Lisfranc Injury Causes, Symptoms & Treatment Options

Lisfranc sprains and fractures are injuries that occur to the Lisfranc joint complex located in the middle region of the foot. The midfoot is home to a number of bones, ligaments, and muscles. For this reason, an injury to the Lisfranc joint can oftentimes be complex. There are three layers of ligaments in the Lisfranc joint that can be affected by injury:

• Dorsal (on top of the foot)
• Plantar (on the bottom of the foot)
• Interosseous (between the dorsal and plantar ligaments)

Lisfranc injuries typically occur with twisting and falling motions. They can also occur with crushing or compression of the foot, like if another player jumps and lands on your foot during a game.

Lisfranc sprains and fractures are most common in these sports:

• Ballet
• Basketball
• Football
• Gymnastics
• Soccer
• Volleyball

Symptoms that develop as the result of a Lisfranc injury will depend on the severity of the injury. For example, a sprain will most likely present as tenderness and/or swelling, while a fracture is generally accompanied by severe bruising on the bottom of the foot. Other symptoms of Lisfranc injuries include:

• Bruising of the arch
• Pain in the midfoot with activity
• Pain that worsens with standing or walking

If you have pain and swelling that do not subside with rest and ice, make an appointment to see an orthopedist specialist. You may have a more serious Lisfranc injury, such as a complex sprain or a fracture. During your appointment, your doctor will check for signs of a Lisfranc injury, like if your midfoot is tender to the touch, if you have bruising in the arch, and if you have pain with standing and/or walking.

In order to make a definitive diagnosis, your doctor will order an x-ray of your foot. Placing weight on the foot during the x-ray will reveal broken bones and dislocations. A stress x-ray may be required to examine the foot for ligament injury. During a stress x-ray, a medical assistant applies stress in a specific direction on the foot to look for places of instability. If an x-ray suggests a Lisfranc injury, your doctor may recommend a computed tomography (CT) scan in order to determine the extent of the injury.

Initial treatment of Lisfranc injuries involves immobilization of the foot by wearing a protective boot and restricting activity. You may be required to wear the protective boot for up to six weeks in order to allow the foot to properly heal. During this time, you will be expected to follow the “RICE” treatment method: rest, ice, compress, and elevating the foot.

If you have a mild sprain, a physical therapy program with a licensed professional should be started after the initial treatment of immobilization and activity restriction.

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Lisfranc Injury

Severe injuries to the Lisfranc joint, such as a tear to the Lisfranc ligament, oftentimes require surgery to restore proper anatomy to the foot. The procedures that are used to treat serious and/or complex injuries to the Lisfranc joint depend on the severity of the injury.

The recovery from Lisfranc injury depends on the severity of the injury. Even with more mild sprains that are treated conservatively, recovery may take up to three months. With surgery, you may be restricted from weight-bearing activities for as many as six to 12 weeks. Full return to sports can take up to six months following surgery. Your doctor will give you clearance to return to full activity when the ligaments and bones have healed and you have full range of motion and strength.