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Foot Bone or Joint Injury

Midfoot Sprain

Minute Read

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Posted 3 weeks ago

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Last updated: 04/12/2022

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by James McCormack

What is a Midfoot Sprain?

Ligaments attach bones to bones to provide stability, and alongside the positional layout of the bones in the midfoot, they provide structural integrity to the midfoot. However, if these ligaments become overstretched through repetitive movement or a sudden twist, it results in a midfoot sprain. The midfoot is the part of the foot connecting the heel bones to the forefoot, and it consists of 5 bones; the cuboid, navicular, medial, intermediate and lateral cuneiform bones. 

Lisfranc Injury Diagram

Midfoot Sprain Symptoms

Depending on the severity of the sprain, symptoms can alter from mild pain when weight bearing and walking to being unable to weight bear due to high pain levels. If there is an injury of the 2nd metatarsal, this can result in a Lisfranc injury that causes bruising under the foot, swelling and, in some cases, a loss of foot arch height.

Early identification of Lisfranc injury symptoms is vital as severe cases require surgery. 

Causes of a Midfoot Sprain

The most common cause of a midfoot sprain is windsurfing, or horse riding, as the foot is held in position by a stirrup and a sudden twist rotates the midfoot causing a midfoot sprain.

We also see this in sports such as football and basketball when an athlete trips or falls while another athlete is standing on their foot. Other causes include falls and car crashes.

Midfoot Sprain Diagnosis

Establishing the correct diagnosis for a midfoot sprain is essential. A consultation with a Sports Doctor or foot specialist followed by a physical examination usually is sufficient to establish a clinical diagnosis of a sprained foot. Still, we often refer to imaging to complement the clinical diagnosis.

In severe cases, a standing x-ray is sufficient to pick up a fracture or dislocation of the midfoot, while a standing CT Scan can provide more in-depth information on bone health. If any x-ray returns normal, we often refer for an MRI scan to establish the stasis of the ligaments and other soft tissues in the midfoot.

Midfoot Sprain Treatment

Regardless of the severity of a midfoot sprain, therapists often consult with orthopaedic consultants on the best treatment for each case.

If the decision is taken to treat the condition conservatively, 6 weeks in a walker boot is often recommended, followed by 2 weeks of weaning out of the boot into a stable trainer.

Some patients may require a custom insole for additional support within the shoe. Physical therapy commences after the initial 6 weeks in a boot. A patient may be provided with a brace or taping for additional support. A specific strengthening and stability rehabilitation program is created for the patients following a physical assessment and gait analysis. Most mild cases of a midfoot sprain make a complete recovery.

Surgery of severe cases often involves a screw to stabilise the midfoot, and recovery from this procedure takes up to 6 months.

Picture of HOKA Bondi 8 Womens Shoes

Midfoot Sprain Recovery Time

A mild to moderate midfoot sprain treated conservatively takes 3 months to heal, 6 weeks in a boot, and 6 weeks of Physical Therapy. A severe Midfoot Sprain requires surgery, which can take 6 months to recover.

Can you walk on a Midfoot Sprain?

You can walk on a Midfoot sprain when wearing an aircast walker boot as pain allows. The function of the walker boot is to allow you to walk short distances while wearing the boot, but it is not designed for standing and walking all day.

How do you rehab a Midfoot Sprain?

1: 4-6 weeks in a walkers boot

2: 2 weeks with taping and stable shoes when transitioning out of a boot

3: 4-6 weeks of Physical Therapy

Physiotherapy with James McCormack

This is not medical advice and we recommend a consultation with a medical professional such as James McCormack before trying any of these exercises. James offers Online Physiotherapy Appointments for £45.

Related Articles: 

Best Shoes for WalkingHow to transition from a walking boot to a normal shoeFoot Pain Chart

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