affect cartilage of the midfoot bones. Cartlidge allows bones to move around each other smoothly. When the cartilage gets damaged, it can make the midfoot even more painful. If this issue is not corrected early on with the right surgery, it could result in arthritis.
Types of Lisfranc Injury/Midfoot Sprain
- Sprain or Rupture – Ligaments between midfoot bones can be stretched or torn.
- Fracture – When bones of the midfoot are broken into smaller pieces than they already are
- Dislocation – When bones of the midfoot slide out of place without breaking in any way
Anatomy of Lisfranc Injury/ Midfoot Sprain
- Lisfranc is a region of the midfoot which is why it is called a midfoot sprain as well
- Meant for joint stabilization of the arch
- Can be injured in multiple ways
- Made of many ligaments, cartilage, and bones
Causes of Lisfranc Injury/ Midfoot Sprain
- Twisting or falling down
- Trauma to the area
- Fall from height
- High energy injuries = Fall from height
- Low energy injuries = Fall from a trip or stumble
Symptoms of Lisfranc Injury/ Midfoot Sprain
Common symptoms of Lisfranc injury include the following:
- Swelling at the top of the foot
- Bruising at top and bottom of the foot
- Pain from standing, walking, and jumping
- Pain so severe that weight-bearing is not possible
Treatment of Lisfranc Injury/ Midfoot Sprain
You have two routes that you can go here. If you are used to starting all health issues with your family doctor, you can go there, if you are an athlete or pretty active you may want to start with a sports medicine professional. Either way, the process will start like this:
- Healthcare provider will discuss concerns
- Will evaluate ankle and foot
- Some tests may seem painful, but they will not make the injury worse
- Healthcare provider will look for things like bruising, tenderness along midfoot, swelling, pain when wiggling toes, and pain while doing heel raises
Imaging for LisfrancInjury/ MidFoot Sprain
The advantage of seeing your family doctor or going to a sports medicine doctor is the fact that they can order imaging for you if needed. Imagery Includes the following options
X-Ray– An x-ray is excellent for seeing broken bones and the placement of dislocated bones from a lisfranc fracture. Also helpful for X rays to be taken of the uninjured foot to help with the comparison.
MRI – MRI scan creates a better picture of soft tissue vs. bone.
Cat Scan – Much more detailed picture than an X-ray. It is not needed at all for a lisfranc fracture. It would be ordered if there was a surgery happening so that a doctor could understand the full depth of the injury.
Going the nonsurgical route is always going to be your best bet if possible. The reason for this is that surgery is very invasive and there is no reversing the damage that it can do. This option works best when there are no fractures, dislocations or completely ruptured ligaments.
The rough part of the nonsurgical option is not weighted bearing for the 6-8 week period. This often means being on crutches or in a boot. Then slowly progressing back to regular weight-bearing and activity.
Nonsurgical Additional Treatment for Athletes
Any athlete going the nonsurgical route will want to rehab extensively and also continue doing exercises to make sure the injury does not happen again. We will explain this exercise in the prevention section below.
The reason seeing sports medicine professional is so important as an athlete is because you have to rehab a bit harder than a nonathlete would need to. The reason for this is because the demands you place on the body are much greater.
If you are a basketball player, for example, your rehab should end with you dunking off of one foot because that is what your sport requires. If you cannot do that without pain, then you are not healed yet.
What you see a lot of athletes go through this, they think are healed and find out they are not when they get back into their first game. They either reinjure themselves or realize that they are not ready yet.
Surgery is recommended for all lisfranc injuries that involve fractures, dislocation or ruptured ligaments. The goal of the operation is to realign the structures and repair anything that has been torn or broken.
Fixation – The surgery often involves holding everything in place with plates and screws.
Fusion – In cases where damage is severe and cannot be repaired, fusion is used as a surgical option. The idea is to fade or “weld” together damaged bones so that they heal as one bone. This is one of the worst options for athletes.
After surgery, the need is still there for rehab like above. The only difference is that the rehab may need to be longer and a more extensive.
Prevention of Lisfranc Injury/Midfoot Sprain
The best way to recovery from a lisfranc injury is not to get hurt at all. When you focus on the prevention of injuries, you can increase your chances of staying healthy.
Roll Feet on Golf Balls
- When the muscles of the feet are tight, the foot does not function properly
- Using a golf ball helps to stop small bones of the feet from sticking together
- Find the shoes that are the right fit for your feet
- Look at five sets of feet, and you will notice that they are all different
- Feet are unique, and you need to find the brand and pair of shoes that best for you
- Exercise helps with arch strength and support
- Move big toe towards heel and heel towards the big toe
- Drive arch upward
Finding The Best Local Sports Medicine Providers for Lisfran Injury/Midfoot Sprain
9INE POINT Health is the best place to start your search for a health care provider to help you stay healthy. The key to success as an athlete is staying healthy and making sure the lisfranc injury does not get out of control.
9INE POINT Health lets you search for providers by type and skill. For example, you can look for a Physical Therapist that also knows Specializes in Feet. It does not matter what kind of provider you need, 9INE POINT Health can help you find them and help you to sort through their skills.
If you are unsure where to start your journey, 9INE POINT Health will ask you questions and help you figure out the best starting place. All you have to do is answer a few questions. From there 9INE POINT Health will connect you with the type of provider best suited for your needs. It does not matter if you are injured or recovering from a lisfranc injury.
The platform makes it easy to compare health providers as they are all given a 9INE POINT Number. Once you are shown the best local options, how do you know which is the best? Reading bios and reviews is just not enough because you need more than that.
Skill Sets to Look for In Sports Medicine Providers
Skill sets are the things healthcare providers learn after they graduate. A healthcare provider can take courses and get certifications for different skill sets. These skill sets are valuable and help them approach injuries from different perspectives for the benefit of your lisfranc injury or Midfoot Sprain.
- Dry needling
- Joint Manipulation
- Active Release Technique
- Graston Technique
- Functional Movement Screen
- Fascial Stretching
- Strength and Conditioning Coach
- Athletic Trainer
- Sports Background
- And many more
KHO Health was acquired by was acquire by 9INE POINT in the summer of 2019 and is now referred to as 9INE POINT Health.