Lisfranc
Injury Care
at Foot Foundation
Midfoot injuries can be deceptively complex—what seems like a simple sprain is often a Lisfranc injury, which, if missed, can lead to chronic pain or arthritis. Bruising under the foot, difficulty weight-bearing, and swelling are key warning signs.
At Foot Foundation, we ensure accurate diagnosis, early management, and structured rehabilitation to protect the midfoot, restore function, and reduce long-term complications.
What is a Lisfranc Injury?
A Lisfranc injury is a sprain, fracture, or dislocation of the Lisfranc joint complex, which connects the midfoot (cuneiforms and cuboid) to the forefoot (metatarsals). These joints are stabilised by the Lisfranc ligament, a strong structure connecting the medial cuneiform to the base of the second metatarsal.
When injured, the Lisfranc complex loses stability, leading to pain, swelling, difficulty weight-bearing, and long-term risk of arthritis. These injuries can range from mild ligament sprains to severe fracture-dislocations requiring surgery.
Because Lisfranc injuries are often misdiagnosed as a “simple midfoot sprain,” accurate assessment is critical. At Foot Foundation, we specialise in identifying Lisfranc injuries early, managing recovery, and providing rehabilitation to protect long-term function.
Causes & Risk Factors
Trauma – twisting injury to a plantarflexed foot (common in sport)
Falls – stepping into a hole or missing a step, forcing the foot into hyper-plantarflexion
Direct impact – crush injuries from heavy objects falling on the midfoot
Motor vehicle accidents – foot planted on brake during collision
High-level sport – football, rugby, netball, gymnastics with pivoting or cutting movements
Hypermobile feet – predisposition to instability
Treatment at Foot Foundation
Management depends on severity:
Mild sprains (stable injuries):
Non-weight bearing boot or cast for 6–8 weeks
Gradual rehabilitation with strengthening and proprioception
Custom orthotics to support the arch and stabilise midfoot post-recovery
Moderate/severe injuries (unstable or displaced):
Require orthopaedic referral for surgical fixation (screws or plates)
Post-op podiatry care: orthotics, footwear modification, progressive rehab
Rehabilitation at Foot Foundation includes:
Gait retraining to restore push-off mechanics
Strengthening intrinsic foot and calf muscles
Footwear prescription to support recovery and reduce overload
Long-term monitoring for post-traumatic arthritis
Symptoms
Pain and swelling in the midfoot, particularly over the Lisfranc joint complex
Bruising on the plantar (underside) of the foot, a classic sign
Pain worsened by standing or walking, especially on tiptoe or pushing off
Difficulty weight-bearing or limping
Instability or “giving way” feeling in the midfoot
In severe cases: visible deformity or collapse of the arch
Diagnosis
At Foot Foundation, diagnosis includes:
Clinical examination – palpation of Lisfranc joint, stress testing, plantar bruising
Weight-bearing X-rays – to detect widening between the 1st and 2nd metatarsals (diastasis)
MRI – identifies ligament injury and associated cartilage damage
CT scan – provides detail of fractures and joint alignment in complex injuries
Lisfranc Injury – FAQs
It is a sprain, fracture, or dislocation of the Lisfranc joint complex in the midfoot, often involving damage to the Lisfranc ligament.
They commonly occur from twisting injuries to a plantarflexed foot, falls, sporting trauma, or crush injuries.
Midfoot pain, swelling, plantar bruising, and difficulty weight-bearing are key symptoms. Severe cases may cause visible deformity.
They can mimic a simple sprain. Without weight-bearing imaging and specialist assessment, subtle injuries may go undiagnosed, increasing the risk of chronic pain and arthritis.
Diagnosis involves clinical testing, weight-bearing X-rays, and MRI or CT for detailed assessment.
Mild sprains may heal with immobilisation and podiatry rehab. Unstable or displaced injuries require surgery to restore alignment and stability.
Even with treatment, many patients develop midfoot arthritis due to joint damage. Early management reduces this risk.
Yes. Orthotics stabilise the midfoot, improve load distribution, and help prevent long-term symptoms post-injury or post-surgery.
Mild sprains: 8–12 weeks.
Surgical cases: 3–6 months or longer, with gradual return to sport.
If you have midfoot pain with swelling, bruising, or difficulty weight-bearing after an injury, urgent podiatry or orthopaedic assessment is needed.
Why Choose Foot Foundation?
Foot Foundation provides specialist diagnosis and rehabilitation for Lisfranc injuries, ensuring accurate assessment, orthotic prescription, and long-term recovery support. We collaborate with orthopaedic surgeons for surgical cases and manage post-operative rehab to restore function.
With clinics in Rosedale, Takapuna, Remuera, Botany, Hamilton, and Tauranga, expert midfoot injury care is available across New Zealand.
