The Center for Podiatric Care and Sports Medicine

A New Study Suggests: Lisfranc Injury Not Such a Big Deal for NFL?

Posted by on Wednesday, April 1st, 2015


In a previous post, we’ve dubbed Lisfranc Injuries–damage to the midfoot ligaments–the “scourge of the NFL.” The diagnosis is one that spooks even the most seasoned veterans, who have been down the road of injury recovery in the past. It’s so commonplace that orthopedic surgeons call it an “epidemic” among players–prompting further investigation into what a diagnosis means for the future of football stars. A new study of NFL data taken between 2000 and 2010 was presented at the American Academy of Orthopaedic Surgeons’ (AAOS) annual conference in Las Vegas on March 27th. As podiatric surgeons who treat a lot of athletes with Lisfranc injuries, we were especially interested to hear the results of this late-breaking research.

lisfranc injury
This foot is not flexed during the fall, so it’s not likely #84 will suffer a Lisfranc injury. Image Source:

What Does The Latest Research Say About Football Players’ Lisfranc Injuries?

Researchers from the Perelman School of Medicine at the University of Pennsylvania presented the following important findings:

– 93% of the NFL athletes who sustained trauma to the midfoot in the study returned to gameplay less than 15 months after injury, at full performance level.

– In fact, 14 of the 28 players injured had at least one post-injury season where their power rating (a formula for analyzing their game stats) was better than their pre-injury level of play.

– Only 11% of players returned to compete during their injury season; most players took the rest of the season off to recuperate.

– The median timetable for return was 11.1 months, with a loss of 8.5 regular season games.

– On average, players who did not require surgery returned to play five months and three games earlier.

– Of the 28 players treated, 22 underwent surgery and 6 were managed non-operatively.

– All but two athletes returned to their NFL careers following treatment.

Lead author Kevin J. McHale, MD, explained, “While Lisfranc injuries have a reputation for resulting in poor player performance in the NFL, our study is the first to fully assess their career impact, including effect on athletic performance following return to competition.” Co-author Brian J. Sennett, MD, adds that further investigation is warranted to determine which specific factors lead to a more positive or negative outcome.

Symptoms of Lisfranc Injury & Treatment Steps

A Lisfranc injury is the result of a bizarre twisting and turning of the foot that damages bone, ligament, and joint. Initially, athletes often suspect they’ve sprained their foot, especially because these injuries often occur from a twist-and-fall motion where the body tumbles over the downward-flexed foot. It is important that the injured person avoid trying to “walk it off,” as Lisfranc injuries often require complex intervention to fix. The foot will appear swollen, with telltale bruising on the top (and sometimes the bottom) of the foot. Touching the midfoot at all will hurt, especially if the heel is wiggled or the toes try to move up and down.

If there are no dislocations or fractures of the joint and the ligaments are not completely torn, you may be a candidate for spending six weeks in a cast, followed by some time in an orthopedic boot and physical therapy program. The majority of athletes are not so fortunate, and must undergo some type of surgical repair with plates or screws. A good eight weeks in a cast or boot usually follows surgery. Running and jumping activities are limited until the hardware is removed.

Foot Injury Treatment in NYC

The Center for Podiatric Care and Sports Medicine accommodates athletes who have sustained acute midfoot injuries with same-day appointments. We have a full suite of diagnostic tools including x-ray, MRI, and ultrasound to provide an accurate diagnosis. Our staff is comprised of experienced podiatrists, podiatric surgeons, sports medicine professionals, and physical therapists who will guide your complete recovery beyond your initial assessment. We have worked with top-caliber Olympic and pro athletes, as well as children in school sports. Contact us to explore treatment options for this serious (but likely not career-ending!) foot injury.


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.