Midfoot Sprain Causes, Symptoms & Treatment Options

The midfoot is the middle region of the foot that connects the back (hindfoot) with the front (forefoot). The midfoot bones and ligaments help to form the arch of the foot. The midfoot is supported by five bones: the cuboid, navicular, and the three cuneiform bones, as well as several ligaments. An injury to one or more of the ligaments that connect these bones is called a midfoot sprain, often resulting in mid-arch injury or midfoot instability.

A midfoot sprain can occur in different grades, each one classified by the severity of the injury:

• Grade I: There is stretching and microscopic tearing of the ligaments.
• Grade II: The ligaments are partially torn.
• Grade III: The ligaments are completely torn.

One type of severe midfoot sprain is called a Lisfranc injury, a serious form of foot trauma.

A midfoot sprain is usually the result of an injury from cutting and twisting motions of the foot (for example, if the foot is planted while the athlete turns and pushes off). This type of foot trauma can overstress the ligaments and bones in the middle of the foot.

Midfoot sprains are common in these sports:

• Basketball
• Field hockey
• Football
• Soccer

You may have a midfoot sprain if you suffered an injury and have the following symptoms in the foot:

• Pain in the middle and top of the foot
• Swelling and bruising
• Pain with weight-bearing

If you experience an injury and have symptoms of a midfoot sprain or injury, treat initially using the following steps:

1. Rest (you may need crutches if your pain is extreme). While complete rest is not needed, you want to make sure that you do not do any activities that can aggravate your foot.
2. Ice the affected area intermittently throughout the day. It is a good idea to use ice for 20 minutes every few hours for the first 48 hours or until the swelling is gone
3. Elevate the foot as much as you can to decrease swelling

If initial treatment does not relieve pain and/or swelling or if you are unable to bear weight on the foot, make an appointment to see an orthopedic specialist. Your doctor will do a physical examination of the foot and may prescribe the following imaging tests to look for damage to other structures, like a bone fracture:

• X-rays
• MRI

Midfoot sprains are mostly treated using non-operative treatments, which include:

• Resting the leg and using crutches to keep weight off of the foot. While complete rest is not necessary, you want to make sure that you do not do any activities that may aggravate your foot.
• Immobilizing the foot with a boot
• Icing the foot intermittently throughout the day.It is a good idea to use ice for 20 minutes every few hours for the first 48 hours or until the swelling is gone.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, to help relieve pain and inflammation.
• Physical therapy with a licensed professional to stretch and strengthen the foot to prevent recurrence in the future. Physical therapy exercises may begin with some gentle stretching and later advance to more strengthening exercises.

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Midfoot Sprain

Most midfoot sprains are treated non-operatively. If your doctor finds that you have a more serious midfoot injury, such as a Lisfranc injury, surgery may be needed to correct midfoot instability or extensive foot trauma.

The time it takes to recover from a midfoot sprain depends on the severity of the injury. Mild midfoot sprains can heal in four to six weeks using conservative treatment methods. Patients who suffer a severe foot ligament sprain may need at least three months to regain the foot’s stability and flexibility. Full recovery, which includes patients returning to high-impact activities like running and jumping, can take three to six months.