The Center for Podiatric Care and Sports Medicine

Lisfranc Injury: What Causes Midfoot Pain?

Posted by on Friday, July 5th, 2013


Every year, 1 in 55,000 people suffer a lisfranc injury — often men, and caused by car accidents or athletic injuries 70% of the time. A lisfranc injury is often mistaken for a sprain because it usually occurs as a result of twisting and falling. However, this type of foot trauma cannot be simply “walked off.” A lisfranc injury results if bones in the midfoot are broken or ligaments are torn. There are varying degrees of injury, but it is a complex condition requiring treatment by a podiatrist.

Lisfranc Foot Injury: What Happened?

The middle region of the foot is responsible for arch stability and proper gait. As you walk, the midfoot transfers force from the calf muscles to the ball of the feet. During a twisting fall, the small cluster of bones that form the arch on the top of the foot can break and the connective ligament tissues holding the bones in place can tear. Cartilage in the joints are often damaged during this injury, which must be treated as well to help prevent arthritis. Football and soccer players succumb to this type of injury often, as they stumble while the foot is flexed at a downward angle. People also suffer lisfranc injuries frequently when they fall from a significant height.

How Do I Know If I Have ALisfranc Injury?

Here are a few questions to ask yourself:

  • Is the top of my foot swollen and painful?
  • Is there bruises on the top and bottom of my foot?
  • Does the pain worsen when I stand or walk?
  • Does rest, ice and elevation do little to relieve the pain and swelling?

How Is A Lisfranc Injury Treated?

In mild cases, you may only need to wear a non-weight-bearing cast for six weeks, followed by a removable cast boot or custom orthotic. Fractures and/or misalignment of the joints will require surgery. The internal fixation method repositions the bones with plates or screws, which may be removed three to five months after surgery. The fusion method is reserved for severe traumatic foot injuries and welds the damaged bones together so they heal into a solid piece.

What Is The Recovery Like?

You’ll need to avoid putting weight on your midfoot for at least six to eight weeks. This means you will probably be wearing a cast or boot. Running and jumping should be avoided, and it will be up to your surgeon’s discretion when you can resume your regular activities again. Some athletes never fully recover after this type of injury and the development of arthritis is still possible, despite recent advances in treatment.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.