Lisfranc injury
An injury to the midfoot involving the joints and ligaments around the Lisfranc region. It can range from a minor ligament injury to fracture or displacement and should be taken seriously.
Minor Lisfranc injuries may cause pain and tenderness in the midfoot, particularly during weight-bearing and push-off. Swelling may occur.
Lisfranc injuries can occur through forceful twisting of the foot under load, for example when the forefoot is planted while the body continues to rotate. They can also result from direct trauma or significant axial loading.
Common situations
- •Twisting of the foot under load
- •Tackle or fall
- •Significant load through the forefoot
- •Foot becoming stuck in the ground while the body rotates
Lisfranc injuries are often traumatic and therefore cannot always be prevented. Good foot and leg strength and progressive load increases may improve load tolerance.
- •Train foot and calf strength
- •Develop good balance and single-leg control
- •Increase training load progressively
- •Use appropriate equipment and playing surfaces for the activity
Stop football activity and reduce loading. Because Lisfranc injuries can be difficult to assess, persistent midfoot pain after trauma should be medically evaluated.
Protection and basic function
Loading is adapted while pain and swelling are controlled.
Goals
Reduce symptoms and restore basic function.
Progression criteria
Able to load the foot according to individual recommendations without significant worsening.
Strength and load tolerance
Progressive training of the foot, calf and leg followed by gradual return to running.
Goals
Restore strength and the ability to tolerate football demands.
Progression criteria
Able to tolerate progressively increased loading without pain or swelling reaction.
- No significant pain or swelling
- Good foot function
- Adequate strength
- Able to tolerate single-leg loading and push-off
- Able to tolerate running and football-specific movements
The information in the Injury Center is for educational purposes and does not replace professional medical advice. Always consult a qualified healthcare professional for diagnosis and treatment.
Lisfranc injury
An injury to the midfoot involving the joints and ligaments around the Lisfranc region. It can range from a minor ligament injury to fracture or displacement and should be taken seriously.
Mild — Återhämtningen varierar kraftigt beroende på om ligament, leder eller ben är skadade.
Symptoms
Minor Lisfranc injuries may cause pain and tenderness in the midfoot, particularly during weight-bearing and push-off. Swelling may occur.
Acute Treatment
Stop football activity and reduce loading. Because Lisfranc injuries can be difficult to assess, persistent midfoot pain after trauma should be medically evaluated.
Rehabilitation
Loading is adapted while pain and swelling are controlled.
Goals
Reduce symptoms and restore basic function.
Progression criteria
Able to load the foot according to individual recommendations without significant worsening.
Progressive training of the foot, calf and leg followed by gradual return to running.
Goals
Restore strength and the ability to tolerate football demands.
Progression criteria
Able to tolerate progressively increased loading without pain or swelling reaction.
Return to Play
- ☐ No significant pain or swelling
- ☐ Good foot function
- ☐ Adequate strength
- ☐ Able to tolerate single-leg loading and push-off
- ☐ Able to tolerate running and football-specific movements
Moderate — Flera veckor till flera månader är vanligt beroende på skadans omfattning och stabilitet.
Symptoms
Significant pain and swelling in the midfoot may occur, often with pain during weight-bearing and push-off. Bruising on the sole of the foot can be an important sign.
Acute Treatment
Stop sports activity and avoid unnecessary weight-bearing. Seek medical assessment after trauma with significant midfoot pain or swelling.
Rehabilitation
The stability and extent of the injury are assessed and loading is adapted.
Goals
Protect the injury and restore basic foot function.
Progression criteria
Sufficient healing and function for progressive loading.
Strength and loading are gradually rebuilt before running and football-specific movements are introduced.
Goals
Restore full load tolerance.
Progression criteria
Able to tolerate running, jumping and changes of direction without pain or swelling.
Return to Play
- ☐ Good foot function
- ☐ No significant pain or swelling
- ☐ Adequate strength
- ☐ Able to tolerate single-leg loading and jumping
- ☐ Able to tolerate running and changes of direction
- ☐ Medical assessment before full return
Severe — Allvarliga Lisfrancskador kan kräva flera månader och ibland längre, särskilt vid fraktur, instabilitet eller kirurgisk behandling.
Symptoms
Severe Lisfranc injuries may involve fracture, displacement or instability in the midfoot. Significant pain, swelling, deformity and inability to bear weight may occur.
Acute Treatment
Stop all sports activity and seek medical care. Weight-bearing should be avoided or limited according to medical advice.
Rehabilitation
The extent of the injury is assessed and any fracture or instability is treated. Rehabilitation begins when medically appropriate.
Goals
Protect the injury and restore basic mobility and function.
Progression criteria
Sufficient healing and function for progressively increased loading.
Strength, balance, running, jumping and changes of direction are progressively rebuilt according to an individualized plan.
Goals
Restore full foot function and load tolerance.
Progression criteria
Able to complete relevant functional testing and tolerate football-specific loading without pain or swelling.
Return to Play
- ☐ Good foot function
- ☐ No significant pain or swelling
- ☐ Adequate strength
- ☐ Able to tolerate jumping and single-leg loading
- ☐ Able to tolerate full running and changes of direction
- ☐ Medical assessment and individualized return-to-play plan
When to Seek Medical Care
Midfoot pain after significant trauma should be medically assessed because Lisfranc injuries can sometimes be difficult to detect initially.
- Inability or significant difficulty bearing weight
- Significant midfoot swelling
- Bruising on the sole of the foot
- Deformity
- Persistent pain after trauma
References
- Lisfranc Injuries — American Academy of Orthopaedic Surgeons (https://orthoinfo.aaos.org/)