Physical Therapy and Lisfranc Fracture

Have Patience Everyone. I suffered a very severe lisfranc injury to my right foot in November 2009, suffering sever ligament damage, dislocating all five metatarsal bones with completely crushing (not fracturing) two of them. The x-ray revealed a completely empty space in the middle of my foot. All the remaining bones were apparently pushed to the side. The doctors were surprised that I still had a pulse. This all occurred from a simple fall in my kitchen. Emergency surgery was crucial but had to be delayed due to slow diagnosis and swelling, but the doctor said that the surgery had to take place within 6 weeks or I would be in big trouble due to the bones trying to fuse themselves back together incorrectly. The doctor had to take a picture of my left foot to rebuild the right. Finding and researching your foot surgeon is critical. I was relentless to find one that had experience in this injury and to interview him on his past successes and failures.


To make a long story short, a wonderful head foot surgeon with professional athlete experience (wouldn't settle for anyone else) 2 surgeries, a great physical therapist, 2 plates and 19 pins and screws later I'm walking, dancing and very pleased with my recovery (considering).I have 3 five inch incision markings covering the top of my foot, but completely overjoyed not to have any pain.


The pins, screws and plates are still in, but my toes move fine and my doctor told me that he left the plates and screws in to provide more support since my foot injury was so severe. I'm unable to run due to non-mobility of the middle of my foot, but I can still dance, play basketball with my daughter and walk with no pain.


Clogs and New Balance sneakers are my shoes of choice. I 'm about to venture into more decorative shoes, but I will have to make sure the sides of my foot are supported and it accommodates my orthotic.

Have Patience Everyone. I suffered a very severe lisfranc injury to my right foot in November 2009, suffering sever ligament damage, dislocating all five metatarsal bones with completely crushing (not fracturing) two of them. The x-ray revealed a completely empty space in the middle of my foot. All the remaining bones were apparently pushed to the side. The doctors were surprised that I still had a pulse. This all occurred from a simple fall in my kitchen. Emergency surgery was crucial but had to be delayed due to slow diagnosis and swelling, but the doctor said that the surgery had to take place within 6 weeks or I would be in big trouble due to the bones trying to fuse themselves back together incorrectly. The doctor had to take a picture of my left foot to rebuild the right. Finding and researching your foot surgeon is critical. I was relentless to find one that had experience in this injury and to interview him on his past successes and failures.

To make a long story short, a wonderful head foot surgeon with professional athlete experience (wouldn't settle for anyone else) 2 surgeries, a great physical therapist, 2 plates and 19 pins and screws later I'm walking, dancing and very pleased with my recovery (considering).I have 3 five inch incision markings covering the top of my foot, but completely overjoyed not to have any pain.

The pins, screws and plates are still in, but my toes move fine and my doctor told me that he left the plates and screws in to provide more support since my foot injury was so severe. I'm unable to run due to non-mobility of the middle of my foot, but I can still dance, play basketball with my daughter and walk with no pain.

Clogs and New Balance sneakers are my shoes of choice. I 'm about to venture into more decorative shoes, but I will have to make sure the sides of my foot are supported and it accommodates my orthotic.

Chris, We seem to have had the same surgery. I have a "tight rope", not screws in my foot. My surgery was on 12/19/11 and have been weight bearing with my walking boot and crutches only. I have my next appt. in 1 week and don't want to do PT if I can avoid it. Could you please tell me what to expect? Since everyone else had screws, I was hoping your experience was different.

My lisfranc injury happened on Jan 1st 2012. Yay happy new year. I ruptured the tendon between the 2nd and 3rd metatarsals along with the bone chip pulled away during the injury. I knew right away something was wrong. ( fell down my friends front porch) I went to the ER immediately. Then to the OS on the 6th ( I stayed in a cast from the get go ) They caught my lisfranc tear right away, and I had 2 screw put in horizontally that same day. At my 2 week post op appointment, my stitches were taken out and I was told to start rotating my ankle and moving my toes and was cleared to sleep without my cam boot ( I didn't want to until 3 days ago and I love it out of the boot) . 6 weeks post op ( Feb 15th) I was given the go ahead to start weight bearing. I had my original cam boot which was not the right fit for walking and ended up going back in for the right walking/curved sole, cam boot. I can hardly stand to have any amount of weight on the heel 3 days in but, I am determined to walk soon. I wont push it on my own. I have been going crazy with this no walking deal. ( I bought a drive knee scooter on craigslist for $200 and its a life saver. Google it, its worth it for months of no walking) I use a walker with a seat for my trials with bearing weight. 

Peggy, I'm happy to hear your determination and drive in getting back to normal as quickly as possible. Keeping a positive attitude is truly the best way to conquer this injury, and your right reading bad reviews could do more harm than good regarding your mental state of recovery.I remember being imprisioned on my sofa reading negative post after negative post crying and thinking I would never be normal again. Positive thinking is very powerful tool in recovery. Please keep using it.

Question...I am one year post surgery with 4 pins and four months post removal. I too have a lot of pain and the Dr is talking about fusion. How is you gait and pain now. Does the fusion reduce the foots movement dramatically? Any info you can give would be great. Thanks!

Hello, I also have has the unfortunate displeasure of having a Lisfranc fracture. On Oct. 6, 2011 I fell from one stair at a concert, my butt landed on both my feet, causing the fracture in the left foot and a sprain in the right. needless to say, i had to be carried out of the concert.4 days later i had surgery for it. I have not been told about what kind of gap or anything i had. they cut open the top of my foot, for i guess to put the bones back together? then they made incisions on the side to insert two screws, one horizontally and one diagonally. pain was horrible but next day i felt much better and was sent home with a soft splint. came back 2 weeks later for a hard cast. month and 1/2 later a boot, but still no weight bearing. Jan 4th I'm told i can start walking, and it took about two weeks to not have to use anything, and it was a bit painful but tolerable. I'm having the surgery to have the screws removed on Feb. 27th and i hope all goes well. I'm not into sport, i just want to walk normally and wear flip flops again one day. =/

Today was my 8 weeks post op celebration. And my first physical therapy appointment. I was cleared to start adding weight 2 weeks ago, so 6 weeks post op. Today was the best day ever. The physical therapist had me actually stand on both legs. Apply even weight gradually on both feet, and holy cow, I did it! It was amazing to feel myself with no pain yet full even weight distribution to my lisfranc injured foot. I was terrified I would be in pain, that I would not be able to walk normal or somewhat normal. Not true. I have 2 screws staying in unless it goes bad. I have a lot of range of motion because I worked on it as soon as my OS said I should rotate my ankle and toes. I was taught by my physical therapist today how to properly walk on one crutch, it's so important. And guess what? I left there on one crutch, no more knee scooter, no more walker, no more showers on a seat. I get to stand and use my boot to walk. I wouldn't forgo this physical therapy knowledge for anything. It's the best feeling ever to know I have a shot at my heels by Christmas. She did say swelling would last months and I will graduate maybe in two weeks to a stiff sole shoe. But to me that is awesome news. I am thrilled with how I feel. A little stiff, a little tender, but a lot happy. Keep your determination going and let a pro help you get where you want to be. I started like everyone else. Injured, and in need of surgery. Then weeks trapped on my sofa like a prisoner in a boot. Foot up, depression kicking in. I did what I could like loading the dishwasher and keeping the blinds open to let the light in. I bought a little adjustable table at walmart for a laptop that allowed me to have my desktop computer brought to the sofa so I could have something to do. A week ago we put all that back and I went to making myself get up to the office if I wanted to be online. I pushed myself back to some of my daily routines. I was never happier being off the sofa. I drove myself for the first time last week. And now can get out of the car alone and into my job alone and I feel so free. I just wanted you guys to know. Xoxoxoxo

You are so lucky you got physical therapy. i was just sent home and told to figure it out myself =/

I requested physical therapy and of course have to pay my copayment. I don't know if you have kaiser, but with a lot of insurance companies you don't need a referral it's an optional appointment. If the therapist needs anything it would be an all clear to safely start therapy on your lisfranc. It our health and we need to take control of it. If you want therapy, request the referral if its needed and if not, go make the appointment as soon as possible, it's the best way to be gradual and properly working the foot back to new. Often the surgeon is interested in fixing the immediate problem, and not concerned with how you handle it from there.

I have free care at LSU hospital here in sheveport, LA....they pay for so much but thats it, i have zero money for anything else =/

So here is where my discouragement comes in. I have been doing PT every 2 weeks for a few months now, and the foot is worse. The pain from walking is downright obnoxious. I need to wear shoes as barefoot is forcing me to the outside of the foot and that is causing pain in the side of the calf. My foot is still swollen, and just gets bigger throughout the day. I am doing ice baths often to try and get that swelling down. I have a tens unit I use and that's hardly helpful at this point. PT has done a few different things to try and ease the constant pain. Which gets worse and sharp during movement. This limp has thrown my back out, I need a cane full time. I will see my OS for my 6 mo post op here in a few weeks. I have no one that can relate to me. Its really not progressing like I thought it would. I have such terrible stiffness in the foot and ankle that flexing is a no go, I work on that several times a day. I can point my foot and go side to side, with pain of course, but I cannot bring the foot up. I am not even sure how to accept the way things are at this point and its making me an angry person. Pain 24/7 will do that. I am now on the look out for a foot support system to keep my foot in the flexed position all night. One that works for plantar fasciitis That is recommended for my lack of motion. My incision site is very tender even to the touch, yet I can bear weight with discomfort. And the injury site is painful. PT believes its muscular, and severe tissue damage. OS will have to talk more this time. 

Well I have had a similar experience to everyone on here. Back in 2003 I had a lisfranc fracture dislocation in both feet and suffered from an acetabular fracture (pelvis) as well (I was 18 at the time of injury) I was non Weight bearing for 5 months ( hopefully never have to be in a wheel chair again) as far as recovery and physical therapy I mainly just did pool therapy on my own. Recovery was quite a painful time and took a while to learn to walk again but hope was not lost. I eventually returned to my pre injures lifestyle. I used to race motocross and loved doing it and just couldn't give it up. Well of course the high impact sport broke some of the screws and pins in my feet so I had the hardware removed. 2 years post op I had a fusion in my right foot and my heal adjusted to align my foot better and hopefully ease some of the pain. Throughout the years I have had some flare ups of pain and was seeing pain management docs. Pretty depressing time but one day I finally decided I had enough of the meds and was gonna try and make it and live a normal lifestyle with just the occasional ibuprofen. It has been 4 years now since I made that decision and it has been a battle but I am doing just fine. I joined the army last year so I could stay active (even joined as an infantry soldier) I was tired of my desk job because it seemed that when I wasn't active I was thinking about my feet and the pain. Hince the reason for joining the army. As of today I am able to run and endure the physical aspect of the army life. Yes I am in pain everyday but it seems that when I am active I think less about the pain. After work and mornings are pretty tough but I make it through. I just wanted to post this to encourage people that u can still have a somewhat active lifestyle. I'm not going to say your not going struggle with pain and have some tough times but you have to make the most of what you have and take it one day at a time. I have been through a lot throughout the years so if u have any concerns or questions post on here and I will reply.

Thank you so much for the update bkendrick. I appreciate knowing what others are doing and how they differ from each other. I am very happy to read your in the Army and able to manage the pain on your own. Very encouraging to hear. I am trying to figure out a way to come to terms with this injury and all it has to offer me as a life challenge. This happened not of my own fault and I often feel angry because it could have been prevented. So I am working on my attitude. I cannot walk far without having to stop, and that's discouraging on its own. I want to go to the zoo, or the festival, or vacation, but not being able to go far puts me in a wheel chair, and I don't want that. I really appreciate the communication with others suffering this rare injury. Thank you.

Hey Peggy just want to tell u a little about my depression during my recovery time. I was told by the docs that I had a 60% chance I would not be able to walk again or I would walk with a severe limp for the rest of my life. So of course naturally I took the news pretty rough I was only 18 at the time. At first I tried to stay optimistic but it was tough because I was restrained to a wheel chair because the injury was to both feet and my pelvis. Half the time I just laid in bed because it hurt my hip when on the wheel chair. It got to the point where I was tired of being stuck at the house. I was going insane because I am an active person. I missed the last month of high school, but fortunately they still let me graduate. I had to be pushed across the football field in a wheel chair. Not the perfect graduation but oh well. Anyways I'm not going to go into the whole story but I had to get out of house and go somewhere on my own. Tired of ppl always trying to help me. So I grabbed a baseball bat some ductape and made a stick with grip so I could drive my car. Bad idea git in an accident with a brick wall. Was ok from accideng but probably depressed me more. After that I was pretty much like a zombie. I just laid there everyday. When I was finally given permission to start weight bearing it was a very painful time. It took me a a good week or so just to be able to stand up on both feet. Very painful. After I realized I would be able to walk again depression was still there but in the back of my mind. I talked myself into doing pool pt. Very helpful. I would say for the first year maybe year and a half I had a bad limp when I walked. Over the years I guess I have learned to walk differently and not limp. Still a slight limp but not near as bad. Peggy all I can say is give it time and don't give up on yourself it will get better. Just stay positive. Forgot to mention during this time I also became religious and still am today. Saved my life but prayer was always helpful and encouraging. Well stay positive and keep us updated I like see everyone's story and update.