The midfoot is crucial for stability and transferring power during movement, so when you injure it, your season could be significantly hindered. We at Your Next Step know this as a Lisfranc injury, and while perhaps not as commonly discussed as ankle sprains, understanding them is vital, especially for athletes and active individuals. Let’s explore its symptoms and causes in detail.

What is a Lisfranc Injury?

A Lisfranc injury involves damage to the bones or ligaments in the midfoot (think literally about the middle of the foot).

This area is stabilized by the Lisfranc ligament, which connects the first metatarsal (the long bone leading to the big toe) to the medial cuneiform (a midfoot bone). Injuries can range from simple sprains to fractures and dislocations.

Rarity and Symptoms of Lisfranc Injuries

Lisfranc injuries are not common at all, as about 1 in 55,000 people per year get them. However, certain groups are more at risk than others (as we’ll discuss later). Symptoms can range from subtle to severe, and they often lead to misdiagnosis.

Common signs include pain in the midfoot area, which may worsen with weight bearing. Swelling at the top and bottom of the foot, difficulty walking, pain in the midfoot, and a nasty bruise on and around the sole are all hallmark warnings.

Who is at Risk of Lisfranc Injuries?

Certain athletes are more susceptible to Lisfranc injuries due to the nature of their sports. Football players often sustain Lisfranc injuries from falling awkwardly while their feet are wrapped by another player.

Soccer players can get twisting injuries during pivots and slides. Horseback riders’ feet can get caught in the stirrup during a fall. Snowboarders can get stuck in their boot bindings and fall in such a way that the feet twist or hyperextend. Typically, it involves a lot of situations in which the feet get stuck.

However, athletes aren’t the only ones at risk. Anyone can sustain a Lisfranc injury from a fall, a direct blow to the foot, or even a seemingly minor misstep. For instance, stepping into a pothole awkwardly can generate enough force to damage the midfoot ligaments.

What are Lisfranc Injuries Mistaken For?

Due to the varied and sometimes subtle symptoms, Lisfranc injuries are frequently mistaken for less severe conditions, most commonly:

• Ankle sprains: Pain and swelling can be localized around the ankle. However, Lisfranc injuries typically involve more midfoot tenderness.
• Midfoot sprains or strains: These can be difficult to differentiate without proper imaging, as the symptoms can overlap. However, Lisfranc injuries often involve more significant instability.
• Plantar fasciitis: While both can cause foot pain, plantar fasciitis typically presents with pain, specifically in the heel and arch.

Dr. Eric Ricefield, Dr. Mark Yagodich, Dr. Aliza V. Eisen, and Dr. Cassandra Stache are happy to solve your foot and ankle problems. Book your appointment and contact us today!