The Center for Podiatric Care and Sports Medicine

The Scourge of the NFL: Examining Lisfranc Injuries, Causes, and Treament

Posted by on Tuesday, June 10th, 2014

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Lisfranc injuries to the midfoot are very common among football players. Recently, Washington Redskins’ Safety Phillip Thomas said, “At first I heard all the things about this Lisfranc injury and it spooked me,” adding that he took a full four months off to recover. Like many cases, trainers first labeled it “a sprain,” but ultimately became a season-ending injury. The torn ligaments were bad enough to necessitate surgery, but he is expected back next season.

Other players suffering Lisfranc injuries recently include: Tennessee Titans quarterback Jake Locker, NY Jets star receiver Santonio Holmes, Green Bay Packers running back Cedric Benson, Pittsburgh Steelers running back Le’Veon Bell, St. Louis Rams offensive lineman Barrett Jones, and the list goes on and on. As orthopaedic surgeons, we see Lisfranc injuries quite often, but it’s become so alarmingly commonplace that professionals in the field are calling it an “epidemic.”

What is a Lisfranc injury?

Dr. Robert Anderson, co-chairman of the NFL’s Foot and Ankle Committee, describes a Lisfranc injury as “a ligament injury in any part of the body,” but most commonly the foot. “The ligaments of a midfoot joints rupture and the joints become unstable and shift out of place. You can have some small bony emulsions or chips injuries occur if the ligaments do pull off.”

Over time, the joints become unstable and football players have trouble pushing off when sprinting down the field. Shortly thereafter, the inflammation, swelling, and pain symptoms appear. A Lisfranc injury in the foot requires a long recovery time because the athlete must restore full stability through the top of the arch — which tends to absorb a lot of shock and stress, whether a person is walking or running.

What causes Lisfranc injuries?

Lisfranc injuries are among the three most common in the National Football League — right up there with turf toe and high ankle sprains. Defensive ends often suffer this injury when their cleats embed in the turf as they try to get around the offensive tackle, and the twisting maneuver, along with the heavy load, causes the joints to move out of position or the ligaments to tear.

The NFL’s Foot and Ankle Committee has found that these injuries are occurring in greater frequency due to the lighter weight and increased flexibility of the shoes the players are wearing, the use of artificial turf, and the fact that players are more powerful and competitive than ever before. While players and coaches want advances in performance, these “improvements” to the game can sometimes come at a cost.

How are Lisfranc injuries treated and how long does recovery take?

Our team at The Center for Podiatric Care and Sports Medicine may treat a Lisfranc injury in one of several ways, depending on the severity. We’ve seen sprains, fractures, and dislocations. With a minor injury, the athlete may be required to wear a dorsal pad to reduce pressure and pain. We generally recommend that players wear a removable cast boot for a month, up to six weeks, to stabilize the foot and keep weight off tender areas. Our physical therapists then guide players through upper body strength training and low-impact activities to keep them in tip-top shape.

In more severe cases of dislocation or fracture, surgery is often necessary. The bones and joints will be physically realigned and then affixed in place using wires, screws, or plates. A non-weight-bearing cast is needed for six weeks, followed by a walking boot for another month. All told, it could easily take five months to recover, which is why the word “Lisfranc” strikes fear in the hearts of all NFL players.

Are Lisfranc injuries ever career-ending?

“There have been plenty of cases where guys are fine,” Michael Pagnani, former team physician for the New York Giants and Nashville Predators, tells USA Today. “If you catch it early and you’re aware of it, I think the results are generally pretty good.” However, there have been exceptions. New York Jets wide receiver Santonio Holmes, whom we mentioned earlier, went a full year after suffering a Lisfranc injury in September 2012. Worse yet, former Cleveland Browns running back Errict Rhett and former Titans safety Robert Johnson suffered career-ending Lisfranc injuries in 2000 and 2012, respectively.

Treatment and surgery for Lisfranc injuries in New York

The Center for Podiatric Care & Sports Medicine specializes in sports injuries, including Lisfranc injuries that are so common among football players. We accept over 20 different insurance plans, including HIP and Medicare. Our licensed and board-certified team of podiatric surgeons can diagnose and treat injuries ranging from mild to severe. For your convenience, we offer clinics in both Westchester and Manhattan, and we also book appointments online.

 

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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.