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Exercises to aid recovery from minor Lisfranc

Discussion in 'Ask your questions here' started by minikas, Nov 13, 2009.

  1. minikas

    minikas New Member

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    on 21/9/09 I substained a minor lisfranc injury to my left foot, which was picked up on a CT scan. All my bones were in the right place but the consultant could see there were tiny bits of bone.

    I had a non weight bearing cast for 6 weeks. As soon as the cast was removed the registrar examined my foot & told me to be on my way. No CT scan or physio required! He didn't even hang around to see me try standing up. I went to my own GP & who contacted the consultant's secretary & they are going to now refer me to physio. But they don't know how long this will take.

    Initially when my cast was removed (nearly two weeks ago now), I could only place very little weight on the foot. If I was bare foot, I would have pain in the foot, like pins being stuck into my foot. Every day there seems to be a slight improvement & I now can walk short distances without the aid of crutches although I am limping. The pain is around the ankle, under the arch & the top of my foot. The position of the pain depends on the position of my foot & which part of the foot I'm placing weight on.

    My foot is discoloured & swells up during the day. The swelling around the ankle doesn't seem to be improving or if it is, it's only slightly.

    I have been doing the exercises the practioner & my own gp showed me. These consisted of moving the foot up & down, left & right, circling clockwise & anti clockwise, scrunching my toes & rolling my foot on a tennis ball.

    My job involves visiting residents in their homes & I need to be able to drive ie use my left foot for the clutch. For the moment work have agreed to base me in the office until Christmas.

    Basically I need to be able to drive by Christmas.

    Until my appointment with the physio comes through, does anyone have any other suggestions about what other exercises I can be doing to aid & speed up the recovery?
  2. minikas

    minikas New Member

    Forgot to add that wearing my trainers makes it much easier for me to walk. Though can't actually tie the laces up.
  3. Ginger

    Ginger New Member

    I also sustained a non-displaced lisfranc injury, which went undiagnosed for a month, so I walked on the injured foot and after a CT scan revealed a fracture and some separation between the 1st and 2nd metastarsal I was placed in an air cast boot for over 6 weeks. Since then I have slowly regained full mobility of my foot and the exercise that helped is one where I sit in a chair with my feet flat on the floor and then pull my toes towards the heel by scrunching the arch - the arch does all the pulling. I am also plan to get prolotherapy injections in the hope of strengthening the ligament joint.

    I have also swithched from flexible to rigid arch supports which aliveated the jabbing pain under the arch and for most of the day I keep my foot taped to stabilize the midfoot. My foot is a far cry from what it was before this injury, but I intend to keep fighting with exercise, massage, orthodics, tapes, prolotherapy - whatever it takes.

    Hope some of this helps...

  4. Zora_DB

    Zora_DB New Member

    Another query rather than an answer - I've been off my injured leg (Lisfranc again) for 6 weeks already and will be off it for another month at least as I had to wait a while for surgery. I'm still in a hard cast - is there ANYTHING I can do to try and get my leg back in shape? The muscle has gone from my calf and is rapidly disappearing from my thigh too.
  5. Ginger

    Ginger New Member

    I don't know if there are any exercises that you can do for your leg while it's in the cast - it doesn't take much for the muscles to deteriorate, however once you are out of the cast the muscles will regain their stength - swimming is good and there are other exercises that you can do. I know it's frustrating, but it will get better, it just takes a lot of patience.
  6. Zora_DB

    Zora_DB New Member

    Thanks Ginger. I have experimented a litle with a theraband around my ankle and have been able activate my thigh muscles somewhat, but there really seems to be nothing I can do for the calf!
  7. ThaFoot

    ThaFoot Guest

    Hello Zora and Ginger,

    I injured my lisfranc(minor ligament tear im guessing) and 10 days after(walking on it until this point) the Ortho said the size of the space between my 1st and 2nd mt is within (under 2mm) the range of non-surgical.....so im in a hard cast for 6 weeks......my question to ya'll is from what this sounds like to u do u think i should be just fine after the 6 weeks go by and i get this cast taken off?

    Any info will help
  8. Ginger

    Ginger New Member

    Hi Andrew:

    I think my injury was similar to yours, except that I also had a fracture between the intermediate and lateral cunieform, which indicates that there was major tearing and streching of the ligament - the location of the fracture indicates that it is the Lisfranc ligament.

    I must admit that I was very frustrated and discouraged when I got out of the air cast boot, as my foot was still swollen and the pain was still present. I had to fight the habit of limping - orthodics, exercises and taping helped, but it still took a long time for my foot to get better.

    It's been over a year now and I still have to be careful, however I have been able to resume with most of my activities - my passion is ballroom dancing and so far I am still able to keep it up, although I must say it's not that easy now - I am aware of my foot all the time - there is discomfort and a feeling of some instabity.

    Andrew, it sounds like your injury is much milder than what I had - I don't think you did any damage by walking on it for 10 days and the air cast will help everything heal in the right place.


  9. Unregistered

    Unregistered Guest

    Hi Ginger,

    Thanks for the speedy reply....i've been sitting here reading on the computer for the last 3 days and all i hear is horror stories about this injury but it sounds like everyones stories i read are much more serious than ours im guessing because everyone had surgeries.......but my ortho said its not necessary..........
    ...........my foot was not very painful or swollen when i got it casted, was yours???
    .....i'm just sitting here praying that my injury is not that serious..........i didn't ask many questions and just got casted and left the orthos office(which was 4 days ago)....i have so many questions now after ive read into this injury that i scheduled another appointment for monday....i want him to go over the weight bearing x-rays with me and tell me that my injury is minor and i DO NOT NEED surgery......i didn't have any fractures either like you did...do you know the amount(in mm) of space between your 1st and 2nd mt?....and your doc said you didn't need surgery either?....also did your foot swell more in the cast?....because if my foot was pretty much normal size going in the cast than it should be normal coming out too right?......you had lots of pain when you were casted?.


    ......Thanks again for all your info!!

  10. Ginger

    Ginger New Member

    Hi Andrew:

    Not to worry about asking questions - I know how scared I was when I went on the internet and read all the posts about this injury.

    I think you are so lucky to have seen the orthopedic surgeon so soon - I walked on my injured foot for over a month before, I saw the ortho. He did a weight bearing x-ray and placed me in a cam walker, which I was able to take off at night - I think it was too late for a non-weight bearing cast, as the damage was already done.

    When I injured my foot, falling down the stairs, the pain was unbearable, I almost passed out. I had major swelling and some bruising. The doctor at the walk in clinic diagnosed me with a Lisfranc, but did a regular x-ray which didn't show any fracture or separation, he thought it was just a sprain, told me to take it easy for a few days and continue with reglar activities.

    I really don't know how big my sepaation is - when I asked the otho he just said it didn't require surgery. From everything that I have read up on this injury a separation less then 2mm does not require surgery and your ortho is probaly being very conservative by putting you in a non weight bearing cast.

    My foot did not swell in the cam walker, it actually became thinner, but nothing significant - yours might react differently as you are not putting any weight on it and I presume you can't take it off like I could. After about 6 weeks in the cam boot, I wen't into regular shoes, my foot had some swelling and it was hard to resume walking, as my muscles had grown lazy - so there was some pain and I had to walk very gingerly at first. It took me more than a month to start walking without a limp. I would strongly suggest to get a good pair of arch supports when you start with regular shoes, at least for the first month or so.

    My foot is still the same size it was before the injury.

    Andrew, I think you will be okay - your injury is milder than mine and you got prompt treatment which is so important in a Lisfranc injury. Even with the late treatment that I got my foot is not doing too bad - tonight I went out dancing in heels and my foot feels okay.

  11. Unregistered

    Unregistered Guest

    Hi Ginger,

    thanks again for your quick reply...it's good to talk to someone who's been in my position. So when your injury first happened were u able to walk on it at all? Did u ever have weight bearing x-rays? Did u always keep your foot elevated and take anti-inflammatories too?....so did your foot bend and forward or back when u fell down the stairs?...or did you just have hard impact on top of the foot?...I'm going to the ortho again this week so I'm going to get lots of things answered so I can have a better mindset on this...

    Thanks again...Andrew
  12. Ginger

    Ginger New Member

    I am not sure what happend when I fell, as it was in the middle of the night, I assume that I landed on my toes and twisted my left foot sideways, fell to my left side because my left hip and the side of my forehead was swollen and bruised. Right after it happened I wasn't able to put any weight on it at all, but the next morning after a night of intense icing, I was able to limp on it to the doctor's office. The doctor did a non - weight bearing x-ray and this did not show any abnormalities, so he sent me home and told me to rest for a few days. I had the weight bearing x-ray a month later and that one showed the separation between the 1st and 2nd mets and a "fleck which the ortho suspected was an avulsion (fracture). This led to a CT scan which confirmed the fracture between the first two cuneifoms.

    I think you are being very pro-active by going to the ortho to ask questions. By the way how did you injure your foot?

    I am very interested to hea what the orhto will say.

    Cheers and good luck...Ginger
  13. Unregistered

    Unregistered Guest

    Hi Ginger,

    Sorry about the late reply.....we decided to put a couple screws in to make sure it healed the best way possible....got that done last week....im not even in a hard cast since he said the screws are like an internal cast so im in a cam walker boot (non-weight bearing) for 5 weeks then i can start doing normal walking for 2-4 weeks(no running or jumping) then screws come out....i feel pretty good about it now....surgery wasn't that bad....most of the pain is gone except right around the areas he drilled in to........should be walking in less than 5 weeks now....

  14. Ginger

    Ginger New Member

    I am really happy that you have such prompt treatment - with your mild injury you should really have a good outcome long term - good for you for being so pro-active, I wish I was more informed about this injury - I am sure that I should of had at least a non-weight bearing cast. However, what's done is done. I am having polotherapy injections tomorrow in the hope of strengheniing the Lisfranc joint -it may not work if the ligament is completely torn - but I have to try.

    Keep in touch...Ginger
  15. Unregistered

    Unregistered Guest

    Hi Ginger,

    Thanks for the support. I am hoping that's the case with my injury(getting surgery quick and letting it heal will be the best). The only thing I worry about now is my muscle atrophy in my leg as I still have 3 weeks more non-weight bearing. I hear the muscle does come back once i'm active though probably not as quick as it left. I'm sure your injections will work because from what you've explained on the way you live and move around, there's no way yours is COMPLETELY torn.....

    Good luck and let me know how it went

  16. Ginger

    Ginger New Member

    Hi Andrew:

    I wouldn't worry about the muscles, as they will completely recover - when I got out of the boot, my calf was visibly thinner and my foot was kind of flat looking and witin weeks my foot and calf was the same as the unijnured one. However there may be some pain and discomfort for a long time, until everything gets back to full functionality, but don't let that get you down, it doesn't mean your foot is not going to recover. How have you been managing emotionaly, especially with the holiday season - it was not easy for me last year, being in the boot at this time...also, nobody understands this injury...when I started walking in shoes again I knew that I will never take the simple act of walking for granted ever again...it is a privilege.

    I wish you all the best in the New Year and thank you for saying that you think, my ligment was not completely torn, I needed that encourgament.

    Take Care... Ginger
  17. Unregistered

    Unregistered Guest

    Hi Ginger,

    You are absolutely right about taking walking for granted. Never again. I already plan on being out and about more often just to walk. I can't wait. It's been a little depressing but getting through it. Shouldn't be too long now and i'll be walking. Thanks for the muscle atrophy news, makes me feel better about the recovery. I plan on doing a lot of therapy and keep working out after therapy.

    Happy New Year

  18. Unregistered

    Unregistered Guest

    Hi, I had a lisfranc injury in May and have only just had the wires removed. I would also like to know if there are any exercises I can do at home as no physio has been mentioned by the hospital and my follow-up appointment is not for another 6 months. Has 2 ops on right foot, one to put k wires in and the second to remove them. I am managing to walk around the house without the aid of my crutches, but need them when out and about. Painkillers are wonderful things!
  19. Zora_DB

    Zora_DB New Member

    1 year post-op to the day, and I am still having a lot of trouble with the foot - it is far weaker than the other one, hurts all the time and swells up easily. I can walk normally now, as long as I concentrate on not limping, but not without pain. I can't run or jump.

    I had physio for 6 weeks on the NHS, which got me from not walking at all to walking, and since then, despite constantly doing the gentle exercises they gave me, and treating the foot as normally as possible (as instructed) the pain has got worse.

    I am now considering private physio and requesting a referral for a 2nd opinion, as my surgeon isn't interested and won't see me again before March.

    To the last poster- don't wait around assuming it will take care of itself. Go to your GP and ask for physio!
  20. Unregistered

    Unregistered Guest

    I just want to put my lisfranc story out there. It'll be 2 years ago in another month that I injured my foot playing basketball. I was finally diagnosed with the injury(compression to the medial cuneiform and lisfranc sprain) about 6 months later. Way too late for surgery. Especially since I had been on my foot 12 hours a day, 6 days a week for work. And thus began the scouring the Internet for answers. Anything. I read forum after forum after forum and it was quite depressing. I tried PT, electro-acupuncture, and spent many months in a walking boot. And it just kept getting worse. After a year I literally couldn't walk a block without being in immense pain. But then I came across info on prolotherapy, which leads me to some good news. My life is pretty much back to normal now. I can only wear running shoes and I have custom orthotics and I can't run but I can walk for miles and my day to day life is completely back to normal. A year ago (which was a year from my injury) I laid awake after spending hours reading these forums convinced I would never walk again. But I am. I highly recommend looking into prolotherapy and PRP for all you lisfranc sufferers. I'm hoping to one day run again which is miles away from the hopes I had a year ago. If you are in California look up Dr. Alderman. After about 6 months of treatment from her I was
    walking again. This is a VERY slow healing injury. But it does get better. Good luck!

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