Lisfranc Fractures/Tears and Recovery

I was going to bump an old thread, but MP seemed to want me to make a new one.

I'm curious about people who've had a Lisfranc injury in their foot and had a successful return to climbing. I completely tore mine taking the whip on a friction pitch near Lone Pine Peak (only time I've ever fallen friction climbing...) and am having the tight-rope surgery on Monday. There are few stories I can find online about climbers with this injury, so would be nice to see some more uplifting stories. Tips and tricks encouraged!

Hey Dude- I have an old thread on here for my lis franc injury.

Sorry to hear about the injury. I agree that the internet is a scary place to read about injuries like this. However, I believe that folks who have had bad recoveries tend to share their stories more than those who rebounded uneventfully.

My injury was pretty significant—lots of displaced fractures and the lis franc, too. I found the right surgeon. From the date of my surgery, I was ice climbing four months later. I ended up having 50+ days ice climbing that season. Since then, I have returned to pre-injury status rock climbing. I climb several days per week and my foot is a non-issue. My surgeon did tell me it was a bit unusual how fast I recovered, same with the PT. I think docs are so used to people who do not take care of themselves that “typical” recoveries are not the same for athletic folks. 

I will say that, for me, this injury did change my risk threshold a bit. I now mostly stay in my comfort zone on lead. I’m also very cautious bouldering and skip highballs that are close to my limit.

 Also, I think staying active during the non-weight bearing phase is key. I live near Lake Superior and was paddling on a sit on top kayak every day. I was also doing a lot of hang board workouts and chair yoga. Gotta focus on what you can do and stay active.

One other thing I will throw out there, with the huge caveat that I am not a doctor. . . . I definitely shopped around for surgeons who treat this injury, as it has the potential to be disabling. There are many options for surgery--including a ORIF or a complete Fusion. My surgeon told me that ORIFs almost always fail at some point and will require a fusion. He also explained that the midfoot joint barely moves, so there is no real impediment to having a fusion. That is what I did, and I have zero regrets. 

Last one other thing: my foot is still slightly larger than it was. I am just now able to put on Scarpa VSrs and VSs that I had pre-injury. To provide more support, I bought a pair of Maestro Mids in a slightly larger size. The extra support was nice when I started climbing again. 

Cheers. Good luck! If you have any specific questions, I’m happy to answer them.

John

Thanks for the uplifting information John! Definitely more optimistic now. :D 

My surgery (on June 20th) went well, although I'm still non-weight bearing till the end of July, but seem to be healing ahead of schedule according to the doctor at the first checkup. The doc said, optimistically, I could start very easy climbing by late August and should be able to get back into running and harder climbing by mid-October. One interesting thing she said was to definitely not do any jamming motion with that foot till at least the end of the year. Apparently the sustained twisting motion could damage the healing ligament before any pain would set in. 

To share a bit more to benefit anyone who comes across this thread in the future with a similar injury:

My main injuries were a completely torn Lisfranc ligament and instability between my first metatarsal and first cuneiform. I got a tightrope put in where my Lisfranc ligament used to be, and a screw put in across the first metatarsal-cuneiform joint on June 20th. The screw will probably be taken out in a week or two pending scheduling (~August 22nd). So far my recovery has gone quite well relative to the horror stories online... Very little pain or swelling with either the surgery or the recovery so far. I spent my not-weight-bearing time traveling and hiking around on my iwalk (highly recommended!) 

I started partial weight bearing 2-3 weeks ago and am already full weight bearing without any issue. Earlier today I went climbing in the gym with a boot for a bit, mostly just using the boot for some stability or putting it on huge ledges. I'm currently quite optimistic for my immediate recovery and can only hope for no longer term effects requiring additional surgery (i.e. fusion). I'll try to update in a few weeks once I'm allowed to put on normal shoes and try to get back to harder climbing...

Picture with the screw and tightrope-tunnel after surgery...

I'll give a last update for the thread to help anyone else out who comes across it... Overall very positive! 

At ~4 months post surgery my foot is pretty much back at 90+% in terms of face climbing (mostly climbing at Pine Creek Canyon and the Owen's River Gorge). I got back on a lot of old favorite 10/11s and some harder projects in the past week and barely noticed the foot while climbing. I'm still avoiding jamming motion with the injured foot and sometimes I back off of climbs with very powerful layback-type moves off of that foot. Beyond climbing, the foot still swells a bit after longer hikes with lots of downhill but I've haven't felt a need to ice or elevate my foot in past month or two. 

Hey Ben,

I realize this post is a bit old, but the comment above regarding positive experiences vs negative experiences and those being shared got me motivated to share.

I blew up my Lisfranc a few years ago doing something completely non-related to climbing. Long story short: I was crushed by a machine and in the panic of trying to get out from under it, I twisted my leg/foot and BOOM. Straight to the ER.

Anyway, I connected with a solid Ortho through Penn State Health and he gave me a pretty stern talking-to. Basically, I had the option of fusing or the tightrope. Obviously went with the tightrope so I could still climb, hockey, and bike without issue. I didn't have any screws put in, so I'm not sure how that will change your recovery or experience. I did similar things to John in regards to staying active while I was down. Hangboarding and other activity while not putting any weight on the foot was tricky, but it kept me sane.

Anyway, a few years later, I sometimes forget I had foot surgery. I'm climbing as hard or harder than I was at the time. I'm biking just as much. My skating has improved. I'm a little more hesitant to take big leaps and falls, but I think that has more to do with age and the fact that I'd go bankrupt from a hospital visit...

Stick with supportive shoes or shoes with a stiffer last while you get back into it. Do as much low-impact lower body work as you can to support and re-balance your bottom half.

For anyone else who suffers from a Lisfranc and opts for the tightrope - follow the doctor's instructions. Don't cheat. Wait the full term. I was super vigilant about my recovery because I don't want to slow down for quite a few more years and I'm beyond happy with my status. I only sometimes feel a bit of referred pain in the back of my foot.

It sounds like you're doing things right, Ben. Good luck with the rest of your recovery!

I think it’s more or less said above: when u return to climbing upsize your shoe size and get a stiff shoe.  Tc pros at your actual shoe size or 1/2 size larger or something like that. Nothing down pointing and nothing that compress your toes. Good luck u stand to make full recovery