Prolotherapy for Lisfranc injuries

Danielle R. Steilen-Matias, PA-C

What is a Lisfranc injury?

A lisfranc injury simply refers to a “midfoot injury”. This can include a fracture or dislocation of bones of the midfoot or a ligament tear or sprain. The midfoot (essentially the “middle of your foot”) is where a group of small bones form the top arch of the foot. These bones are held together by multiple thick connective tissues (i.e. ligaments).

A lisfranc injury can occur by direct trauma to the foot or with a simple twist and fall (as can frequently happen with soccer players). After initial injury, the foot may be bruised, swollen, tender, and difficult to walk on. Bruising on the bottom of the foot after injury is typical of a lisfranc injury. Often, patients require crutches to avoid placing weight on their foot due to pain.

Lisfranc fracture: one or more of the bones in the midfoot is broken

Lisfranc dislocation: one or more of the bones in the midfoot has become displaced
Lisfranc tear: Complete tear: one or more of the ligaments in the midfoot is torn into two separate pieces, no longer connecting bones together
Partial tear: one or more of the ligaments in the midfoot is torn, but remain in one piece
Lisfranc sprain: Damage to one or more ligaments without any evident tear.

What are my treatment options?

Traditional treatments for Lisfranc injuries depend on their severity. Lisfranc bone fractures and complete ligament tears (where the ligament is torn into two separate pieces) may require immobilization and a non-weight bearing status (i.e. crutches) for optimal healing. Surgery may be necessary for severe cases, especially those involving multiple fractures, dislocations, or tears.

Traditional treatments for lisfranc sprains include rest, ice, and anti-inflammatory medication. Immobilization may also be recommended, which often requires the use of a “boot” or walking cast.

Prolotherapy for Lisfranc injuries

If you have a true Lisfranc fracture, immobilization is still the best way to heal the broken bone. However, once the bone is healed and if you are still left with chronic foot pain, it may be due to underlying joint instability due to ligament injury. Why is that? Think about it – If you receive enough trauma to your midfoot that causes a bone to break, it is not hard to understand that the surrounding tissues also received the same force, making it likely that you also suffered a concurrent ligament tear or sprain as well.

While bones heal well with immobilization, ligaments do not. This is why people often continue to experience pain after suffering a broken bone; they are still left with an underlying ligament injury and joint instability. Even “simple” lisfranc sprains or partial ligament tears can leave someone with chronic foot pain and unsolved joint instability in the midfoot. A great treatment for ligament injuries to the foot is Prolotherapy to stimulate healing and repair.

Prolotherapy, also known as a regenerative injection technique, works to heal injured tissue by the induced proliferation of new cells. If you have suffered a Lisfranc injury and still have chronic foot pain, Prolotherapy may be a good treatment option for you. The team at our Florida treatment center would be happy to talk with you to discern if your case would be a good fit for our clinic. Please understand that we cannot take all cases. We wish you all the best in health and getting to the bottom of your foot pain!