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SportsDoc Update: Gionni Paul 4/18/14

1280 The Zone - April 18th, 2014
Tags: Spence and Gordon, SportsDoc

A Lis Franc injury is an injury to the midfoot that involves tearing of some critical ligaments in the area where the foot bones join the midfoot bones in the front part of the arch. It is the injury that took Chad Lewis out of the Super Bowl when he was with the Eagles. He sustained the injury on the catch that got them the win in the NFC championship game and got the Eagles in to the Super Bowl. It is named for one of Napolean's army physicians who described the injury in horsemen who would get their foot tangled in the stirrup as they were falling off of their horses. It was a disabling enough injury that the treatment for it at that time was often amputation. Fortunately medicine has come a long way and that is no longer the treatment but it is an indicator of how difficult the injury can be to get better.

The injury occurs usually form the foot getting jammed upwards with the ball of the foot staying planted and seems to be more prevalent with artificial turf. This causes the bones to splay apart because the ligaments between them tear. It is very painful to try to walk on though some try. The injury is sometimes missed and called a sprain but it continues to be more painful and for longer than a typical sprain. There can be milder Lis Franc injuries that can heal with non-weight bearing (crutches) for 4-6 weeks, but in the athletic population is more often severe enough to require surgery. The surgery consists of putting some screws across the bones that have been separated to hold them together while the ligaments heal. The biggest problem with the rehab is that there is no weight bearing  for the first 6 weeks and then it is gradual. This allows all the muscles and joints on that leg to atrophy requiring an extended period of time to be fit enough to return to play. Usually 4-6 months from the time of surgery. The athlete may loose a half a step because of the loss of some of the spring in the foot. 

This unfortunate injury can be a career ender in some, but Chad Lewis was able to return at the Pro level. The injury can also lead to some arthritis in the foot down the road. Hopefully, Gionni will be able to heal well and be on an aggressive rehab program that will allow him to play this year. If everything went well, he will still miss most if not all of fall camp. Best of luck to him with this difficult injury.

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