Foot Sprain: Lisfranc Injury

The 26 Review

  • What is a Lisfranc Injury An injury that results in a fracture of the midfoot bones with the tearing of midfoot ligaments
  • Causes Sudden forceful twisting or crushing injury
  • Symptoms Swelling, pain, bruising, instability, and difficulty bearing weight
  • Diagnosis Physical examination and advanced imaging tests, including X-ray, CT scan, and MRI
  • Treatment Immobilization with a boot or cast, physical therapy, and/or surgery
26 Foot and Ankle Peroneal Tendon Tear Injury

Let’s take a closer look…

A Lisfranc injury is a complex injury in the midfoot region, specifically involving the Lisfranc joint complex. The Lisfranc joint complex is a collection of bones and ligaments that connect the long bones of the midfoot to the forefoot. This type of injury often happens when there is a forceful twisting or crushing motion applied to the foot, such as during a fall, sports-related incident, or motor vehicle accident.

Lisfranc injuries can range from mild sprains to fractures and dislocations, and they can be challenging to diagnose due to their subtle symptoms. Common signs of a Lisfranc injury include pain, swelling, bruising, difficulty bearing weight on the foot, and a feeling of instability.

Prompt medical attention is crucial to diagnose and treat a Lisfranc injury properly. Treatment options may include immobilization with a cast or boot, physical therapy, and in severe cases, surgery to realign and stabilize the affected bones and joints. Rehabilitation and gradual return to weight-bearing activities are important for achieving optimal recovery and restoring foot function.

Causes & Symptoms

A Lisfranc injury generally occurs when the foot is twisted or crushed. Most commonly, this injury occurs during falls, sport-related incidents, or car crashes. Specifically, sports such as football and soccer see this injury the most. Symptoms to look out for include swelling, bruising, redness, instability, pain in the midfoot, and difficulty bearing weight.


A physical examination will be performed to diagnose this ailment. The medical professional will look for bruising along the bottom of the foot and tenderness along the midfoot. The doctor will also conduct a stress examination to determine where there is pain in the midfoot.

The piano key test puts stress across the midfoot, meaning an individual with a Lisfranc injury should feel pain. In addition, advanced imaging tests like X-rays, CT scans, and MRIs can help to see the extent of the injury. 


Treating a Lisfranc sprain injury typically involves a combination of conservative measures to reduce pain and swelling and promote healing. Initially, it is important to rest the injured foot and avoid putting weight on it.

Immobilization with a cast, splint, or walking boot may be recommended to provide stability and protect the injured area. Applying ice packs to the affected foot for 15-20 minutes at a time, several times a day, can help reduce swelling and alleviate pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) can also be taken as directed by a healthcare professional to manage pain and inflammation.

Physical therapy exercises and stretches may be prescribed to maintain joint mobility, strengthen the surrounding muscles, and aid in the recovery process. As healing progresses, gradual weight-bearing activities can be introduced under the guidance of a healthcare provider.

It is important to follow the recommended treatment plan and attend regular check-ups to ensure proper healing and minimize the risk of long-term complications.

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