Ask Dr. Anderson: How Are Sprains Different From Lisfranc Injuries?
Dr. Anderson explains that although Lisfranc injuries can be mistaken for simple sprains, they are much more serious.
Foot injuries are common in competitive sports. In fact, half of all foot and ankle sprains are sports related. But not all foot injuries are equal. Sometimes, what may appear to be a simple sprain is actually a more serious Lisfranc injury. Foot and ankle specialist Dr. Michael Anderson discusses the difference between common sprains and Lisfranc injuries.
“Foot and ankle injuries are defined by whether bone, ligament, or tendon has been damaged,” explains Dr. Anderson. “Fractures describe a break in a bone. Sprains are injuries to a ligament—the strong bands of connective tissue that hold the ankle joint together. Fractures and sprains are two common athletic injuries we treat. A Lisfranc injury can involve both bone and ligament damage in the midfoot. This serious injury is trickier to treat because it is often mistaken for a simple sprain.”
The anatomy of the midfoot
The middle of the foot houses a complex joint called the Lisfranc joint. It is composed of a group of small bones that stabilize the arch on the top of the foot. Proper function of this joint is critical to walking. Midfoot bones are held in place by ligaments that stretch across and down the foot. A twisting fall can break or dislocate these bones, damage the connective tissue of the ligaments, or both.
Lisfranc injuries affect midfoot function
“Simple sprains and Lisfranc injuries can both be caused by a straightforward twist and fall,” says Dr. Anderson. “This type of fall is common in sports like basketball, football, and soccer. Athletes may be tempted to chalk up fall-related pain to a sprain. I’ve also treated Lisfranc injuries that were originally misdiagnosed as sprains. The distinction can be subtle—but it is critical. That’s why it’s important to have these injuries evaluated by an orthopedic foot and ankle specialist.”
Lisfranc injuries can cause serious damage requiring specialized treatment. Sometimes midfoot bones are fractured or broken. Ligaments that support the midfoot may be torn. In some cases, a single midfoot bone may be affected. But when the injury is complex, there can be multiple fractures that displace bones. These injuries often require surgical treatment and carefully monitored rehabilitation.
Symptoms of a Lisfranc injury
Understanding the specific symptoms of Lisfranc injuries can help you distinguish between damage to the Lisfranc joint and a simple sprain. Dr. Anderson describes the most common Lisfranc injury symptoms:
- The top of foot may be swollen and painful.
- Bruising may appear on the top and bottom of the foot. “Bruising on the bottom of the foot is a red flag,” says Dr. Anderson. “It’s a strong indicator of a Lisfranc injury.”
- Pain that increases with standing or walking. “With these injuries, athletes often feel pain when they attempt to push off on the injured foot,” Dr. Anderson notes.
“If you notice any of these symptoms, and if rest, ice, and elevation don’t relieve the pain and swelling, it’s time for you to consult with Summit’s team of foot and ankle experts,” states Dr. Anderson.
Nonsurgical treatment for Lisfranc injuries
Lisfranc injuries don’t always require surgery. “If there are no fractures or dislocations in the joint and the ligaments are not completely torn, a nonsurgical treatment plan may get you back in the game,” says Dr. Anderson. “This means wearing a cast or boot for six weeks. During this period, it is critical for the patient to not put any weight on the injured foot. After six weeks, we monitor the healing progress with X-rays. If we see that the injured bones have moved, we’ll discuss surgical options to put the bones back in place.”
Surgical treatment for Lisfranc injuries
Surgery is recommended whenever a midfoot fracture causes abnormal joint positioning. “The surgical goal is to realign the joints and return broken bone to normal position,” explains Dr. Anderson. Various methods of internal fixation are used to repair Lisfranc fractures. When the injury is too severe for a fixation repair, fusion is another surgical option. Rehabilitation immediately after surgery includes a period of six to eight weeks in a boot or cast. During this time, no weight can be put on the injured foot. Following the non-weight-bearing recovery period, the healing process is carefully monitored.
“Successful Lisfranc repairs require subspecialty orthopedic expertise and patience on the part of the injured athlete,” says Dr. Anderson. “That’s the winning combination to get these athletes safely back to their sport.”
Summit Orthopedics offers personalized foot and ankle expertise
Our fellowship-trained foot and ankle physicians understand that your mobility depends on the health of your feet and ankles. If you have suffered an injury or are experiencing symptoms that make walking painful, our team of foot and ankle specialists can help with conservative treatment, seasoned surgical teams, and expert rehabilitation support. Summit Orthopedics specialists have the expertise to evaluate your discomfort and develop a plan to quickly and safely get you back on your feet and on your way.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.
More resources for you
Learn about whether you need medical evaluation if your legs give out.
Dr. Choi identifies bruised spine symptoms that require medical evaluation.
Ask the Expert: Foot and Ankle Video Series