The Center for Podiatric Care and Sports Medicine

Who is Lisfranc and What is She Doing to My Foot?

Posted by on Friday, March 23rd, 2012

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It started happening a few years ago. An athlete went down with a foot injury on a seemingly benign play or in practice. When the medical report came out, the injury was called a “lisfranc” injury. And sports reporters and sports talk radio hosts everywhere said, “Who is Liz Frank and what did she do to this guy’s foot?”

Chien Ming-Wang of the Yankees, Philip Rivers of the Chargers, Dwight Freeney of the Colts, Darren McFadden of the Raiders, all down with Lisfranc injuries. Then last November, with the Houston Texans seemingly Super Bowl bound, quarterback Matt Schaub went down with the dread Lisfranc injury. His season was over, and the Texans, though they made it to the playoffs, didn’t go as far as they would have with Schaub playing.

So let’s dig into this demon of the foot and find out what’s going on!

All right, no more jokes. What is a Lisfranc? The Lisfranc complex is a group of bones and ligaments found in the middle of your foot. They act as a kind of connector piece between the long metatarsal bones that reach out to your toes and your ankle bones. Put your foot flat on the ground and see how it slopes up from your toes to your ankle. The top of that arch before your ankle is the Lisfranc complex.

Glad to meet you, Lisfranc! What can go wrong? The quickest way to break a Lisfranc bone is do have something heavy land directly on your foot, like a fragment of old satellite hurling in from outer space or a 380 pound defensive lineman (they both feel about the same, right?). However, torn ligaments in the Lisfranc complex are just as big a problem, and can occur in a much more subtle way. The American Association of Orthopedic Surgeons describe Lisfranc injuries as “low energy,” meaning they can happen from twisting your foot the wrong way or taking a bad or awkward step, as happened to Yankee pitcher Wang. Healthy Feet says the injury was originally associated with soldiers on horseback, who incurred the injury when they were thrown from their horses in battle, and fell with a foot caught in stirrup, twisting the foot and putting sudden pressure on it;  the name comes from Jacques Lisfranc de St. Martin, an early 19th century surgeon who served in the French army.

How do I know I have a Lisfranc injury? That’s a tricky question–symptoms are swelling, pain, and sometimes bruising on the top  and/or bottom of your foot; if there is bruising on the bottom of your foot, that’s a good clue that you have a Lisfranc issue. Nevertheless, because of where the pain is located, many people often confuse a Lisfranc injury with a bad ankle sprain. If you treat that “ankle sprain” the traditional ways–rest, ice, compression, elevation, and there’s no progress, you might have a Lisfranc injury. The next step  and should see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) for an accurate diagnosis.

Suppose I, like Matt Schaub, have a Lisfranc injury. I am not a pro athlete and am always out for the season. Can I just let it get better on its own? No. If it’s a clean, simple break, you’ll probably have to wear a cast for about six weeks, and then progress to a walking boot. If the injury is more complicated, you may need surgery in order to have screws or plates inserted in your foot in order to hold everything in place. Severe injuries may require fusion of several badly injured bones so they can heal in one piece.

This sounds like it can all really take a long time. Indeed it does. The cast phase alone can take six to eight weeks, depending on the severity of the injury; follow that with walking boot time and rehab. When athletes are out for the season with a Lisfranc injury, it’s not because they need some extra time off for their fantasy teams or because management needs roster space. They genuinely are taking months to heal. In this interview with Schaub, he talks about how thirteen weeks after surgery, he’s still in the middle of rehab. As for ordinary people who aren’t prepping for a new football season, well, the process takes long enough that it seems like many have taken to blogging about it: see So You’ve Got a Lisfranc Injury, Lisfrancless, and The Lisfranc Chronicle amongst others.

I hope I never find out where my Lisfranc is. I hope not either. The best way to avoid a Lisfranc injury is, well, don’t play a high-impact sport that requires a lot of fancy footwork. For ordinary folks, just watch where you walk–keep an eye out for potholes, indentations in a path, and awkward steps off curbs or stairs.

If, however, you find yourself struggling with a foot injury and suspect it’s a Lisfranc issue, contact us at The Center for Podiatric Care and Sports Medicine. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.

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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.