stable nonsurgical Lisfranc injury

Hey Y'all,

Wondering if there's anybody out there who had a stable lisfranc injury, and what their experience was with recovery and rehab. On March 27 I somehow managed to miss the pads at the bouldering gym and broke my medial cuneiform. The joint is stable and not displaced according to the podiatrist, but there may have been some damage to the ligaments regardless. I've been in a boot up to now to let it heal, but I've also been partially weight bearing the whole time. Still, I'm impatient to get this thing to heal so I can get back to life, work, and climbing.

Anyone have a similar injury? Most of what I can find regarding lisfranc injuries involve surgery.

Also, what was peoples' experience with PT or rehab? My podiatrist kind of poo-pooed the concept of PT, as "it wouldn't simulate walking on uneven ground," but I've found it wildly helpful with other injuries over the years.

Any info is appreciated. Thanks!

Had an extremely unstable Lisfranc injury years ago, so I can't speak heavily toward what a "stable" injury is like, but I would encourage you to be as patient as possible in your recovery. Most of the literature that I've read/heard about suggests being completely non weight bearing on the foot to let it heal. Again, this is for a full rupture, so I'm not sure if the same rules would apply, but I imagine it wouldn't hurt to be more conservative. Lisfranc ligaments are no joke and if you rush it, it could alter the way you walk. 

As far as recovery/PT, once I got the green light from my doctor, my PT was basically doing the things I enjoyed in a lower-impact way. Road cycling, top roping, etc. No bouldering, lead falls, or rowdy mountain bike trails until 2ish months after you're fully weight bearing again. After a few weeks of rebuilding the muscles in my leg, I was totally good to go and have been hardly aware that I ever blew up my foot in the first place.

Be careful, take your time, listen to your body.

I had a stable Lisfranc on my left foot in 2017. I wore a boot for about 6 weeks; for the first two weeks I used crutches and severely limited time on my feet, then weaned off crutches and started walking more while still in the boot. I made sure to rest as soon as the injury started feeling sore/tired. Everything healed up very well and I haven't noticed any lingering problems from that injury. I almost forget it even happened. Super grateful I didn't need to have hardware put in.

I had a “mid foot sprain” that was less serious than a lisfranc, per the imaging. I got a boot and crutches and was mostly non-weight-bearing but it did not improve after a month. Switched to a different specialist who insisted on absolutely no weight bearing at all for 4 weeks. I switched from crutches to an “iWalk” peg leg thing and did not let that foot touch the ground at all for 4 weeks. At the end of that time the specialist imaged and examined and said I was good for light activity; “let pain be your guide.” A few days later I was doing short hikes with some aching. I got back to 100% over a few months and have had zero issues since.

If you’re not satisfied with your progress, try to get a second opinion. And maybe ask specifically about going completely non-weight-bearing.

BTW the iWalk peg leg was amazing, with some practice I could stump around almost as fast as I could normally walk.

Thanks for the info, y'all, I really appreciate it. It's easy to get sucked into the horror stories on the internet.

Slightly different perspective- I sustained a stable LS injury in 2002(?) in a town league soccer game...

It healed on its own with some rest, but I now have a nice calcium deposit on top of my arch that gets irritated in snug footwear. At last check, the joint was not developing arthritis, but long days of high impact are felt. That being said, long, slow days of high impact are my forte. 

Not sure of the lesson, but think about future repercussions if you're a long-distance runner, etc. 

Again, thanks for the perspective y'all. I got a second opinion appointment on Monday and a PT consult on Tuesday. Stoked to develop a more cohesive plan to getting this thing to heal.

One follow up question for y'all, how was returning to crack climbing? I live next to Zion and have predominantly been climbing there for the past decade plus, and really hope to return to climbing there in the fall. Any anecdotes about crack climbing post injury? Thanks again y'all!

EJN wrote:

One follow up question for y'all, how was returning to crack climbing? I live next to Zion and have predominantly been climbing there for the past decade plus, and really hope to return to climbing there in the fall. Any anecdotes about crack climbing post injury? Thanks again y'all!

Give it time to fully heal and you shouldn't have any issues. Considering I had surgery and a long, long recovery and the fact that crack climbing is pretty standard as far as pain goes, I'd say you'll be ok if you take the proper steps to healing.

I had surgery for what I would call a "moderate" injury (some info here: https://www.mountainproject.com/forum/topic/122571380/lisfranc-fracturestears-and-recovery). I had injured it this past June with surgery a week after, was back to to very easy "controlled" crack climbing in January, and recently did a bunch of pitches of slightly awkward crack climbing up to 10a without any issue. I haven't yet tried what I would consider "hard" cracks, but will probably try next opportunity I have (I've been too busy skiing this winter). I would assume your recovery would be faster...

If you have good insurance, I would definitely get an MRI and/or another x-ray. I had what looked like a stable non-displaced injury in initial x-rays, but the MRI showed a complete tear of the LF ligament plus the ligament between my first metatarsal and first cuneiform. My ortho strongly suggested (basically assumed) surgery with that diagnosis, and so far I haven't regretted the process. 

Edit: Also, if you are concerned or otherwise recommended to go non-weight bearing on the foot, the I-Walk is great and highly recommended! :)