Midfoot sprains can be quite painful with symptoms consisting of bruising, swelling and inflammation. Midfoot sprains are also called Lisfranc sprains/fractures within the medical community. Lisfranc injuries are the most undiagnosed and untreated traumatic injury in the foot. The Lisfranc joint involves the midfoot bones of the 1st Metatarsal, 2nd Metatarsal, medial, intermediate, and lateral cuneiforms, and the associated ligaments. The mechanism of a Lisfranc injury can either be direct or indirect. A direct injury can be caused by dropping a heavy object on your foot or a crush injury to the top of the foot. An indirect injury can be due to stepping off a curb wrong, sudden rotation on a plantarflexed foot, or forced dorsiflexion of the foot: often times these types of injuries occur with sports such as football, soccer, snowboarding, or gymnastics. Because of how they occur, midfoot sprains and Lisfranc injuries are considered common sports injuries among athletes and active individuals.
Some of the classic symptoms of a midfoot sprain or Lisfranc injury include: pain, swelling, and bruising. Pain will typically be amplified with weightbearing, simple turning of the foot, or any stress applied to the foot. Because these symptoms can overlap with other foot conditions—such as haglund’s deformity or Achilles-related problems—proper evaluation is essential. Diagnosis of midfoot sprains is sometimes difficult, but starts with a physical exam. This is one of the reasons it is important to see a podiatrist for foot pain, especially when symptoms persist or worsen with activity. Imaging modalities, such as x-rays, CT scans, or MRI’s, are at times required to confirm diagnosis or evaluate the extent of the injury.
Treatment of midfoot sprains and Lisfranc is determined by the extent of the injury. For simple injuries, following the R.I.C.E. protocol (Rest, Ice, Compression, Elevation) is indicated. Immobilization of simple or moderate injuries is sometimes indicated-typically this is done using a walking boot or a cast. More serious injuries, such as those involving the Lisfranc ligament or if a fracture is present, may require surgery. It is important to have these injuries evaluated because non-treatment of the more serious forms of midfoot sprains can lead to permanent disability and non-healing.
If you think that you have suffered a midfoot sprain or have lingering effects from one, please contact our office.