Six weeks ago, I fell while working out of town. This website gave me a lot of information and insights into my Lisfranc injury. For example, my (former) doctor’s assistant could not answer a single question about it when she delivered the diagnosis. Her suggestion to “Google it” led me here. I would like to share my story as a way of repaying the favor. My injury was about a 6 mm separation and dislocation of the first and second metatarsals, as I fell up a large step, landing on the top of my foot, with the leg folder under me. Instantly, the pain was intense and would not hold my weight and lost all mobility due to swelling and pain. I was able to treat it kindly, with ice, compression, use of a wheelchair or cane (due to the care of knowledgeable friends). I took nothing by Tylenol—I was warned NOT to take ibuprofen--which tricks to body to ignore the injury to dull the pain, but caused scar tissue to form which complicates healing. I am an incredibly healthy, active middle age woman, and have practiced Chinese martial arts and Taiji for more than half of my life. I am not used to being inactive or ‘cared for’, but I am convinced that listening to my friends early in the injury made a lot of difference. Once home and x-rayed, I was given the diagnosis of “no fracture, but a Lisfranc injury” and my first referral was to an orthopedic surgeon. As I live near a major university hospital with a renowned sports medicine program, I was seen by an orthopedic doctor who is considered an expert. After less than a minute in my company, he recommended surgery to insert wires or screws to move the bones into correct positions. This would mean: cutting through connecting tissue to move the bones and inserting screws; no weight on the foot for 4-5 months before the screws are removed, then rehab. He barely took a breath to add: “This is a bad injury that will give you a lot of trouble later. You will probably be back and the permanent fix is to put a plate and screws in permanently. Research shows that it’s best to do that now and save the time and hassle.”
When I stated that mobility in my whole foot was important to maintain (especially in the martial arts I practice) he said, “There isn’t enough mobility in that part of your foot to make any difference.” Though he scheduled the surgery for the following Monday, I immediately went to a well-respected chiropractor for a second opinion. This doctor treated several good friends of mine for serious ankle and backs injuries, providing near ‘cures’ for what orthopedics wanted to wire or fuse. He studied the x-ray and asked a lot of questions about the exact nature of the fall and how I landed. He confirmed that one should ONLY take tylenol or aspirin for a soft tissue injury to avoid scar tissue forming. He commented that it was often 3 weeks before a hairline fracture would calcify enough to appear on an x-ray, but that he suspected one in my case. He was the first person to look at my healthy foot to compare the shape, flexibility and mobility. (It seems like when you have a symmetrical body, it’s a good plan to check the uninjured side.) He also was the first person to check my ankle and heel, which I also seriously sprained in my fall. (This seems obvious now, but the intense LI pain over-rode every thing else.) This chiropractor was very knowledgeable on the structure and physics of the foot and ankle, and pronounced that I have very healthy, “young” feet. He thought I had every chance to recover full, pain-free use of the foot without surgery. He then ‘adjusted’ the bones in the foot—old-fashioned bone setting--moving them back into place which was very painful. He also adjusted the ankle and heel, working on me for about 20 minutes. But, almost instantly, the pain was different—and there was considerable relief as I could tell the bones had moved into correct alignment. He prescribed keeping it wrapped, iced, elevated, very little weight. He also suggested that after a few days to begin gently flexing the muscles in both toes and ankles to begin to regain the mobility. I stayed off the foot, almost entirely for 2 weeks, then, very limited walking with a cane and support shoe. I’ve returned to the chiropractor about once a week. He has adjusted it a little and worked to realign and stretch out the outside of the foot, which became tense from over compensating for the injury. It is now 6 weeks after the fall. My foot has returned to almost its old self, I am back to limited walking on it, wearing solid, orthopedic shoes and at times a cane. I expect that I will be back to practicing Taiji (weight-baring) in another 2-3 weeks. With stretching and exercise, I have regained almost complete flexibility already. It gets a little tired and achy by the end of the day (then I wrap it), but I am sure my normal life will return. I can’t describe how glad I am that my community includes such talented alternative medical options. I know I was lucky my injury was not as serious as many Lisfranc injuries, and I really can appreciate how painful and disheartening an injury it is. But as my great chiropractor said: “You can always have surgery to try to fix a problem like this. Why not FIRST try something less invasive, that does not further damage the soft tissue?” In my case, he knew exactly what I needed. I hope everyone finds as ‘simple’ and effective an answer to his or her situation. Good luck, everyone who needs this info! Have hope.
When I stated that mobility in my whole foot was important to maintain (especially in the martial arts I practice) he said, “There isn’t enough mobility in that part of your foot to make any difference.” Though he scheduled the surgery for the following Monday, I immediately went to a well-respected chiropractor for a second opinion. This doctor treated several good friends of mine for serious ankle and backs injuries, providing near ‘cures’ for what orthopedics wanted to wire or fuse. He studied the x-ray and asked a lot of questions about the exact nature of the fall and how I landed. He confirmed that one should ONLY take tylenol or aspirin for a soft tissue injury to avoid scar tissue forming. He commented that it was often 3 weeks before a hairline fracture would calcify enough to appear on an x-ray, but that he suspected one in my case. He was the first person to look at my healthy foot to compare the shape, flexibility and mobility. (It seems like when you have a symmetrical body, it’s a good plan to check the uninjured side.) He also was the first person to check my ankle and heel, which I also seriously sprained in my fall. (This seems obvious now, but the intense LI pain over-rode every thing else.) This chiropractor was very knowledgeable on the structure and physics of the foot and ankle, and pronounced that I have very healthy, “young” feet. He thought I had every chance to recover full, pain-free use of the foot without surgery. He then ‘adjusted’ the bones in the foot—old-fashioned bone setting--moving them back into place which was very painful. He also adjusted the ankle and heel, working on me for about 20 minutes. But, almost instantly, the pain was different—and there was considerable relief as I could tell the bones had moved into correct alignment. He prescribed keeping it wrapped, iced, elevated, very little weight. He also suggested that after a few days to begin gently flexing the muscles in both toes and ankles to begin to regain the mobility. I stayed off the foot, almost entirely for 2 weeks, then, very limited walking with a cane and support shoe. I’ve returned to the chiropractor about once a week. He has adjusted it a little and worked to realign and stretch out the outside of the foot, which became tense from over compensating for the injury. It is now 6 weeks after the fall. My foot has returned to almost its old self, I am back to limited walking on it, wearing solid, orthopedic shoes and at times a cane. I expect that I will be back to practicing Taiji (weight-baring) in another 2-3 weeks. With stretching and exercise, I have regained almost complete flexibility already. It gets a little tired and achy by the end of the day (then I wrap it), but I am sure my normal life will return. I can’t describe how glad I am that my community includes such talented alternative medical options. I know I was lucky my injury was not as serious as many Lisfranc injuries, and I really can appreciate how painful and disheartening an injury it is. But as my great chiropractor said: “You can always have surgery to try to fix a problem like this. Why not FIRST try something less invasive, that does not further damage the soft tissue?” In my case, he knew exactly what I needed. I hope everyone finds as ‘simple’ and effective an answer to his or her situation. Good luck, everyone who needs this info! Have hope.
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I'm in sports medicine and have dealt with 2 lis franc injuries in the past year. I have found the best way to diagnose this with a weight bearing xray, AND what they call a stress x-ray. With a stress x-ray the doctors bends your foot and takes the x-ray. One person I dealt with had 3mm of gaping. She continued her sport but it was very painful. Had two screws inserted, after about 2-3 (i believe) months the screws were removed. Still has pain day to day, but it was WAY better than before surgery. Has good and bad days... and similar to ACL surgery will likely be this way for the first year post surgery. The second case I had, was less than 2mm of gaping. Has not required surgery, but pain level is pretty high.
What I have found is most people who have a lis franc sprain (ligament damage, but no fracture/displacement) will be pain free to walk in 3-6 weeks...its when they return to a high level of athletics that it becomes problematic (Cutting and changing directions stresses the midfoot). Even if you become pain free while using boot/crutches, or even visiting your chiropractor I'd be wary. In addition, the pain come from there being too much motion in a joint that is fairly stable. I'd be concerned with a chiropractor manipulating a joint that is already too mobile.
I also saw one other comment that concerned me. Someone said they are out of their boot, and there is no pain or arthritis... you wont have arthritis in the first few months... you're looking at years down the road. Too much motion of the bones where there should be minimal... it will rub, wear away, and cause more issues.
Finally, talking to the podiatrist that worked with both cases.... we removed the screws because of the sport the person was playing... otherwise could have left them in. All of these injuries need to be treated on a case by case basis. Remember MRI/CT scans are good tests, but they are static tests no weight bearing or movement. The best way to diagnosis is to move the joint and see if it spreads using a stressed xray view.
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It's been 4 years since my daughters Lis Franc injury (she was 16 at the time of injury). Like most her injury was initially mis-diagnosed allowing 5 weeks to go by before surgery. Her surgury included screws, weeks of no weight bearing, weeks of wearing a boot, surgery to remove screws, and physical therapy. Eight months after surgury she slowly resumed her athletic activities (Volleyball, Track) pain free. All was going well, but wait.
Arthritis began to set in the injured joint around two years after surgury. We are now four years post surgery and the arthritis pain has begun to takeover my daughters life. Since she is only 20 years old the orthopedic surgeons advise we hold out on fusion (it will stress surrounding joints resulting in more arthritis).
My daughter is now emotionally in a funk. She has lost her identity... the pre-injury person had many goals and aspirations that involved her interest and skills in athletics. The post injury person can no longer pursue or enjoy these interests and outlets. She is struggling to figure out who she is today. I'm looking for others that have gone through this rollercoaster and would be willing to talk with us and share their similar experience. This is a life changing injury that is hard to appreciate unless you have directly experienced it's dreadfull impact.
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I have crushed my foot liz franc metatarsols etc. Developed Chronic Regional Pain Syndrome. I was operated on plates and screws. The doctor by mistake left a two inch plate in my foot and had to further operate. Three and a half years later, now my foot is purple, so badly bruised for no reason and cannot walk. Only short distances round house and foot gives way. The bruising started one here and there months ago and now my whole foot is one massive bruise Diamond .... syndrome I have just checked. Yet another obstacle. It is travelling up my leg with bruises swelling right up to thigh. The doctor says there is nothing available or cure
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Hi, please tell me the name of the chiropractor you saw. I would love to see him. I have a small injury too with only a little fracture.
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hell yes id get them out its minor surgery but if a screw breaks leaving a jagged edge in your joint wow what a mess that would be to fix !!!
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