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A foot injury caused by a massive trauma to the top of your foot is known as a Lisfranc joint injury, and is either a ligament sprain or fracture dislocation. It’s a rare type of injury, annually affecting just 1 in 55,000 people.
If you have foot pain that is localised in the top of your foot, then there is a chance it could be a Lisfranc injury.
However, it is not an easy condition to diagnose, as its symptoms can be similar to bone bruising or a tarsal fracture. Your foot will be bruised and swollen and tender to the touch and you will not be able to bear to put any pressure on it. A good foot support may help you to walk a little more easily, but it is important to seek medical advice.
Your GP will very likely send you for an x-ray, but these are not always definitive. Your x-ray will need to be taken while you are standing up, and your clinician will need to check for any displacement between your tarsal and metatarsal bones, effectively a ruptured tarso-metatarsal ligament.
For less severe injuries you could expect to be in a cast for around six weeks. These tend to be removable for this type of injury, but will help to keep your foot immobilised, reducing foot pain. You will be referred to a physiotherapist, who will usually suggest exercises which are not weight-bearing, such as pool running. You will need to remove your cast for this, and a buoyancy belt is often recommended to help optimise the exercises.
After six weeks you will usually be able to remove the cast completely and walk normally, although you may still benefit from some physiotherapy and massage and may still experience some foot pain. You can also gradually return to your normal sporting activities.
More severe injuries will often require surgery, and screws or wires will be used to reposition your bones. You will then have a removable cast — this time for up to three months. You can then start to gradually reintroduce your sporting activities under medical advice. It is particularly important to take care with sports such as football, as kicking and twisting motions can exacerbate your injury.
With any type of foot pain or injury it is always a good idea to rest as much as possible and only do the exercises recommended to you by your doctor or physiotherapist. A good foot support can help, but it is vital that you do not try to get back into your normal sporting regime until you have the all-clear from your clinician. You will need to ease yourself back in gradually and not attempt to go back to your former levels immediately, as you could undo the benefits of therapy or surgery.
Once you have recovered from surgery to repair your Lisfranc Joint it is important to strengthen the muscles in the foot in order to support the arch of the foot. Strengthening the affected region is important in order to minimise the risk of future injury being caused, the same can be said following any injury you may incur.
There are a number of exercises which you should look at as part of your rehabilitation, though your physiotherist may offer a tailored programme to suit your individual needs.