The Lisfranc Joint - Not your average ankle sprain.

Rob Parish28th of June 2018www.thebiomechanicslab.com.au / blog / afl / the-lisfranc-joint-injury


Adelaide and Collingwood supporters alike, are most likely wondering why star names such as Rory Sloane and Daniel Wells have been sidelined for indefinite periods of time with no guarantee on their return to their respective AFL teams.

 

The Answer: both players have suffered a ‘Lisfranc joint’ injury, described often in the media as a ‘foot or low ankle sprain’.

So why does this injury require greater recovery times than other ankle and foot injuries? And why is a timeline for return to sport so uncertain?


To understand what is a complex and potentially devastating injury, it is important that we have an understanding of both the anatomical makeup and function of the Lisfranc joint.


This Lisfranc joint describes the union between the midfoot and forefoot. It consists of 3 articulations; tarsometatarsal, intermetatarsal, and intertarsal joints. The Lisfranc Ligament is critically important in stabilising the 2nd metatarsal and maintaining the mid foot ‘arch’.

The arch is the load sharing centre of the foot and allows us to accept the forces generated through our body when walking and running.
The mid foot is responsible for transferring force generated at the calf muscle to the forefoot for propulsion.
The Lisfranc joint itself is inherently stable with little motion due to its stable osseous structure and ligamentous restraints. It is essential for maintaining overall foot structure and function.

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Injury is usually sustained through a simple twist and fall movement such as stumbling over a foot which is flexed downwards.  This may result in damage to the cartilage surrounding the joint surfaces, strain or tearing of the supporting ligaments and dislocations and fractures of the bony anatomy. Often a Lisfranc injury may be misdiagnosed as a simple ankle sprain especially in amateur sport environments. This has the potential to severely affect the treatment required and recovery times.

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Potential complications of undetected or poorly managed presentations include;

  • compartment syndrome and 
  • early onset arthritic changes resulting in chronic pain and altered foot function, often ultimately requiring surgery.

Options for treatment are varied and will be determined by the degree of injury or disruption. Both surgical (internal fixation/ fusion) and conservative therapy- consisting of an offloading period in a moon boot or cast followed by intensive physical therapy to restore strength and stability to the foot are utilised depending on the presentation. Some athletes do not return to pre-injury levels due to structural changes and associated altered loading characteristics of the foot.

 

 If you have any further questions regarding this issue, please do not hesitate to contact either Rob himself at Rob@thebiomechanicslab.com.au or contact the Clinic on (08) 7130 0130 or Admin@thebiomechanicslab.com.au

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The Biomechanics Lab