In the middle of your foot there is an area called the Lisfranc joint complex, this is the top of the arch of your foot. In this area there are many tiny bones and ligaments connecting the bones of the front of your foot to the bones of the middle of your foot. However, between the bones of your first and second toes there is no connective tissue supporting the ligament connecting these toe bones. Connective tissue is a structure that supports and reinforces these ligaments, and without it the ligament can be torn or the bones can pop out of place if the foot is twisted the wrong way.

This injury is very common in football and soccer players, it usually happens when the player’s foot is bent downwards and they stumble over it. Last year Houston Texans star player Matt Schaub got this injury and it ended his season. The injury is usually mistaken for a sprain and many people think they can just walk it off, however this injury is far more serious than a simple sprain. The common symptoms of this injury are swelling and bruising on the top and bottom of the foot on the same side as the big toe. The pain normally worsens when standing or walking.

A podiatrist should be seen immediately if these signs are present as this is an injury that shouldn’t be ignored. A doctor will order X-rays and MRIs to look for torn ligaments and broken bones in this area. Depending on what is found the treatment can be surgical or non-surgical.

If there are no broken bones, dislocations or if the ligament is only partially torn non-surgical treatment is the best route. This includes a non-weight bearing cast for 6 weeks, and it is very important to place no weight on the foot while it is in the cast, this could make the injury worse. After the 6 weeks weight bearing will be increased as time goes on and shoe inserts may be prescribed.

If the bones are broken, dislocated or the ligament is torn surgery will be required. In this surgery the bones will be set back into place and hardware (screws and plates) will be put in to hold the bones in place. This is usually left in place for 3 to 5 months then it is removed and rehabilitation is required.

This is a very serious and devastating injury for athletes, despite the success of the surgery it is very difficult for athletes to get back to their pre-injury activities. The best way to keep this injury from becoming very serious is to be seen right away by your podiatrist.

By: Nrupa Shah