Feet > Midfoot Sprain > Treatments

   Immobilization

If you have sprained or torn your Lisfranc’s ligament and your bones have not dislocated or displaced, your physician may be able to ease your pain by immobilizing your foot and ankle in a short leg cast. A short leg cast wraps around your foot, ankle, and lower leg. It starts below your knee and is open around your toes to allow toe movement. Short leg casts are made of layers of fiberglass. Your physician usually rolls a thin, elastic stocking, called a stockinette, over your skin. Soft padding is applied and a dry layer of fiberglass is wrapped around your leg and foot. Extra fiberglass strips are wrapped around the sole of your foot. Additional fiberglass layers are applied wet over the first layer. Your foot usually remains in a cast for six to eight weeks and you are instructed to not bear weight on your cast.

While wearing your short leg cast and recovering from a midfoot sprain, it is important to retain blood circulation and movement in your toes. Wiggle your toes frequently and pinch them to check for numbness. If your toes become numb, you should call your physician. It is essential to keep as much weight as possible off your foot while wearing your cast. The more weight you put on your foot, the greater your chances of further straining the Lisfranc’s ligament. If your ligament does not heal properly, you are at risk of suffering complications, including fractures, a flatfoot deformity, or a chronic limp. Though everyone’s recovery is different, patients generally return to their physicians every two weeks for a check-up and X-rays to assess the healing in your foot. You usually can begin bearing some weight on your foot when the cast comes off after about ten weeks. You typically wear a removable brace called a cam walker for a couple weeks when you begin putting weight on your foot. You can bear additional weight in the cam walker as you can tolerate the pain. Full weight bearing and normal shoe wear usually can begin about 12 weeks after the injury. You typically need to wear an orthotic arch support in all your shoes. Successful treatment often requires routine foot stretching to be done two or three times a day. Physicians generally recommend that before you get out of bed in the morning, you should warm up by stretching your foot up and down and side to side. Before walking, it is often helpful to stretch the bottom of your foot, by pulling your toes back with your knee straight and your ankle flexed towards you. Your leg may feel weak when the cast comes off, and you may be instructed to visit a physical therapist who can help you strengthen your foot and leg muscles. Patients over age 55 more frequently are prescribed formal physical therapy. v=PAT&doc_id=29" target="_new">William G. Hamilton, M.D., team physician for the New York Knicks and New Jersey Nets.

Complications after a midfoot fracture are especially common after a fracture that involved dislocations. Midfoot sprains and fractures are difficult to rehabilitate, and you may not be able to return to competitive sports for as long as a year after the injury. It is important to strengthen the muscles and tendons in your foot and lower leg to protect your midfoot bones. You usually can begin range of motion exercises when your cast comes off six to eight weeks after the injury. You may be able to perform stretching and strengthening exercises on your own. But active people who want to speed their recovery time may benefit from supervised physical therapy. v=PAT&doc_id=29" target="_new">William G. Hamilton, M.D., team physician for the New York Knicks and New Jersey Nets.

Prevention

After a closed reduction and cast treatment for your midfoot sprain or fracture, you typically can return to normal daily activities within four to six months of the injury. To prevent reinjury, you may want to take it easy on your foot and avoid activities that could result in falls or direct contact with your midfoot. Unfortunately, midfoot sprains and fractures may be associated with long-term complications. Your midfoot is at an increased risk of redislocation, osteoarthritis, and some patients continue to feel stiffness in their feet. To prevent complications after a midfoot sprain and fracture, it is important to make stretching and strengthening exercises part of your everyday routine. If you do not suffer any complications and your midfoot heals properly, you may be able to return to sports and activities about one year after the injury. However, midfoot sprains are serious injuries, and your physician may restrict you from playing contact sports and other physically demanding activities.

Finding a shoe with the proper shape and support for your foot can help prevent abnormal foot strain. Your athletic shoes should have good shock absorption in the heel, good flexibility, and sturdy materials to prevent side-to-side motion. Try to avoid walking long distances in unpadded dress shoes or boots. Women should avoid wearing everyday shoes with heels higher than one-and-a-half inches. Wearing an orthotic arch support device in all your shoes can help stabilize your midfoot and prevent reinjury. Based on your activity level, shoe inserts usually wear out within six months and need to be replaced. v=PAT&doc_id=29" target="_new">William G. Hamilton, M.D., team physician for the New York Knicks and New Jersey Nets.