What is a Lisfranc Injury and Why is it So Bad for NFL Players?

Every season in the NFL, we hear about players who have suffered a Lisfranc injury. I fielding many calls asking me about this injury that so many have never heard of; these calls were especially pressing back in 2011, when the Texans' Matt Schaub missed an entire season with this problem.Since it is something of a medical mystery to many non-athletes, I thought we'd take some time to closely examine this common sports injury.  Football players cuts leave them vulnerable to Lisfranc injuries


All About the Lisfranc Joint
The Lisfranc Joint usually refers to the series of joints that connect the rearfoot to the forefoot. It is also known as the tarsometatarsal joint, since it includes the interface between the bones of the tarsus with the metatarsal bones. The joints and supporting ligaments contribute to the overall stability of the foot, particularly the arch.

Why Do Football Players Injure Their Lisfranc Joints?
Overall, a Lisfranc injury is an uncommon one. It is not, however, unfamiliar to the sport of football. Football players commonly experience this injury when they have a foot firmly planted in the turf, but then suddenly start to rotate. This type of move usually is necessary if the player is suddenly trying to cut and change directions or if he is tackled. 

How Do You Know If You Have A Lisfranc Injury?
Types of Lisfranc's InjuriesUsually, after a Lisfranc injury, you feel significant pain in the midfoot. In fact, it will be difficult, or even impossible, to bear weight on the foot. Over the next several hours, the pain will increase, along with swelling and bruising.

When you visit your Houston podiatrist to have the injury evaluated, x-rays will be taken. These are often taken while standing, even though the foot is painful. We simply won't be able to see the injury if we don't keep you on your feet. An ultrasound evaluation may also be performed.

If further evaluation is necessary, which it often is, your podiatrist will order an MRI or CT of the injured foot. This will provide a more in depth analysis of the injury and aid the doctor in developing the appropriate plan of care.

What's the treatment of a Lisfranc injury? What is the timeline for recovery?
If evalution of the injury shows that it is stable, non-operative treatment may be pursued. This generally consists of a period of non-weight bearing and immobilization for 6-8 weeks. Unfortunately, most of these injuries, particularly in athletes, are unstable and require immediate surgery.

Surgery for a Lisfranc injury involves stabilizing the fractures with screws, pins, and plates. This allows the foot to properly heal. After the surgery, the patient remains non-weight bearing for 6-8 weeks. This is followed by physical therapy to restore strength and motion.

There are times when the podiatrist will opt to fuse the joints rather than simply repair them. The school of thought is that this will prevent the injury to the cartilage in the joints to break down and become arthritic. This is a decision that is made based on findings from the imaging studies, the surgeon's expertise, and the activity level of the patient.

When can I return to sports after a Lisfranc injury?
This is the question on every football fan's mind: when can players return after this kind of problem? If the injury was stable and does not require surgery, it is possible for a return to playing in 10 weeks. 

Unfortunately, however, athletes of a professional level will require surgery in almost every case. This puts their return to the playing field at 3-6 months after the injury. Unfortunately, the athlete does not always return to their pre-injury form. The injured joints can remain painful and weakened. This injury also can cause traumatic arthritis to set in which can cause ongoing problems.

What do I do if I suspect I have a Lisfranc injury?
If you suspect that you have a Lisfranc injury, time is of the essence! Contact your Houston podiatrist for an immediate evaluation to ensure you get the best treatment. In every case, not treating a Lisfranc injury will cause ongoing pain and problems. Don't let that happen to you!

Dr. Andrew Schneider
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Dr. Andrew Schneider is a podiatrist and foot surgeon at Tanglewood Foot Specialists in Houston, TX.