Midfoot Sprain

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Midfoot injuries come from broken bones in the midfoot or torn ligaments of the foot. Sometimes, these injuries are mistaken for just a sprain, but they can definitely be more complex. If there are multiple bones and/or ligaments that are involved, it can be severe and can last months to heal and possibly require surgery. 

The following will describe where the midfoot is, a more detailed explanation of the injury, causes, symptoms, and treatment.

Midfoot Sprain – Image of Foot

Midfoot Sprain- Where is the Midfoot?

The quick answer is the midfoot is considered the middle region, or central, area of the foot. It includes a small cluster of bones that form the arch on the top of your foot. Then there are five long bones, which are called metatarsals, that extend to the toes. 

All of these bones are held in place by connective tissue that runs down and across the foot. Your midfoot is very important because it helps stabilize the arch of your foot. It also assists in transferring weight and forces from your calf muscles to help you walk properly.

The midfoot is also named the Lisfranc joint after a French surgeon, Jacques Lisfranc de St. Martin who served in Napoleon’s Army. This is why you will often times hear this injury as a Lisfranc Injury.

How Does a Midfoot Sprain Happen?

There are multiple ways to injure the midfoot, some are very simple, and some can be more complex. A simple injury may only include one joint, while a complex injury can include multiple joints, multiple fractures, and multiple ligament tears or midfoot sprain. 

These injuries can cause lifelong issues if not treated properly. It can damage the cartilage in the midfoot around the joints which can increase overall midfoot stress. If the stress is too great, the arch can collapse which requires surgery to correct. With any injury, you always increase your risk of developing arthritis in that joint later in life.

Causes of Midfoot Sprains

These injuries do not take a lot and can be from a simple twist and fall. It is seen in football and soccer players but also occurs commonly in ballet dancers. When a ballet dancer is on pointe, or on her toes, if she loses her balance and rolls over the front of her foot causing a foot sprain, and injury to the midfoot can easily occur.

A way to receive a complex injury would be from a more severe impact or fall from a height. This is considered a high-energy injury and the foot can often dislocate or have multiple fractures.

Symptoms of a Midfoot Sprain

There are a few common symptoms that can point to a midfoot injury and they are as follows:

• Swelling and pain on the top of the foot.
• Pain that increases when standing and walking. Pushing off with the affected foot can also increase pain and may require the use of crutches.
• Visible bruising on top and/or bottom of the foot. If there is more bruising on the bottom, there is a greater chance of it truly being a Lisfranc injury.

Midfoot Sprain and Foot Anatomy

Treatment for Midfoot Sprains

When you receive an injury, it is always a good idea to get a doctor’s opinion to diagnose foot pain and treat foot pain. In this case, most medical doctors will do an X-ray to see the extent of the injury. If the injury is not severe and there are no fractures or dislocation then the treatment can be conservative and not require surgery.

Conservative treatment may include wearing a boot or cast for 6 weeks or more that is non-weight bearing. Eventually, the patient will progress to weight bearing status and the MD will continue to get X-rays to ensure proper healing and/or no change in status.

Surgical treatment of foot sprains may be necessary if the joints in the midfoot are dislocated or in abnormal positioning. In this situation, pins, plates, or screws are required to place the bones back into a normal position. There may be a reduction in overall motion after due to the hardware, but the hardware may be removed at a later date.

Rehabilitation of a foot sprains is introduced around 6 to 8 weeks if the X-rays are appropriate. This is where weight bearing status is introduced and strength building can begin. Therapy will also introduce range of motion exercises to allow the patient to reach a sense of normalcy with gait work. Some hard impact activities should be avoided until hardware is removed.

JOI Can Help You With A Midfoot Sprain

In conclusion, midfoot sprains are not to be taken lightly and can often times result in long term injuries. If you think that you have injured your midfoot, please seek medical attention to increase your chances of a great recovery.

For Physical Therapy appointments, please call JOI Rehab at 904-858-7045. 

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By: Ehren Allen, DPT, Certified Manual Therapist