Lisfranc Injuries – what are they and what can you do about them?

side and aerial views of foot bones showing where lisfranc injuries can occur

Lisfranc injuries are common in sports such as AFL, NRL and soccer.

Because of this, they are often spoken about in the media.

It is referred to as a ‘dreaded’ injury as it takes a while to recover.

Today, we’re going to tell you exactly what a Lisfranc injury injury is and how we can treat it.


What is a Lisfranc injury?

A Lisfranc injury occurs when there is a dislocation or fracture between the 1st and 2nd toes and the midfoot.

It can result in tearing of the ligaments that connect the bones, which can also affect the cartilage between bones.

Lisfranc injuries are also referred to as midfoot sprains and tarsometatarsal (TMT) injuries.

There are 3 stages of Lisfranc injuries:

  • STAGE 1: Classed as a sprain of the Lisfranc ligament with no separation between the 1st and 2nd digits.
  • STAGE 2: Classed by a rupture of the Lisfranc ligament, as well as some separation between the 1st and 2nd digits.
  • STAGE 3: Classed by a rupture of the Lisfranc ligament and separation between the 1st and 2nd digits of more than 5mm.


What does a Lisfranc injury feel like?

Symptoms of a Lisfranc injury include swelling, bruising, and pain through the top of the foot at the forefoot.

The pain often worsens when weight bearing and can be quite severe.

Pain is generally at its worst during the propulsion/toe off phase of the gait – when the joint in question is under the most amount of pressure.

The pain can continue to worsen if not treated properly.


What can cause a Lisfranc injury?

A Lisfranc injury can occur with a simple injury involving twisting of the feet and falling or through impact when the toes are flexed.

It can also be caused by a direct force placed on the area, such as in a crush injury.


Who does it affect?

Lisfranc injuries are most common in athletes and rarely affect the general population.


How are Lisfranc injuries diagnosed?

Proper diagnosis of a Lisfranc injury is crucial in order to avoid a delay in treatment.

If you have been experiencing pain for more than 5 consecutive days in the area, it is important to consult a podiatrist as soon as possible.

If pain is present on the palpation of the site, as well as with simple range of motion tests, we may suspect a Lisfranc injury.

We will send you for an X-ray or MRI to confirm the diagnosis and determine the extent of the injury.


How is a Lisfranc injury treated?

Immediate and proper treatment is crucial to assist with the healing of a Lisfranc injury.

How the injury is treated is dependent on the severity of the injury, and can include:

  • The use of a CAM boot/Moon boot – This will help to completely offload the area and allow the structures to heal, whilst also keeping you mobile.
  • A strengthening program – This will involve simple exercises to help increase the strength of the muscles within the feet. It will also target muscles in the lower leg, such as the calves.
  • Orthotics therapyOrthotics can assist with redistributing pressure through the feet and allowing the feet to function efficiently in proper alignment.
  • Padding and strapping – Offloading the injured site with the help of padding and strapping can assist with pain relief.
  • Referral for surgery – If there is a rupture of the Lisfranc ligament, significant separation of the 1st and 2nd digits, or a fracture, surgery may be the best course of action to repair the joint.


If you’re experiencing pain to similar what we’ve discussed today, or any pain or discomfort in your feet and/or lower limbs, come see us at Watsonia Podiatry. You can book an appointment with us by calling us on 03 9432 2689 or online here.


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