Physical Therapy, or the Easy Way to Recover from a Lisfranc Injury…
Considering that the cure used to be amputation (though perhaps for an injury that was more serious than mine) I figure physical therapy is the easy way!
I am making this a separate account for interested family members, and anyone who wants to know what is ahead…
June 22-First day: Mostly testing to see how much mobility I have in the foot (almost none) and how much strength I have lost in the leg (almost all).
Exercises:
Active Range of Motion
- Trace alphabet in air with foot
- Wiggle toes
Strength Development to do at home (3 sets if 10, 3x a day)
- Straight leg lifts keeping the lifting leg very straight (only to the height of the knee of the bent (good) leg)
- Bent leg lift sitting on a chair
- Side leg lift, being careful to keep the hips stacked and the leg slightly to the back
- Inside leg lift
- Back leg lift (lying on stomach)
- Keeping leg straight, put a towel under the knee and push down.
Strength exercises on machines:
- Straight leg side lifts
- Bent knee, lift calf forwards (9 lbs)
- Lying on stomach, straight let, bend calf back (10lbs)
Ice as needed, 5-10 minutes
She didn’t want to put any pressure on the foot herself until she got the ok from the doctor. Massaged the foot and the calf.
June 26
Range of motion:
- All previous exercises
- Flex foot up and down (3 sets of 10, 3x a day)
- Inversion-Eversion (side to side) holding knee still (3 sets of 10, 3x a day)
Strength exercises:
- Same as last week, just didn’t do the side leg lifts on the machine
June 29 Therapist got the ok from the doctor to put pressure on the foot, so she did a manual stretch forward and backward.
Range of motion:
- All previous exercises
- Calf stretch with a towel or elastic band, keeping knee straight (30 seconds, 3 x daily)
- Tennis ball manual massage of instep
- Manual stretch of foot forward and back (30 seconds, 3 x daily)
- Put a bunched out towel on the floor and try to pull it in with the toes (visualize doing it if you can’t actually do it)
Strength exercises:
- Same as last week,
July 2
- the range-of-motion exercises from before, but with a stretchy elastic strap giving resistance
- working with the foot on a board that has a ball in the middle of the underside so it rotates-forward and back, side to side, and rotating
- therapist stretching foot
- then calf strengthening on machine
These are the therabands I used. I lost the yellow one.
July 6
- We added a movement pointing the foot all the way to the right and out, then moving it all the way to the left and in, against the pressure of the therapist’s hand.
- Started working more on the toes, stretching them, then having me push back against her hand.
- Also started working the area around the scars to break up adhesions
- MEAN massage of foot and calf!
July 8
- The big addition was putting the foot (toes only, and still wearing the boot) on the ground when walking, with virtually no pressure. “Walking on eggs.” It’s actually harder and slower than not using the foot at all!
July 10
We added a leg press, using the hurt foot, with 25 lbs, and then added 6 more.
Also picking up marbles with the toes. I could only do it with the fourth toe. (The next day I could do it with all but the bit toe, which still doesn’t work.
July 14
Nothing really new. Spent a bit of time making measurements to see how my flexibility and strength have changed, to take to the surgeon on the 15th.
My calf muscle is still really tight. Massage is excruciating!
July 19
Went over the x-rays with therapist. Surgeon said there is scar tissue on the ligament going to the big toe, which is why the toe won’t work. Therapist noticed a lump on the side of the toe itself, so we have to find out if that is scar tissue.
Added exercises:
Standing facing a barre, shifting weight from uninjured (right) to injured (left) foot, keeping torso straight
Standing with barre on left side, left foot flat on ground, behind right foot. As much weight as possible on left. Slowly lift heel, rock to ball of foot, lift foot, step it forward, put down heel, ball of foot. do 10 times.
Walk, using crutches, but putting as much weight on left foot as I can take.
We did these with bare feet because when I work out it’s in bare feet, (also because I didn’t bring a shoe), but I am going to try doing them with a shoe on, since the foot feels very unstabilized.
August 12
More catch up…Since I went back to work, I haven’t had time to list a blow-by-blow description of PT. Basically, we are now concentrating on getting the toes to move forward and back, and getting some mobility in the talus. I am still doing the leg lifts, but with ankle weights (at home), and the ankle exercise with the resistance bands. We usually don’t have time at the PT session to do all the machines, but I focus on the machine that has you lie on your back and flex the foot forward and back with weights. (not a very clear description!)
I have added calf stretches done on the edge of a step, and I practice going down steps when I am going home in the evening.
August 14
We worked on going down steps. Established that there are two reasons I have trouble:
- My ankle is too tight.
- My toes aren’t strong enough. I can’t go up on the ball of one foot without the help of the other one.
More exercises to do!
I was, however, able to stand on the left foot (without shoes on). tho I cannot balance yet, because the toes don’t touch the ground.
August 25
Had a good pt session today. I have stopped writing down all the exercises and find I have forgotten some. I also don’t realize that this or that one is important until the therapist finds I haven’t been doing it!
So today we’ve added pushing a weight back with my toes, balancing on a tippy circle, marching slowly in place, and balancing on the left foot with my eyes shut (holding on to a bar).
Much improvement. I can walk without my cane, although I use it because I need it for balance if the ground gets uneven.
September 20
It’s been a bit sobering…my foot HURTS! I almost feel that it has betrayed me. This isn’t a bad thing, though. The physical therapist has abruptly upped the ante on me, and since I fear the insurance case supervisor will run out fo patience soon, it’s a good thing. We are re-training the arch muscles and the toes, and I am now tired and hurting for two days after a session.
Exercises include: throwing a ball back and forth while standing on one foot (or trying to!). To be fair, my therapist stands on one foot, too; jumping and prancing (alternating feet) on a mini trampoline; standing with the toes squished up against a step, and balancing on one foot on a squishy hemisphere. The band around my big toe really burns afterwards.
A few weeks ago, I decided I needed short-term goals. I chose a few that were measurable: balancing on one bare foot (the hurt one) for 7 seconds, walking downstairs without holding onto the bannister or using my cane, increasing the legweights to 5 lbs. for most of the strength exercises, and being able to sit in seiza for 5 seconds without support. The therapist suggested that for this one, we count the number of folds of towel I need under my ankle. Within the first week i had done the stairs (not gracefully, but who said it had to be graceful?), balanced once for 7 seconds, and am working towards the other goals. Yipee!
October 12
I am in shock! I just discovered that the hospital has been charging all my pt to the wrong insurance company and then taking a co-pay from an overpayment I had on the books, without telling me, billing me, etc. By chance I finally got to the patient advocate, who forwarded my story of woe to their finance department. The billing people, of course, had been worse than useless. I will post a detailed story later!
But I will have to continue with physical therapy, since my toes still don’t work properly! Last visit we added:
- A four-direction lunge exercise
- jumping, while lying on my back on the pilades reformer machine
Afterward, my foot and leg were both exhausted, but now I can move the heel of the injured foot off the ground without providing power with the strong foot. Just a little, but it’s a start!
Nov 4
Managed to balance on one foot for 20 seconds (with shoes on). this is a new skill. Added several exercises that involve jumping or skipping. They really exhaust my foot!
Nov 9
Had a few breakthroughs: going from cat/cow yoga pose to downward dog, plank, and slowly back to cat/cow. This involved using the toes of the hurt foot.
Did a standing back roll and a full back roll, catching myself with my toes. Yippee!
Much later...I am discontinuing this page because I am not doing formal PT any more…so I am putting the entries on the regular blog…
So You've Got a Lisfranc Injury! 
This is extremely helpful! I am still in my cast, but I think I can start doing a few of these exercises (at least the ones you mention before you get into pressure/weight bearing on the foot). I’ve asked the surgeon what kinds of things I can do starting now to keep the muscles active and the blood pumping through the leg and foot. He says I can do whatever I like that doesn’t involve putting pressure on the foot, but beyond that– no clear suggestions. So, anyway- thanks!
I’m glad it was helpful! I didn’t realize how much muscle I would lose, and how stiff I would get from being in the cast, so doing as much as you can safely do should really help!
hey, this blog is really helpful!! i had my injury about 6 months ago and got surgery putting two screws into my foot which luckily will not need to be removed unless they start bothering me. so now i got my cast off and im in a boot which i can remove every night.. but unfortunately i also sprained my other foot’s ankle and had a small fracture on that foot as well, so basically physical therapy is going to be CRAZY! thanks for your posts, they really gave me an idea of what its going to be like afterwards.. im now able to walk with a walker/crutches and put full weight on the sprained foot and half weight on my lisfranc foot. just scared that putting too much weight will cause permanent damage!
I’m glad it’s helpful. If you can walk with a walker, you are way ahead of where I was when I started PT. The therapist should be able to tell you how much weight is ok.
You are lucky they told you that the boot can come off at night. Both the doctor and the therapist forgot to tell me! So ask them lots of questions!
The foot may feel weird when you put full weight on it. The feeling eventually goes away. Good luck wth the PT–it does get better–really!
hey! sorry i never replied, but this blog really helped! now it’s been almost 8 months since my injury and i want to update that i have been walking on both feet, no walker no crutches no boot for atleast 5 months!! however, i have a question – how long has it been since your injury? and have you gotten back to normal feeling yet? because i still walk with a limp, and if i walk for over 15 minutes, my foot starts to ache. also, its nearly impossible for me to go on my toes without putting most of the pressure on my good foot and to crouch down or sit on the ground for extended periods of time is difficult as well. what have been your experiences with this??
I’m sorry, I don’t remember replying to this…I have been upgrading my computer and I think I missed your comment. It’s been 2 years and two weeks since I got hurt…The sole of the foot feels normal. The only strangeness is right at the base of the big toe. There is still a bit of nerve damage, so it sometimes feels a bit tight and tingly. I don’t think I am limping at all. I can jog, although I can’t sprint yet. I can go up on my toes, although my balance isn’t that good, but it isn’t that good with the uninjured foot either. Squatting down is problematic, but it’s a problem with both feet, because my tendons tightened up when I didn’t stretch them while I was off my feet. I have to loosen up before I sit in seiza..which was never a problem before. When I walk on uneven ground, especially in bare feet, I can sometimes feel that there’s something “different,” and it does hurt a bit.
I went birding in Central Park with my sister last week, and we walked all day. She commented that I couldn’t have done it a year ago. My experience is that the last year has been crucial in getting energy and strength back.
I hope this helps. The recovery from this injury really is a bitch, but I would look for more improvement, although your injury may also be worse than mine!
9:01 AM CDT
cindylmart
Posts: 1
First: 8/22/2012
Last: 8/22/2012
I am 5 months post op from a fusion from a lisfranc fracture and I cannot yet run. I am reading these posts that I must be patient. Ha Ha We all know that we runners are not the PATIENT type! I can at least do the elliptical and walk but not long distances. My question is which exercises will hastent the healing and when to lay off? For instance.going up and down on my toes seems a little severe. I am willing to do it like crazy if it helps but my PT claims that it takes so long to heal because I am on it all the time. I wonder if I should just walk normally and lay off the radical stretches and it might heal on it’s own faster?? I’m tempted to take some ibuprofen and try running!!! PT says “Patience Cindy. Let pain be your guide. If it hurts when you run you are not ready.” What do you all think?
Frustrated, Cindy
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Oh boy, Cindy, I know how you feel! I am going through a similar experience these days, following surgery for a meniscus tear. I know that in my case, 5 months post op from the lisfranc operation I could barely walk, much less run. I understand that this isn’t an injury one wants to push, because if it heals badly one is in a whole lot more trouble! But there’s lots you can do to build up muscle and aerobic stamina without stressing the foot. What about swimming and water exercises, bike riding, elliptical, stretching, and weight work that doesn’t require standing? Then when the foot is ready to run, the rest of your body will be, too. But remember, I’m not a physical therapist…if you have one you are working with the best thing is to listen to what they say and check with them before you start doing stuff. Really.
I know it’s pretty depressing, but now, 4 years after my injury, the foot is basically 100% functional, and I credit my PT person with a great portion of that. Good luck with the recovery!
I hope you don’t mind me putting my experinces on your blog – it’s nice to know there are others out there suffering from a similar injury (you know what I mean)
I had my injury on the 29th August and had my op on 9th September because there was too much swelling
I had dislocated and fractured (?not too sure) 4 metatarsals on my right foot having fallen 7 feet from a ladder
I have two screws and two hooks in my foot at the mo, which I am told come out in about 3-6 months time.
I have spent the last 8 weeks in a cast. First a surgeon’s cast (a half cast with all the bandages blood soaked – yuk) and then a modern lightweight cast
I have had no pain at all from the injury and am now in a boot (a Donjoy knee length) which is awkward and cumbersome. It’s like strapping on a jet pack except it slows me down.
Still I can partially weight bear now with crutches and the boot and when I take it off, once an hour I have to do ankle exercises for ten minutes very much as you did
The main problem I find with the injury is two fold
1. Everything is so damn slow – I’m told I can only go back to work after Christmas and then only on light duties
2. My big toe feels really weird – it does not hurt but feels numb inside if that makes sense
I had an injury 30 years ago where I broke my tib and fib and cut the main tendon to the big toe so maybe that’s it – I’m just a bit concerned that it maybe the c=screws causing problems
Still one step at a time – I can sleep at night without a cast and will satrt physio in 10 days time
for all of you starting out out there, hang on in, it gets better !
I love it when people write comments about their experiences! The slow recovery is really a drag. I was so excited when the surgeon told me to bring a shoe to the next appointment, and crushed when he obviously hadn’t meant it, because there was no way I could put on a shoe at that appointment. Are you able to keep the foot elevated?
My big toe felt really weird, too. First it felt as though there was a band around all the toes, then just around the big toe. Now the numb feeling is almost, but not quite gone, and after a lot of work on it, I can move the toe independently of the other toes. But it took work! So, yes, you are right, it does get better. Keep us posted as to how you are doing.
@ Chris Price: Sorry to hear about your fall, but it actually sounds like you’re healing quite well. I have the same numbness in the big toe, it’s getting better but has taken a while. There’s a nerve that runs right through the area of fusion that is often damaged in lisfranc surgery, but my surgeon told me it “wakes up” again in most cases. He also advised that I could help it along if I massaged the area and that some people even use a fine grained sand-paper like surface to gently bring the nerve around. I’m about 4 months out of surgery and it’s significantly better but still not back to normal. My blog is linked here as well, I’m overdue for an update now that I’m almost done with PT. Good luck with everything!
Hi
Thanks for the encouragement !
Especially thanks for the comments about the toe – it’s very reassuring.
You are right about asking lots of questions. The plaster room told me that I had to wear the boot ALL THE TIME. Physio told me that I had to rotate my ankle for 10 minutes once an hour. It takes 5 minutes to get the damn thing on ! When I phoned, physio told me to phone plaster room and a long conversation ensued before they agreed that “yes maybe you don’t have to wear it all the time” It seems like the right hand doesn’t know what the left hand is doing.
I think a lot of what happens is that the health service does not trust us patients so they just put the worst case scenario on everything and make us take precautions that are prohibitory
Talking about boots, how long was anyone in one ? The reason I ask is that the NHS boot they gave me is a pain in the bum and the SP cast advertised in the physio room site looks like a much more usable prospect. But if I’m only in the boot for 3/4 weeks, it’s probably not worth it
I love the Xrays by the way – my family call it Band Q surgery
Chris
High excitement ! I just went out to the car to check the oil etc (son has been using it and now lays claim to it) and thought I would try the pedals with just a trainer on.
Turns out it’s not anywhere near as bad as I thought it would be and the pedals are actually very easy to push down.
I guess I’m lucky I don’t have any pain
Point is, when did you guys start to drive again ?
Chris
I think, because this injury can be so varied, it’s hard to say when the cast or boot comes off. I was in a cast for a week between the emergency room and seeing the surgeon, who put me in one of those black boots that strap on with velcro and you keep coming out of, then in a cast after the operation, then a boot again after about a week. I kept it on for about 2 months, although I could have taken it off when I wasn’t moving around, but they forgot to tell me that.
The toe took quite a while to come back. I tapped it (and the top of my foot) too, and that helped it develope sensation.
Driving wasn’t an issue, because it was my left foot, and I don’t drive much anyway. I think I could have driven as soon as it was ok to stop elevating the foot.
I was in a velcro boot for 6 months prior to surgery, then a plaster cast for about 7 weeks, then back in the velcro cast for another 6 weeks or so. I don’t drive, so can’t weigh in there. As much as of an annoyance that the boot is, I really think staying in it for the long-end of the recommended time is for the best. I do think that waiting until x-ray confirmed the fusion is making for a more productive and quick recovery in the long run. I have an uncle who’s physician had him back on his foot/in pt too soon and just had to go through the whole surgery (and another 8 weeks of no weight bearing) all over again. You don’t want that!
Thanks for that. I intend to stay in the boot when I am mobile, but I have to do the ankle rotation exercises every hour, so I rest it elevated.
I take it from the talk of insurance companies on here that this is mainly an American blog
If you have the time and are interested, I would be happy to compare the relative merits of insurance v our national health system. Although our health system is very good (treatment when you need it, albeit crowded wards) the lack of information and advice is sometimes a little scary and the person who generally knows (the surgeon) gives you 3 minutes of their precious time
Oh well ! Back to the ankle rotations
Thank you so much for your input and advice
Chris
Sorry to take so long to respond…been a bit distracted. One of the problems with the insurance system is that even if you have decent insurance, you have to be so vigilant. In hospital, for instance, a doctor will come by, look at you, go “hmmmm” and next thing you know you have a $400 bill from a doctor who is out of network. You have to pay it and you didn’t even know you were incurring the debt. Many treatments have to be approved, and it is on you to find out.. so half way through my radiation treatments I suddenly couldn’t remember if I had checked the approval (It turned out to be OK, but who needs that in the middle of radiation?) Just finding a doctor who takes your insurance is a big job when you cannot walk and are doped up with oxycodone!. And then there’s the billing. As you may have read in the blog, I suddenly found that the hospital was billing the wrong insurance. I finally got that straightened out, then got a bill from a hospitalization four years ago. They hadn’t bothered to send an invoice for all that time!
On the other hand, I do have insurance, which is a boon. A friend who didn’t have insurance needed a hip replacement, and we all had to do a huge fundraising for her to get the money to pay the doctors’ bills.
Sorry I have not been in touch, I have been in a rehabilitation centre. Not done through our National Health Service. I am a police officer and we have three centres in the country that we pay into through our union
The surgeon said I could wear a pair of Magnum boots instead of the orthapaedic boot – hurrah for him !
I had two weeks at the centre, getting physio every morning and then exercises in the hydro pool and then the big swimming pool, together with custom exercises for my foot.
I discovered that it’s not the injury site that is the problem – it’s the fact that my ankle seized up through lack of use and my dorsiflexion is only about a 1/4 of what it should be
I have had no pain from my foot until physio started seriously – now it aches !
Now back to the real world. Saw the surgeon’s registrar and she said I could walk on it as long as I could walk “properly” otherwise I should use crutches to walk properly
I can walk for a short time properly, before the foot begins to ache so there is hope. I have been pushing every medical person that I met for better exercises and now I have them I’m begiining to regret it a bit
After the centre, the NHS is a bit of a let down. I have my first physio appointment in a week’s time. What crud !
Still, work usually offers at least 6 physo sessions to get me back to work quicker
Registrar says that I should go back to work on light duties in January and as I am not front line that should be fine, but even then I’m not looking to be back full time much before May, especially with the screws having to come out as well
It makes you realie that it takes a long time with this injury when your physio says “but Chris you are only 12 weeks into your recovery”
Hmmm
Best wishes to all of you and I hope you get to run your marathons and other sporty stuff. Me, I’ll be happy just to walk !
Chris
I had very little movement of my ankle when I finally got out of the boot. If I can find the video I took of it, I will send you the link, so you can see how much it can improve. At this point, I have pretty much full mobility. Balancing on the foot was a really problem, but that has come back, too. Do you have therabands? (Elastic bands of different resistance). They were really useful in the initial physical therapy. It sounds really wonderful to have the hydro therapy and the pool. That would have made a lot of difference for me!
I know how you feel about being happy to walk! But aim at being able to run! It feels so freeing, I can’t believe it. Good luck! By the way, at 12 weeks I wasn’t even walking without crutches, so you are ahead of where I was… lChris
April 12, 2012 was my surgery date. I have a lisfranc fracture and I broke all of the metatarsals! I am transitioning from the boot to a sneaker with orthodic. The sneaker is not big enough for my foot, which is now higher due to the plate.
Any suggestions for other kinds of shoes/boots?
Patty
Hello! This is the first time I ever replied on one of these. I have a Lisfranc fracture/dislocation as well… 😦 I got it when I was 16 years old!!!! A golf cart flipped over onto my foot squishing it on the cement with its tire. Long story. I was in so much shock that I pulled it out from under the tire, and that’s when I heard pop pop pop! I broke 5 bones and dislocated two joints. Horrible. It was externally pinned (3 ) and that was that. I had a hard cast for two months and had to do phisyo for 4 months or so and I never played many sports after that. I just did what I thought would be fine, RUN! I was pretty poor and so I couldn’t afford orthotics until just last year (2010!).
Eight years later I am 24 now, and I have arthritis in my midfoot and I am having pelvis problems from limping. I have had two ”flare ups” once just the beginning of last year in Mexico ( I was wearing crappy shoes ) and another when I was doing hot yoga ( bending my big toe in the heat). Just recently I went to the best surgeon in the province and he said that the longer I wait for surgery the better (WTF) since it is such an invasive surgery (joint fusion where they take out one of the joints and drill it all back together). He said it is better when I am 30 or 40 years old also there will hopefully be some medical advances. Pretty horrifying. I am a bit depressed but I am trying to take this all in and learn from it. Buddhism has really helped. It has gotten me to meditate, become more spiritual and realize how fragile we all are and that the human body is an amazing gift. I am trying to be positive and the more I really try the better things seem to be. I currently am in phyiso once a week, (its free ) and I see a chiropractor for my pelvis/ foot. I somehow go to school full time and have just until now realized that I have a lifelong disability. I am currently working on the grieving process. After the second flare up, which happened right before school in September of last year, I had to drop all but one class and I was in a wheel chair for a month or so when we walked our dog (my husband pushed me! ) I am a member of the Arthritis Society—- they have helped me out so much, all for free. I take Glucosamine, MSM,Chondrotin,WildFishOil, Vit E, Vit D and a really good calcium. They seem to help. I convinced myself that running sucks for your body anyway— It helped me with coping without a good run. I have a pull up bar and work on my upper body (totally helps with my mood) and use the gym at my school to work everything else out, even my feet. I am in pain everyday though some days less. For example the pain I am in right now is a 4 out of 10. I walked a lot. I don’t smoke cigarettes but I do smoke marijuana once a week and I find that the pain gets a bit worse but I just ignore it. I heard that it does something to your circulation? I am getting used to it though! I have a rolling backpack which is great, I use Nordic Walking Sticks (They are the best! You look funny and people say a lot of comments about your liking to ski. They help with taking 20% weight off the and knees– my friends at the arthritis society taught me— plus it keeps my back straight and hip rotation to a minimum–less limp. They have removable feet- when you remove the feet there is a metal rod sticking out for when you go for a hike, for stability too.
One last thing. I have also thought of an actual amputation. If the pain keeps up like this and I get all miserable for 10+ years I will seriously think into it. I have talked to a lady with a similar problem (she is 58 years old) and she said it is the best thing she has ever done and that she shouldn’t have waited so long. OKAY. Enough typing. Anyone have anything to add to help would be greatly appreciated. I hope this helps anyone out there. Anyone that has had a Lis Franc injury for 10 + years I would love to hear from you. Thanks for reading.
Oh yeah: Here are two great books that have really helped me through all this fun stuff:
Recomended readings: Eckhart Tolle- ‘ A New Earth ‘
David S. Butler- ‘ Explain Pain ‘
Hi, Athina…I am sorry this didn’t get posted until now! I missed it completely, and just found it in the list waiting for approval. Thank you for the suggestions!
Athina, you have made me realize how lucky I am. If you can deal with your injury, I can certainly manage mine, which is so much lighter. I am going to pass on your information about the Nordic Walking Sticks to a person who has rheumatoid arthritis. They sound really useful. He also found that water exercises were useful.
I see that someone with a lot more expertise than I have has already posted a reply to you. Anyone else out there who can weigh in?
Athina,
You have endured so much more than I can imagine. My faith, too, has sustained me (Christian). I had bone fusion in Dec. and had no pain during the non weight bearing stage. I have “graduated” to being able to stand and brush my teeth. I over did it some though. So my foot really hurt. I start physical therapy next week — or maybe just an evaluation. I was told to take pain medication before going. So I’m a little concerned about the pain. My surgeon guaranteed me my foot would never be the same, I would get arthritis, and that while it will always be weak, and there were activities I would never be able to do again. I hope you do get another opinion about the fusion surgery. I’ve heard it has made a positive difference in many cases. I would like to add that after reading about others’ experiences here, I have a more hopeful outlook. I had no idea a simple fall would change my life so radically.
So my thanks to all of you who are sharing!
Athina and all,
I appreciate you sharing your story. I too suffered a Lis Franc fracture/dislocation in 2007, while scaling a fence. I’ve never felt so much pain in my life.
Long story short, I was rushed into emergency surgery. My foot was positioned back into place and held in position by (5) k wires. I was placed in a hard cast for 3 months, followed by pt for 2 months.
Here I thought a “dislocation” would result in 100% recovery. Boy was I wrong. Although the pt/recovery process was quick, my foot never felt the same. This is how I can best describe it:
In appearance, my left foot (injured foot) appears as if the arch collapsed. Secondly, when I walk, while wearing shoes, it feels as if I am walking on a stone. Does that make sense? To be more clear, it feels as if my foot doesn’t align perfectly well with the shape of the shoe. The only time my foot feels natural is when I take it out of the shoe and let it sit/rest.
I’ve tried several pairs of custom orthodics soles, and nothing seems to fix the problem. After a long day on my feet, I need to rush home and roll my foot on a frozen bottle.
I’m 30 years now, and I hate the feeling. I walk and run perfectly normal, but at the cost of suffering this uncomfortable feeling. I wouldn’t consider it as a pain, but more of a daunting, uncomfortable, tiring, sore feeling.
Does this story sound familiar to anyone? I would truly appreciate any feedback.
Hi, I had my surgery the day after you wrote this.. I was wonder how long it has been since your injury and If your feet are the same size? I am 3 months post op now. My injured foot is 3 sizes larger than my other foot.. I have to Wear my husbands boots to work.. I can wear my old slippers and another soft pair of shoes that are well worn and stretched. But I really don’t wear anything but boots other than flip flops. Will my feet ever be close to the same size again? Did you have this problem?
Hi, Chris…just to let you know that two years after my injury both feet were the same size, thank goodness. I do have a bit more of a lump on the top of the injured foot, but that’s where the screw is…it was never taken out. At three months after the operation all I could wear was a very wide sneaker with the tongue cut out and a gauze cushion.
Hi all! I had my Lisfranc injury Feb. 11, 2009 and surgery to repair it two weeks later. I had A LOT of swelling so I spent the first two weeks in bed with my foot above my heart so the swelling would go down enough for surgery. Then, I spent the next two weeks in bed with my foot above my heart to ensure that I didn’t develop a blood clot. My Dr. (I was fortunate and had an exceptional orthopedic surgeon specializing in feet and sports medicine), put me in a boot (called an AIRCAST) when I saw him two days after I did the injury. The ER had put me on crutches and in a temporary cast the night I fell. For a total of one month, I was not allowed out of bed except to go to the bathroom and then I had to have my boot on and absolutely no weight bearing(crutches). Before my fall, I had been training for the Indianapolis Mini Marathon. After my fall, my surgeon told me I was looking at 12-18 months to get back to where I was. I was devastated by the news. After surgery, my surgeon told my husband that on a scale of 1-10, I had just done about an 8 1/2-9 on my foot (and he repairs these types of injuries for professional football players, etc). Not encouraging news but I thought the worst was over and looked forward to recovering faster than anyone predicted…HA!
Flash forward SIX months, yes, that’s right, I said SIX MONTHS; I am still in a boot and have to use crutches to walk! At 3 months post-op I was told I could start putting weight on my foot but only in my boot. The problem was, one of the screws that was put in to hold everything in place while it healed, was causing me a great deal of pain when I tried to even put my foot down for balance, let alone try to walk on it. As a result, I was stuck using crutches for the entire 5 months until my hardware removal surgery in July. Believe me, I was counting down the days! We also had discovered, via a nerve test, that I had lasting nerve damage from the fall as well. This resulted in not only aches and pain from my foot itself but episodes of sudden sharp, bring you to instant tears because it feels like a thousand needles just stabbed you, pain from the damaged nerves. The other type of nerve pain would be when my foot felt like someone had just suddenly set my foot on fire. Now, I have never actually been on fire but I can tell you it would be excruciating! This is not a “my muscles are burning from fatigue” type of pain. It is a sharp, intense, bring you to your knees pain that can pass as quickly as it comes on…or not. It made things so much more complicated.
Let me tell you, this is where things get a bit crazy. My surgeon did an amazing job and I still see him for foot injuries, he is the best, hands down. However, all that being said, he has an ego a mile wide and I didn’t learn until August (almost 7 months after my injury) that he had had verbal confrontations with physical therapists before because he did not believe that PT was needed after Lisfranc surgery. I thought it was strange that he said I didn’t need it after the hardware removal but it wasn’t until a friend’s birthday party in August that I learned (from a physical therapist at the party) that PT is standard protocol after Lisfranc surgery…unless you have MY doctor. She had witnessed a few of my doctor’s confrontations and told me to try specifically asking him to order PT for me or I would end up having continual problems with my foot. Well, I asked, repeatedly, and was told it wasn’t needed. I ended up spending the next FIVE YEARS on nerve pain medicine and getting injections to try to stop the nerve pain. I asked about alternative options such as acupuncture, to try to control the pain or heal the nerves. I was told it wouldn’t help. It wasn’t until I needed yet another injection (which were no longer working to stop the pain but helped just enough that I could walk again) and my doctor was on vacation, that I finally caught a break. I saw one of his associates and asked, yet again, about acupuncture. This time, I was told that I would benefit greatly from it!
It took two months to get in to the doctor that was recommended, one that was an MD AND trained in Traditional Chinese Medicine, but it was worth it. Nine months later, after seeing the new doctor once a month for acupuncture and cupping, I was off all the pills, I could walk normally and I was even wearing high heels again (which I had been told would never happen post LIsfranc injury)! I had to go off of all sugar and was only allowed 60 mg of caffeine per day. I also had to buy this special foot massager/stimulator that was $250 and use it 4-5 times per day. All of this was to increase the amount of oxygen in my blood and to increase circulation in my foot to promote healing among the nerves. It worked! Once the nerves healed, the new doctor gave me, yep, you guessed it, EXERCISES! He showed me, in office, several exercises to do multiple times a day to increase foot strength. He also gave me a list of websites to go to that had PT exercises specific for Lisfranc injuries. He told me to start them and follow a schedule he gave me for building repetitions, etc. This man was my savior!
For those of you going through all that is involved with this injury, don’t give up and be persistent! Insist on PT and if you aren’t improving, seek alternatives. Please know this, there is a “normal life” for you after this injury. Don’t be afraid to ask questions, try different things and even make drastic changes to your diet. I am 8 years post injury and last week I just did it again. Things are going differently this time around and I know, without a doubt, I WILL conquer this yet again. Hang in there, as eventually this will be just a “bump” in the road of your life! =)
Hi Dona, what a story! I saw you are following the blog and occasionally someone posts, as you did, but I’m not really keeping it up as there isn’t much to report.
Six years later, my foot is pretty much totally back to normal, although there’s a bump where the big screw is because my surgeon didn’t believe in taking out hardware.
Surgeons are a trip! My surgeon told me that after three months with my foot in the air I would be able to walk. When I put the foot down on the ground after the three months were over, it felt like an electric shock going through my body. And then he prescribed physical therapy, which went on for about six months. I think you need the PT as much because the foot has had no weight on it as much as you do for the original injury.
I am really glad to hear that you finally got affectively taken care of. And thanks for posting because I am sure somebody will find the information very useful.
But wait a minute! You did it again? All I can say is ‘best of luck’ and it sounds as you have a really good grasp on it this time.
April 23, 2011
I have a lisfranc fracture. This site is the first I’ve seen that hasn’t scared the stuffing out of me. I have hope that after pt I’ll be walking again, and ready for a trip planned way before my fall.I tripped — nothing exciting or mystical. My doctor referred me — after putting me in a cam boot — non weight bearing, to a surgeon who would take my insurance. I had surgery Dec. 29 — two metal plates, eight screws, a bone graph, two pins hanging out of the side of my foot. But surprisingly, I didn’t have as much pain as before the surgery. (I broke my foot the day after Thanksgiving.) Temporary cast for the first two weeks, then stitches out, another cast for three weeks. Removed that cast and took out the two pins (k-wires?). Casted again for three more weeks. Moved back to the non weight bearing boot until April 21. Boot off, bare feet, and I was standing — my surgeon said walk and I took my first step of 2011. All this time I have felt guilty for not working. Just staying off my foot and keeping it elevated.After things I’ve read I’m so glad I followed doctor’s orders.
Thank you for the encouragement and hope you have given me.
Sissie
Sissie, I am glad it was helpful. Everything I read scared the stuffing out of me, too! I felt self-indulgent staying home on the couch with the foot up, but now I realize I was really lucky to be able to do it…As far as walking goes, you seem to be way ahead of where I was at that time. I was looking forward to walking when the boot came off, and then the surgeon gave two weeks PT…non-weight bearing! Good luck with your pt..it’s a lifesaver…Chris
Holy moly, Athina. I have to say, my immediate response is that there’s no way you need to have that kind of residual pain and disability this far into your recovery. I can not imagine why they are not encouraging you to do the fusion right now. I know that fusion has only recently become the standard intervention (I met a woman on the plane who was pretty much the last person University of Pittsburgh Medical Center ever chose not to fuse, and her surgery was only a year or so before mine). It’s one thing if you’re a kid and still have a lot of development ahead of you, but even at 24… I’m not sure your physiology is going to change much between now and when you’re in your 30s/40s (except surgery recovery is easier now then it will be then). I would seriously suggest getting a second opinion (or more) from a sports medicine orthopod. I eventually had mine done at Mercy Medical in Baltimore, but got the same (fusion) advice from UPMC and a few others. It sounds like they’re saying you’ll need it eventually (which is in keeping with everything I’ve heard– another reason I decided to just go with the fusion, rather than a second surgery down the road). Why not do it now? You can check out my blog that’s linked here (http://lisfranc.wordpress.com/) and please feel free to contact me there if you have questions about the surgery/recovery. It’s a pretty serious procedure, but really, really hard to imagine that it wouldn’t be worth it for you. I should add that my surgery wasn’t immediately post injury (due to extended misdiagnosis), but it was about 6 months after. It’s been about 10 months now and things are pretty dang good. Much better than your situation it seems. Sheesh, good luck. I hope you work out a solution soon.
Hi, certainly start with a free platform! It at least gets you started. Maybe start by writing your thoughts about various aspects of remodeling, and bits of advice for people who are doing it. The main thing is to start doing it!
And here I thought I was the only Lisfracer to be tracing the alphabet in the air with my toes. I’m still doing it daily four months after surgery……just to be on the safe side as I seem to not be able to let go of my non-weight bearing PT quite yet, even though I’m also doing weight bearing exercises. I’ve enjoyed keeping up with your blog and seeing that I’m actually on course with my recovery. Happy healing to us all!
Keep doing that non-weight bearing PT! It really helps with flexibility and some of the rotations just can’t be done safely while weight bearing…unless one likes straining an ankle! Four months after surgery…yup, that seems pretty good..Keep it up, Chris
Thank you for this post. I had a lisfranc fx in 2006, surgery with screws and pins to repair, and then removal, and have some bone fusion now. Shockingly, they never sent me to PT. I had almost no range of motion in my foot until fairly recently, and I actually found that horseback riding (a great way to get the fracture in the first place) has helped tons because of how you have to keep your legs with weight in your heels. I’m still working on recovery and have recently started the C25K program in VFF shoes, having never been a runner before. I’m not a heel striker when I do run, and the shoes are wonderful for me so far.
All that rambling aside, I am really glad to see the PT exercises posted here. I feel like my range of motion is still more limited than it should be and I want to continue working on it.
I’m glad you found my PT page helpful…bear in mind that I basically wrote it for myself, so I could remember what I was told to do! It sounds as though it would be helpful if you could get to a therapist to get a few exercises, even at this time! I can see that riding could really be helpful. It would build up any atrophied leg muscles, too!
One of my PT assignments, once I could walk, was to walk on uneven ground, so your running on a roughish path sounds like such a good idea. I’ll follow your progress on your blog! Good luck with it!
Hi everyone,
I fractured my foot April 4th, 2012, had surgery April 12th, two plates and 6 screws. It’s been about 10 weeks walking on crutches.
Now that most of the pain has left my foot, I am able to do a lot of the excercises you described.
I’ve had knee injuries before, so I know how quickly the quadricep muscles become atrophied. If you measure your thigh 1-2 inches above your kneecap, there’s usually a huge difference in size because of the atrophy. This is why we limp after an injury because the injured leg is shorter. And this is why we have to do all the quadripcep excercises you described – front, back, side, inside leg – in order to strengthen the muscles again.
I’ve done two weeks with no weights, now started two weeks with 2 1/2 lb. ankle weights. However, after three days my knees really hurt, so I took one day off.
I can’t work because my job requires mostly standing and walking. My surgeon has not indicated when/if he will be taking the screws out. I didn’t see a step and rolled off it and caused the fracture and broke all the metatarsols. The surgeon said he had to throw some of the pieces away because they were in such small pieces.
Thank you to every one for sharing!
Good luck on your continued recovery! Chris
hi, my name is sarah and a bit like you guys i have a lisfranc break with a compact break. my horse fell on top of me and my foot must have been crushed on top of the stirrup. My foot was in half. The A&E could not believe what they were seeing as they have not ever seen such a serious break. My Surgeon told me my foot that did not have a pulse for over three hours was in a serious state of being amptuated. Shock….. I thought i was going to be out the following day…. wrong.
I have had surgery two weeks after break, and I am nearly a week after op. I have plates screws and wires. I have no idea what is going to happen to me. I have been told, no weight bearing for 6 months. in two weeks stitches out, then cast, then 6 weeks wire out, then 6 weeks some plates out. then start the process again. after 6 months i should be able to have rehab. I have horses, 5 dogs and no home help whilst hubby at work from 7am to 7pm. Some friends have been amazing.
How am i going to cope with every day, not going about. i have two horses to cope with. I am not a person who stays in bed or chills out so this is going to be testing to say the least. if anyone has any ideas of how i can cope with my active brain and feeling like i am being physical then please write back.
I am in the first week, OMG i wished it was the last week. I event my horse and was only half way through the season. Not my year i think.
Has anyone else had their foot in cast for 6 months. I have to be in a wheel chair for 6 months and i must say the medical team have been fantastic. I could not thank them enough.
Anyone who can lift my spirits please do, I feel stuck and deflated to say the least.
Sarah
Hi, Sarah…I know (sort of) how you feel! One thing to keep a hold of is that this will pass! If your doctor tells you to keep the foot elevated as much as possible, my experience is that they mean it! Reeeeally important! This makes life a bit difficult! I didn’t have WiFi, so I got a router, set up WiFi, and my family gave me a laptop. Set the laptop up for voice recognition, so I could use it more easily lying upside down on the couch. Then set about learning something new. In my case, one of the things was blogging! However, there are lots of other possibilities. It’s surprising what you can do with your foot up in the air!
Another issue that I bet you take seriously is muscle weakness. Well, with MD approval, maybe you can set up a program for upper body, core, and at least the uninjured leg (and maybe even the injured one!). Gotta get someone who knows what they are doing.
What about training one of the dogs to be helpful? That should take some time and energy!
I bet you will work out what to do about the horses! If you are using a wheelchair, at least you will be able to go and talk to them. How is the horse that fell?
A number of the people who have blogs are really active types…If they don’t comment here, you should comment on their blogs. They should be able to give some good ideas.
Hi Joe, sorry to be so long responding, but I was away from my computer for a few days…I have heard of the arch “falling” after a Lisfranc injury, but I didn’t experience it myself, so I don’t have any suggestions, other than to get a second opinion! It does sound like a real trial to go through. I can only offer good wishes in finding someone who can help!
Lisfranc tear people! HAVE SURGERY! Too many horror stories of lifelong arch pain if you don’t. They just don’t heal in a way to ever support your arch again. Second, you HAVE TO get a knee walker. I had surgery for a lisfranc tear, adding four pretty screws to my 60 year old foot, and no weight bearing for 8 weeks. I can’t believe I almost didn’t hear about knee walkers. However, I rented one which saved me from wanting to die of frustration. I really scooted around and then had my hands free to make a sandwich or cook in the kitchen sitting on the walker. Couldn’t drive the entire time because it was my right foot so good friends made a schedule to drive me to and from work. It took six months to be normal again but after a year, I don’t know I ever had a problem. (Except for high heels, who cares) Yay!
Just a note..my surgeon didn’t recommend a knee walker (it wouldn’t have helped me much anyway, since I live in a fifth-floor walkup), and I think it was because he wanted me to keep it elevated 24/7. I was luck in that I was able to stay out of work and didn’t have to cook or clean for someone! So might be a good idea to check with the doctor before getting one if you have a choice about what to do…They do sound wonderful..
Cindy–I read your latest post, from April 2, 2014, and you encouraged people to contact you with questions. Unfortunately, that post is one of the few with no “reply” button, which is frustrating, but I looked for other posts from you, so I’m replying here. Anyway, I wonder if you might have any insight into my concern. Background is I’m 56, have been a dancer (primarily ballet, but other kinds too) most of my life, with teaching added in more and more over the years (though none of that lately!). Unlike anyone else I’ve read about in researching all this, I didn’t have one event (that I was aware of) that caused my Lis Franc injury; apparently one way or another, I had damage/breakage probably from many years ago. One doc said it could have come from repeated, smaller impacts, and just have built up over time. Of course, arthritis had set in by the time it was diagnosed.
I know that my foot (left) started hurting quite a few years ago, but not badly enough to stop me from dancing, especially as it would recede at times. I always thought of it as a “stringy” kind of pain, and tended to think there was a problem with some tendon or some such, along the metatarsal. This all came at a time when I had no health insurance, and couldn’t afford a lot of medical help. I remember going once to a podiatrist, who didn’t really know what was going on. For a long time, it was more of an annoyance that I could brush aside, even though a bit of worry stayed in my mind, than a big, serious problem. It would also often hurt at night as I lay in bed, before sleep, and seem almost psychological in that, sometimes, if I kind of ‘averted my mind’ from the problem and pain, it would go away. More often, though, it hurt like hell at such times. Still, I continued dancing on pointe, performing and teaching. Only in more recent years, as the arch totally dropped, the shape started changing somewhat, and, worst, I progressively lost more and more strength in that foot, losing ability to do some simple things that are absolutely necessary for me.
Finally I got enrolled in a program with our county hospital and health service, so could get some help, but I could not get the general doc to refer me to the orthopedic dept., to be seen by a specialist. Eventually I got to see one last Sept., because of having injured my right ankle. I told the doctor who diagnosed that particular little fracture that my bigger problem was with the left foot and, thank goodness, I did eventually get help for both injuries. After one surgeon told me that the only thing that might help me get back to strength and ability with that foot (and stop the pain) was to have this operation, I wanted to know more.
I explained about the dancing, and we went over what long-term effects there’d be, especially pertaining to movements and loss of mobility/range of motion. He demonstrated the very small range that would be affected, and it was no problem–not a movement I need to be able to do, and he said it wouldn’t affect my flexing and pointing at all. Later, three other orthopedic doctors said the same, so I felt reassured about that. Had surgery April 29, 2014 (fusion, with 4 screws), followed by a bit more than 10 weeks in cast, then gradually bearing more weight since the last cast was removed on July 11th, weaning off crutches, and now weaning off the boot. I’ll start PT on Aug. 13th.
I’d feel pretty good about how everything’s going (as do the surgeon and nurse practitioner), except for one thing that’s a big problem. Since coming out of the cast, I’ve followed all directions, expecting the ankle and foot to gradually lose stiffness after being stuck in that position all that time, and be able to begin pointing. I’ve done the exercises, stretched gently, massaged, and kept the foot elevated as much as possible, but I’m really getting the feeling now, that my left foot is limited to the extent of pointing it has and has had for three weeks or so, and it is an awful shape.
I didn’t have fabulous arches and line of feet to begin with, as a dancer, but they worked well and looked good enough to be acceptable. Now, however, the left won’t point to the extent that the right one does, and the line it makes is terrible. Of course, everyone (including the surgeon) says to be patient, and I am being, but it’s looking very much like the fused bones are determining how far the point can go, and it’s noticeably less than the right one, less than I had before, and not even acceptable I’m so frustrated, and don’t want to waste time or heartache, stretching my foot, trying to get it into a decent position if it’s never going to go there. I really get the feeling the doctor’s trying to placate me, and hoping I’ll just slowly get used to it the way it is (which, after all, will be the only option if it can’t change). Have you ever encountered anyone with similar problems? Do you know if it’s realistic that the foot would need this much time to decontract? In this regard, this feels like a bad dream. Well, thanks for sharing your experiences, and let me know if you have any ideas. Thanks–Laura
Hi Laura..it seems like quite a journey! Just a reminder that no one here is a doctor or PT person, so we can just tell you our experiences. From mine, I would say that my foot took a long time to regain flexibility, certainly more than three weeks, but it eventually did with the help of a lot of PT. I would go by what the therapists says. Can you get someone who works with dancers?
I had my injury May 11, fractured the base of the 2nd Metarsal bone . Displacement was around 2mm. Had 4 wires placed to let the fracture heal. had to keep foot elevated first four weeks in a soft cast and then had a hard cast put on. No weight bearing, for the next four weeks and then removed the cast to x-ray foot to determine the if the bones have started to heal. Another hard cast for four more weeks, this time weight t bearing.. The pain I was feeling seemed to be coming from my pins sticking out, like a burning sensation in opening. The foot would still swell up causing more pain. Now the ankle feels raw from the inside cast rubbing the skin raw! Also to top things off, I got an ingrown toe nail in the big toe!
Anyways, my day has come to remove my pins!! looking forward to get rid of this cast and starting rehab!!! I will let you know of how it goes!!!
Three long months, thank god for loved ones!
Wishing everyone with Lizzy a speedy recovery!!!
Good luck with your rehab! You’re on the way up now!
Your surgery was a week before mine! I fractured and dislocated all 5 Tarsometatarsals. Displacement 8mm.. My surgery had a huge audience.. Everyone seemed fascinated by my injury. I have been back to work for a week and a half. I drive a truck for work. I still limp quite a bit and it’s embarrassing.. I hate having to explain it. Have to wear boots 3 sizes too big and hope I will someday be able to wear my own again. I have heard many people say their injured foot is half a size larger.. but 3? Hope your recovery is going well.
Hey people I just saw this website and I am glad I did. I have had an injured Lisfranc ligament since May 22nd and it feels like no one gets it. Happened in a soccer game by some guy that was out of control. Anyway after seeing a doctor for three months, the foot never got better. I finally got a second opinion/MRI and the first DR said I only had a grade 1 sprain. THe other DR finds out the whole time I’ve had a hairline fracture AND they tear is a high grade level 2 tear (ligament is barely holding on). The doctor is making me wear a cast/orthotic that fits in my shoe to wear so I can walk around. If it doesn’t work I have surgery. I think that I should have just been in a cast cause I shouldn’t be walking around right?? I’m not a doctor but it just makes sense. What are your thoughts on the matter based off on experience?
April 2012 was when I broke my foot and had surgery. April 2013 was when I had a second surgery to remove the six screws and two plates. Every month during the past year and a half my foot continued to shrink back to normal size!
I also was wearing my husband’s boots for awhile, wearing extra socks and inserting an extra sole for the good foot, want to keep everything balanced.
Today, the length of my foot is back to normal, but I also have kind of a lump over the instep. Ballet flats work really well, as do men’s sneakers since they’re wider at the toes.
High humidity causes my foot to ache constantly and when a big front is coming through, rain or snow, that also causes aches. That’s probably because I’m 58. I do expect that reaction to subside after another year has passed.
Separate from the foot, excercises to build up leg and glute muscles are critical. Strengthening the rest of your body will take the some pressure off your foot when you are walking, because you do have to walk!
Good wishes to everyone!
hi, I suffered a lisfranc fracture by fainting and putting all my weight on the foot.I broke my 2nd and 4rth metatarsal, and suffered dislocation and a shift in the direction of my toes. This all happened five weeks ago.I was misdiagnosed with a breakage but on further examination it was noted (from the bruising under my foot) that is was a lis break. I went in for surgery to have pins and plates inserted. When I came around the doctor told me that instead of having olates and pins, he had just manipulated it back into place and he hopes it heels itself. I am back in a cast for 3 weeks. I was told to return in after these three weeks to remove the cast and put me back into the boot for a month or two. I smoke so I have been told my reovery time will be longer. Can people advise if this manipulation of the fracture has ever happened with them? I have a fear that the bone won’t heal itself and i will end up having to come back in for the pins and plates in the future. Is it true that you will never wear high heels again after this fracture?
Anybody have any advise of how to avoid hand aches from the crutches? I have bandages taped to the handle but they still seem to cause annoyanc.
Happy healing everyone.
I didn’t have that problem with crutches, probably because I was told to stay home with the foot elevated, but I found several suggestions when I googled “crutch” and “hand aches.” Have you checked those sites? Maybe foam around the handles? I also don’t know anything about healing the foot with manipulation. Can anyone help with this one?
Megan,
With my lisfranc injury, I had no bone fractures but my ligaments were stretched/torn. I had about 1/4″ play in my mid-foot, side to side. I have 5 screws, 3 plates & a wire. Maybe your Dr saw your ligaments were in good condition & didn’t need any hardware to keep them in place?
Good news – I asked my Dr if I’d be able to wear heels again. He said Yes, heels will actually help the arch but I won’t be wearing them until next year sometime.
I’m in a boot now. The past 3 weeks, I was allowed to place 50% of my weight on my bad foot, while using both crutches. Yesterday, I was allowed to put 100% of my weight without crutches. I couldn’t wait to ditch the crutches! Unfortunately, the nerve tingling and pressure was too much, I couldn’t do it. Then of course, the swelling started and the boot got tight. I spent most of the afternoon with my foot elevated.
I’m wondering if anyone else has had what feels like every nerve in the injured foot has surfaced on the bottom of the foot?
ps – Because the boot is flat, which is not good for a lisfranc injury, my Dr told me to buy “Dr Scholl’s Arch Pro” insert to put in my walking boot.
Somewhere in my, blog, hidden in all the other stuff, is an account of putting weight on my foot for the first time…the surgeon had told me to bring a shoe to the next appointment, so i was really excited. Well, we took off the boot, put the foot down on the ground, and I nearly went through the roof! It was as though a huge electric shock went through it. As for the shoe, well, he never mentioned it, so I left, discouraged, in the boot, non-weight-bearing, for several months of PT.
What’s the good news? 1. It seems that I was on the long side of the recovery curve. Most people seem to recover more quickly.
2. The foot is pretty much totally normal now. All that pain went away, all my toes work, I can wear normal shoes…So even though I had some work ahead of me, I did recover almost totally. My Achilles tendons are still tighter than they used to be, though.
Yes, an electrical shock is a good description! It’ll be 10 weeks tomorrow since my surgery. I have a long way to go, no doubt. Do you recall how long it took for the hyper-sensitivity to go away?
This foot is really wearing me down emotionally. Thanks for your encouragement.
Well, it took a while, because my surgeon put me on PT as follows: Two weeks non-weight bearing, two weeks toe touch only, and only then full weight. I think he was very cautious. Other people didn’t have such conservative regimens. I couldn’t find any entries saying that the pain went away, although it did, so I think it dissipated pretty quickly once I was walking on it. The top of the foot stayed sensitive longer. I worked on that by tapping it, and eventually it stopped screaming at me, too.
I spoke to my Dr’s assistant yesterday. He said give it another week with both crutches, then try walking with one crutch. I guess my foot just isn’t ready yet. Very frustrating.
Also, the assistant said it was too early for me to be scheduled for PT. The Dr will make that decision when I see him on Nov 12th.
It sounds like the foot has to desensitize slowly. I think I’ll start tapping & lightly massaging my foot to help with blood flow. Sometimes, it still turns dark red to purple.
I’ll have to read thru your blog again. My Dr said recovery is 4 months, but from reading some of the personal stories, it sounds like it can & does take longer than that.
Phew, I’ve been reading everyone’s blogs, and I feel so much better. I sustained my lisfranc ligament injury (2nd metatarsal) on 19th August this year. I can’t believe the time it takes to heal, I don’t think hip replacements take this long. I agree with a previous blog – people just don’t get it. I’m still wearing my boot and my foot still feels weird on top, my big and 2nd toe are still numb and they feel like I’m pinging something inside if I wiggle them. I’m getting my 3 screws removed next Tuesday actually. I haven’t seen a physio yet, but have googled (of course), exercises that I’ve been doing. Every week though my foot has different pains, maybe it’s part of the healing. This week, extreme aching under my toes, that require painkillers.
In terms of desensitising the skin, the doctor told me to rub moisturiser in a couple of times a day and massage it.
You’re right! Hip replacements are usually a faster recovery! I figured out that one reason we have that weird toe sensations is that they have to move a huge nerve bundle to get at the bones, and the foot doesn’t like it one bit! I remember that when the PT person (mine was just great) massaged the foot at first I almost jumped off the table. I desensitized it by tapping it, but then I read someone’s blog, and he said he rubbed it with different textured materials…sandpaper and velvet were the ones I remember. So it seems there are different ways to do it. You are the first person who reported a doctor actually having a suggestion!
My toes felt as though there was a rubber band wound tightly around them! First it was around all of them, the just the big toe, and finally it went away. One of the hardest things to do was to get the big toe to move independently of the others. My doctor did tell me that usually the improvement one gets in one year is all they are going to get, but he said that in my case, I might get even more improvement after that because I worked so hard at it. He was right, it did continue to improve into the second year. So I guess the moral is “don’t give up.”
Hi. I suffered from a lisfranc sprain in my left foot back in June of 2013 when I fell off my bike and my foot stayed in the toe cage. Twisted my foot like wringing water out of a towel. It has been a frustrating and defeating journey to say the least. My trip to the ER resulting in a wimpy foot immobilizer and they said, “you’ll be running again in a few weeks”. Well, 10 MONTHS LATER, 3 rounds of xrays, 1 mri, 2 podiatrist’s opinions, PT every week, dozens of painful and failed exercises, store bought shoe inserts, custom orthodics, cortisone injection, and a closet full of shoes I can’t wear anymore, I am finally going to a chiropractor. It was suggested by my awesome massage therapist that something could be out of alignment in my foot! There are 26 bones in there after all! I am excited to go, but also feeling very desperate. I am in pain everyday. It has messed up my right side because I favor my foot with every step. I just happen to find your blog. It is inspiring yet scary at the same time. I do not accept anyone telling me that this is the way it is going to be from now on. I am a triathlete. I want to be a triathlete once again. Any advice is welcome. Thank you for sharing your experiences.
Hi Jennifer, sorry to hear about your lisfranc. Mine also took forever to be properly diagnosed. Yours sounds particularly maddening because that mode of injury is basically what lisfranc is named for. It is totally treatable, you just need to find the right practitioner(s). Did no one recommend surgery? Have you been to a sports medicine center?
Jennifer! Go see an orthopedic surgeon that specializes in foot surgery! NOW! Not a chiropractor! They only relieve pressure in the joint momentarily. I was fortunate that when I got my lisfranc injury two years ago by slamming on my brake while totaling my car, I got into Vanderbilt orthopedics as my first stop since my husband is a physician there. The general ortho saw my X-ray and said I had no fractured bones. I was relieved! Then he said- no, it’s actually bad news and referred me to the ortho that specializes in foot surgery. The lis franc ligament that is “fractured” (funny word when it’s not a bone-please understand) is like the centerstone of an arch. No centerstone, the arch collapses. He said I need surgery to fuse the arch or I will have chronic pain forever as the arch in my foot collapses, gets arthritis, etc. So three screws later and 8 weeks of no weight bearing, and another couple months to walk pain free, I am 100% Running and jumping. I even have just started wearing a 2 inch heel again! When I hear about others on this blog who waste so much time, effort and pain, I feel so grateful. My dr. said it happens all the time that the diagnosis is missed or treated as a bad sprain with physical therapy. Sad to need surgery but the sooner the better! GO!!!!
If anyone on this site needs other advice about post op issues, please ask me! I’m a nurse practitioner as well as a successfully recovered lis franc patient.
Cindy
I don’t believe it! I thought this blog was pretty well asleep, and then there are two answers to Jennifer’s post overnight, before I even get a chance to comment. Thank you so much guys.
OK, Jennifer, I was going to ask if you had had your x-ray read by a doctor who specializes in feet. The emergency room staff referred me to a surgeon because I had a broken metatarsal. I ended up going to a trauma surgeon who ran off to talk to a few of his friends before coming back and telling me, “Yup, you did it!” And I admit, when I look at my x-rays, I can’t see it at all, and neither could the first set of doctors. So I second the comments of Cindy and Lisfranc…Get to a surgeon who has lots of experience dealing with this injury and see what he or she says.
I haven’t been running because of some unrelated knee and muscle-strength issues, but I am back doing a martial art, and the foot isn’t an issue..except I don’t want anyone to step on it. It was a long, determined recovery, but the foot really did recover. There’s a link to Rebecca Wardell’s blog on my blogroll. She is an Olympic athlete who had a Lisfranc injury, among others, and seems to have recovered totally from the Lisfranc (although other injuries appear to present problems now).
Good luck..let us know how it’s going!
I am so happy I found this stream of comments. I am currently recovering from a lisfranc injury. I, very thankfully, avoided surgery and will be starting my physical therapy in a few days. I just got out of my cast about a week ago and have been wearing a boot for support. I don’t know if any of you have had a similar issue, but I have pain in my heel and at the joint under my big toe when I put any kind of weight on my injured foot. It seems that my injury site is the only part of my foot not in pain. My range of motion in my ankle is a lot better than I thought it would be, though it is understandably stiff and shaky. I feel a lot better about pursuing physical therapy thanks to all of the positive feedback I read. I am not someone who can tolerate pain very well and I have had some anxiety about seeing the therapist, all of your posts are helping to make me feel better and more confident about my recovery. This has been a life altering injury and cannot wait to be able to walk again. I’m thrilled to hear that so many of you have had a full to close to full recovery. My podiatrist told me not to get my hopes up about being a runner again and participating in marathons, which I’m sure you guys can understand was very disappointing to hear.
It seems that every Lisfranc injury is a little different, and certainly doctors have different ideas about how to treat it! I was totally off my foot for three months, so when I put weight on the foot at first, it was as if an electric shock went through the foot. (I did it once, at the doctor’s office before he ordered PT, and didn’t try again until I was told it was OK.) I can’t say where in the foot the sensation was located, as it seemed to be everywhere. My doctor specifically ordered two weeks of PT without letting me put weight on the foot..(just doing range of motion for the ankle and massage for the foot) and then another two weeks of “toe touch” only. Only after that was I allowed to put weight on it. So I didn’t have much pain when I finally was allowed to put full weight on the foot.
As far as the big toe went, I felt as though there was a rubber band around the base of all the toes, and the big toe in particular. It was weird and very unpleasant. The good news is that it went away totally.
I expected that the PT would be very painful, but it wasn’t at all. My therapist and I developed some short-term goals and ways to measure my progress, which made it more satisfying.
Good luck with your recovery! And keep working on it, even after the PT ends. My experience has been that you can continue to improve well after that.
I had a similar experience with my heel, it felt like I had a marble in my heel. It was very painful and even though I wanted to walk, I couldn’t. Try taking a hard ball, like a lacrosse ball and roll your heel over it. This helps to break up the plantar fascia fibers that have matted while wearing the cast & boot – this is how it was described to me. After 3 days of massaging with the ball, it was amazing how much better it felt.
Yeah, it’s definitely something to talk to your pt about. I went back to therapy for the plantar fasciitis (which it sounds like you’re dealing with) about a year ago, a couple of years post-injury, and wish I had gone back much earlier. My pt treated with iontophoresis and I got fast, lasting relief (I’m totally pain free after a couple months of treatment). For ionto, they target your heel pain by using an electrical current to draw topical steroid into a specific location. So, no side effects like you get from oral steroids, plus much more accurate treatment/relief. I’m a total iontophoresis evangelist now.
Hi all: ten days since my lisfranc surgery; injury consists of a completely torn ligament and a small avulsion fracture in second metatarsal; got it all via a nasty fall in the street. See surgeon day after tomorrow for post-op follow up. wearing cast below knee been babying self this last week but if it has started healing am interested in exercises I can do that are non-weight bearing for injured leg but help maintain tone and/or strengthen; the ones up top seem good but any advice appreciated; am 59 and in otherwise OK health
Also, do you advise using knew scooters outdoors? I live in Manhattan.
Hi, Bob, I apologize for the wait in approving this post..I was away for a few days. Myself, I don’t know anything about knee scooters because I didn’t even know about them when I had my surgery. My doctor wanted the foot elevated above the heart roughly 24/7, so he didn’t tell me they existed! I was lucky that I was able to stay home for the duration. So my recommendation would be to see what the surgeon says. Ditto for the exercises. He might suggest that you do leg lifts, etc, while lying down. I wish I had done more when I was laid up.
Other people may be willing to share their experiences if they are still reading this blog!
Bob,
I’m impressed your foot feels well enough to even think about exercising. Mine hurt so much, it was worse than child birth. I used a wheelchair with a leg support for about 6 weeks to keep my foot elevated as much as possible. Don’t worry about muscle atrophy, you’ll bounce back. I started exercising 2 months post-op, upper body & good leg. My Dr didn’t start my PT until after my hardware was removed. It’s a very long recovery. I hope yours continues to go smoothly.
Cindy, I don’t know if you’ll see this, as I couldn’t seem to reply directly to your reply, but I wanted to thank you for that. I doubt that I’ll be able to work with a PT who specializes in dancers, but I feel good about the young lady I have started working with. I am going to just work as diligently as I can, keep a good attitude, and try to let go of expectations. It is encouraging that you were able to get back to running (and I think you said jumping too). At one followup (before the ultimate cast removal) I told the physician’s assistant (or nurse practitioner? not sure) that I was determined to try to get back to doing at least a little pointe work, eventually. Her look said “You’re crazy. Forget that,” but she didn’t say it out loud. Anyway, I keep reminding myself: No expectations. Well, thanks very much, and all the best!
Oh–just remembered I wanted to ask whether your screws were ever removed. I understand that the plan is for mine to stay in unless they start to cause any trouble. I really hope they don’t, as the thought of another surgery and recovery from THAT does not appeal!
If Jake Locker (starting quarterback for the Titans) can do it, so can we!!!
Hello toscaskiss! Sorry I don’t know your first name. I still have my screws and they are causing no problem. As far as my foot architecture goes, I can stand on my toes just fine but I do not quite (but almost)have the full range of motion in my big toe in that flexed position. On the other hand, when I point my toes hard, my 2nd toe is not quite fully curled under (but almost). I imagine that if I had the proper padding in a toe shoe, I could get on point. Think this way- the screws and now bones are fused and strong. If I had to be in full extension or flexion for significant time, it would be the surrounding tendons, ligaments, and muscles that might not like adapting to the fusion. But it could be done if you train those supporting connective tissues very slowly to adapt to the new fusion. And as another word of encouragement. I live in Tennessee and our NFL starting quarterback for the Titans, Jake Locker, had lis franc surgery last year and he is out on the field. Let’s all watch and see how he does! Cindy
This is very helpful. I had my ORIF last Wednesday and I am in a tremendous amount of pain today. I feel so useless and helpless. As a busy mother of 3 with a full-time job and family business this has been a nightmarish injury for me. I look forward to hopefully using my left toes again and having pain free days. Your information gives me hope. Thanks for sharing.
Your situation does sound daunting! But if your doctor has told you to keep the foot elevated above the heart, do it as much as you can. I am told that it really assists in healing! I also remember that the foot was sensitive to cold, so I had to find ways to keep it warm without putting heavy blankets on it. That sensitivity went away, thank goodness. And yes, the toes work now, and while the foot sometimes reminds me that it is there, it doesn’t hurt…Maybe the kids are old enough to help you with your physical therapy when it’s time for it? Children can be quite the task master!
And best of luck! Chris
I had a pilon fracture 10 months ago. My ankle has been froze in an L position for 9 months. One month ago, I had surgery to remove hardware. for one week after surgery, I could move toes and walk down stairs. After one week of physical therapy, all is lost again. I am now stuck in the L position again. Always a short step with the other foot. My question: Is this just due to physical therapy working those tendons and ligaments that were not being used for the last 10 months? Or is there another reason it all froze up again?
Hi, Karmen, I just saw your comment, and actually, I don’t know if anyone is really following the blog as I shut it down a few years ago! But maybe someone who has an answer for you will take a look. I do know that there’s a Lisfranc injury facebook page that is more recent. I am not a physical therapist, so I think it would make sense to go back to the therapist and ask what’s going on. I do know that after my foot was kept still, in the L position for three months, it took a lot of work to get any flexibility back.
Good luck with the PT!
Darn, I am following your physical therapy stuff. Just one last question, did your foot recover?
Yes, the foot did recover. The surgeon left the hardware in, so sometimes I can feel it, but basically, it can do everything the other foot can.
I hope you have a real physical therapist, not depending on the regime I had…everyone is different
I’m sorry! My one question has turned into another. I had a physical therapist but my dr. did not care for him. I am now doing a home program they built for me and I add in things you have stated in your blog. I was avid runner, skiier, and body builder and I am 50 years old. This has been a hard blow for me as everything in my I enjoy is physical. I am faithful with the exercises and am determined to get back to normal. My question, Is your ankle normal or do you get stiff say in the morning or if you have sat for a while?
Hi Karmen,
I had a lisfranc injury in 2013, I still get notices when new comments are added. I was 49 when I had my injury, I understand your situation, physically being restricted is difficult. My Dr gave me the 100% to do what I wanted 10 mths post injury. He told me I will get arthritis in my foot sooner or later. Sometimes my foot &/or ankle will ache in the morning or a day or 2 after I run or jump too much or even if I’m shopping for hours on my feet. It goes away though, sometimes I wear a support brace (made by x-brace) and that helps alot. Overall, I can do whatever I want but my foot lets me know when I’ve pushed myself too hard.
Good Luck with your recovery, Rene’
Hi, Karmen, to be a bit more specific…I can feel a bit of numbness in the foot if I extend my toes up and out..(why do that, anyway?) and I can sometimes feel where the humungus screw is, but basically, the foot is normal. The only remaining stiffness is that I lost a bit of flexibility in both ankles from the three months of inactivity.
I’m not comfortable with the idea that you are using the blog as in your therapy program. For one thing, I had an outstanding therapist who designed the exercises specifically for my needs as an elderly martial artist, based on my abilities and limitations. Also, I have found, in my various experiences with PT, that I really need someone to check that I am doing the exercises correctly. It’s really easy to make some little adjustment that makes the exercise easier, but not as effective, or to overdo them and mess everything up. My main reason for listing the exercises we did was so I didn’t forget them, and to encourage me to do them. I have found a huge difference between therapists, so if I or my doctor didn’t like one, I would try to find a better one.
Anyway, good luck!
Yes, I have done it again. Something I wasn’t told until my ER visit last week, is that once you have had a Lisfranc you are at a much higher risk of having another. This one is right next to where my last one was repaired! On the bright side, the repair held strong, lol. This time around I know what i’m up against & am better prepared for what is to come. I just keep telling myself, this too shall pass. =)
Laying in bed with my cast on 4weeks post op from Lisfranc fusion and 2nd, 3rd and 4th tarsometatarsus fusion and gastrocnemius elongation. All caused from a fall from a ladder 3 1/2 yrs ago. I’m a tough cookie at 62 years old. Reading your blog, you didn’t mention your age. Now I’m scared shitless about my recovery.
Hope you’re doing well
Here is mostly a success story. 12 weeks NWB followed by therapy. Now three years later and while I no longer run on the NYC concrete the foot is fine. I’m 62. Hang in there.
When I did mine, I was a few years older than you. As for the foot, it is basically a non-issue. I don’t feel the rod and screws on the 4th metatarsal (I think that’s where it is) at all. The surgeon did not remove the scre fixing the lisfranc issue, so it has a bump which sometimes rubs against the shoe, but all I have to do is loosen the laces. I did follow the doctor’s orders to a T, which he said was very helpful.
I am a nurse practitioner and I want to encourage anyone out there that has a LisFranc fracture to get a fusion. I am five years after a fusion for a LisFranc tear! My foot is great and everything I have learned is DO NOT THINK PT WILL HEAL A LISFRANC FRACTURE. It is a torn ligament that supports the arch of your foot and does not heal if it is torn so you need a fusion. Yes it was no fun — four screws, 8 weeks non weight bearing ( but the scooter makes life livable) then rebuilding muscles in legs and feet but I am 65 years old and now fully active. I play tennis and I can go up on my toes in yoga, and I am pain free. The only thing I cannot do is wear a heel more than 1 1/2 inches- so I buy wedges to feel dressed up. Find an experienced surgeon and do not waste time in PT!