If you’re an athlete, a Lis Franc sprain is probably the worst foot injury you can get. This injury occurs when the midfoot bones are broken or dislocated from the Lis Franc ligament, which provides support to the midfoot and stabilizes the arch during push off. Essentially, the foot does not work. In this blog post, we’ll break down everything you need to know about a Lis Franc sprain, including its symptoms, recovery time, and surgical interventions.
Lis Franc Injury Information
Lis France Anatomy
The foot is made up of 3 parts; the toes, midfoot and hindfoot/ankle. The Lis Franc connects the toes and midfoot and provides support.
The Lis France additionally stabilizes the arch during push off. If the Lis France doesn’t work, neither does the entire foot (source).
How Does a Lis Franc Sprain Happen?
The most common way to injure the Lis France ligament is through a direct force (axial load) while the foot is plantar flexed. This is most common in football but can occur in any activity in which there are high speed movements.
Symptoms of a Lis Franc Sprain
The most common symptoms of a Lis Franc are as follows:
- Massive swelling/edema
- Inability to bear weight
- Bruising
- Instability (you can basically fold the foot in half)
With a Lis Franc injury, there can be sprains, dislocations and fractures all simultaneously
Recovery Time
A Lis Franc is a terrible injury
Even if you have a low grade sprain, you are looking at weeks to months, most often immobilized before rehab can even start
Recovery time for a minor sprain starts at 6-8 weeks
Surgery may involve being casted/immobilized for 3 months
Full recovery can vary anywhere from 6 weeks to a full year, with 6 weeks being the exception, not the rule
Rehab For a Lis Franc Sprain
Rehab for a Lis Franc is similar to an ankle. As the foot is often immobilized for 6 weeks, ROM and atrophy of the entire foot/ankle complex set in
Any way you load the ankle, the midfoot is loaded and strengthened as well. Only difference here again is the time it will take
The primary goal is to restore full ROM, balance and strength of the foot and ankle
A guide for early ankle ROM can be found here.
For strengthening exercises, see the guide here
Surgical Intervention
Surgery is only performed in the presence of a fracture or complete ligament rupture
There are 2 types of surgical interventions:
- Open reduction internal fixation (ORIF)
- Fusion
Orif
The surgeon will use plates, screws to hold the bones in place
In this technique, the surgeon may leave the hardware in temporarily which means another surgery in roughly 6 months
Fusion
The bones are welded into place to provide support
As to which technique is better, the data is very inconsistent
However fusion typically leads to better outcomes in terms of pain (source)
In summary, a Lis Franc is the last foot injury you want to sustain as recovery time is always in the months. In almost all cases it will end an athlete’s season