Massage therapy · Kitchener–WaterlooLisfranc (Midfoot) Injury
Foot
What It Is
Lisfranc injuries occur when the bones in the midfoot are broken or the ligaments supporting those bones are torn. Injury severity ranges from a simple injury involving one joint to a complex injury involving a number of different bones and joints within the midfoot (American Academy of Orthopaedic Surgeons, n.d.). This injury is often mistaken for a simple sprain, especially when it is the result of a twist and fall. Injuries to the Lisfranc joint are not simple sprains that you can just walk off. Even a simple Lisfranc injury is a severe injury that can take many months to heal and might need surgery (American Academy of Orthopaedic Surgeons, n.d.).
Less severe Lisfranc injuries can happen with a simple twist and fall. They are also seen in sports such as football, when one player lands on the back of another player's foot while it is pointed downwards. More severe injuries happen from direct trauma, such as a fall from a height or a car accident (American Academy of Orthopaedic Surgeons, n.d.). The top of the foot may be swollen and painful. You may also notice bruising on the top and/or bottom of the foot, and bruising on the sole of the foot is highly suggestive of a Lisfranc injury. The pain may get worse when standing, walking or pushing off with the foot, and it can be so severe that you cannot put weight on it (American Academy of Orthopaedic Surgeons, n.d.). Lisfranc injuries tend to damage the cartilage of the midfoot joints, which can lead to arthritis later on (American Academy of Orthopaedic Surgeons, n.d.).
When examining you, a doctor may ask you to stand on one foot and come up onto your tiptoes. Pain over the midfoot during this test can be a sign of a Lisfranc injury (American Academy of Orthopaedic Surgeons, n.d.).
Lisfranc (Midfoot) Injury Anatomy
Not a diagnosis — for more information, contact me or another trusted healthcare provider.
Treatment
Self-Care & Treatment
Treatments you may want to discuss with your family doctor, nurse practitioner or specialist
Tips
- Wear proper footwear whenever taking part in sports where there is a chance of direct trauma to the foot.
- Check with your medical team before having massage on the injured foot.
- If you are doing any pool exercises once your medical team says it is safe, a buoyancy aid can help to take stress off the joint.
- Even with successful treatment, arthritis can develop in the midfoot later in life (American Academy of Orthopaedic Surgeons, n.d.).
Treatment
My Approach
A Lisfranc injury needs a doctor's assessment first. Your doctor or surgeon decides the treatment, how much weight you can put through the foot and when you can return to activity. My aim is to work within those limits, ease the parts of you that work harder while the foot is protected, then help you get the foot moving, strong and back to your activities.
Please bring any X-ray or scan reports and notes from your medical team to your first visit. They're an important part of planning safe treatment for you.
I check what you've been cleared to do, then assess how your foot, ankle and leg move, your strength and balance, and later your walking. After surgery, or with a fracture that stops your normal daily tasks, I need your medical team's okay before any hands-on treatment.
In the Cast or Boot
- No pressure or stretching through the injured midfoot
- Easing the other leg, hips and low back, and your shoulders if you're on crutches
- Gentle lymphatic drainage above the cast or boot for swelling
- Keeping the hip, knee and toes moving, as your team allows
After the Boot
- Hands-on work for the calf and foot, and scar work once a wound has healed
- Gentle joint mobilisation for stiff joints, with no quick thrusts, once your team confirms the injury has healed; no heat over metal plates or screws
- Strength work from gentle holds to heel raises, plus balance practice
- Help with crutches and walking again, and pool work once your team says it's safe
- Footwear advice, and help working out whether you need an orthotic, pointing you to a chiropodist or podiatrist for a custom one
Back to Activity
What to Expect
Typical Course
What I Focus On
Please read
When to See a Doctor First
When to Get Help
Call 911 or go to the emergency room at your nearest hospital if, after a foot injury (NHS, 2024):
- you heard a crack when you had your injury
- your foot has changed shape or is pointing at an odd angle
- your foot is numb, tingling or has pins and needles
- the skin around the injury has changed colour, such as looking blue or grey, or is cold to touch
See a doctor if you cannot put weight on your foot after the injury, or if standard sprain treatment (rest, ice and raising the foot) does not relieve the pain and swelling (American Academy of Orthopaedic Surgeons, n.d.).
How to Treat a Lisfranc (Midfoot) Injury:
Treatment depends on how severe the injury is, and is decided by your doctor or surgeon (American Academy of Orthopaedic Surgeons, n.d.). Once your medical team is happy, I can help you rebuild strength and get the joints in your foot moving again. See the My Approach tab for how I work.
#### 1. Early Care
While you are waiting to be seen, protect the foot, rest and try not to put weight on it. Apply an ice pack (or a bag of frozen vegetables wrapped in a tea towel) for up to 20 minutes every 2 to 3 hours, and keep the foot raised on a pillow as much as possible. Try to avoid heat and massage for the first couple of days (NHS, 2024).
#### 2. Rehabilitation
Follow your medical team's instructions about how much weight to put through your foot and when to return to activity. Recovery to all activities may take 6 months to a year in some people (American Academy of Orthopaedic Surgeons, n.d.).
Sources
References
- American Academy of Orthopaedic Surgeons (n.d.) Lisfranc (midfoot) injury. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/lisfranc-midfoot-injury/ (Accessed: 7 October 2026).
- Mohamed, A. et al. (2025) 'From missed diagnosis to optimal outcomes: a comprehensive review of Lisfranc injuries', Cureus, 17(10), e94615. doi: 10.7759/cureus.94615.
- NHS (2024) Sprains and strains. Available at: https://www.nhs.uk/conditions/sprains-and-strains/ (Accessed: 8 October 2026).