Understanding Midfoot Sprains: Causes, Symptoms, and Treatment

Dr. Courtney Conley (DC, BS’s in Kinesiology & Human Biology)


A midfoot sprain is an injury that affects the ligaments and soft tissues in the midfoot region, which includes the area between the arch and the toes. It is a common injury that can cause pain, discomfort, and difficulty in walking or bearing weight on the affected foot. Midfoot sprains are often misunderstood and misdiagnosed, highlighting the importance of gaining a thorough understanding of this condition.

It is very important to understand the difference between a Lisfranc (midfoot) injury and a midfoot sprain.  A Lisfranc injury is often mistaken for a simple midfoot sprain.  Lisfranc injuries result if the bones of the midfoot are broken or the ligaments that support the midfoot are torn. It can be a severe injury that may take months to heal or may even require surgery.  If you are concerned, we highly recommend seeing a healthcare professional and/or getting the appropriate imaging.  

See our article on Lisfranc injuries here.

What is a Midfoot Sprain?

Understanding Midfoot Sprains and Their Impact on the Foot

A midfoot sprain refers to an injury that occurs to the ligaments and soft tissues in the middle region of the foot. The midfoot consists of a complex structure of bones, ligaments, and joints that help maintain stability and flexibility. When the ligaments in the midfoot become overstretched or torn, it results in a midfoot sprain.

Causes of Midfoot Sprains

Physical Trauma or Injury

  • Midfoot sprains can occur due to direct trauma or injury to the foot. This can happen during activities such as car accidents, heavy object falls, or any forceful impact on the foot.

Sports Activities and Overexertion

  • Engaging in high-impact sports or activities that involve sudden changes in direction, jumping, or running can put excessive stress on the midfoot, leading to sprains. Sports like basketball, soccer, and gymnastics are commonly associated with midfoot sprains.

Falls or Accidents

  • Slipping, tripping, or falling can result in midfoot sprains. When the foot twists or rolls forcefully during a fall or accident, it can strain the ligaments in the midfoot.
Fall is a cause of midfoot sprains

Understanding the causes of midfoot sprains is crucial in taking preventive measures and practicing caution during physical activities to reduce the risk of injury.

Recognizing Midfoot Sprain Symptoms

Common Symptoms of Midfoot Sprains

Midfoot sprains can manifest through various symptoms, indicating the extent of the injury. It is important to recognize these signs to seek appropriate medical attention:

Pain and Tenderness in the Midfoot Area:

  • Individuals with a midfoot sprain often experience localized pain and tenderness in the middle region of the foot. The intensity of pain may vary depending on the severity of the sprain.

Swelling and Bruising:

  • Swelling and bruising are common symptoms of midfoot sprains. The injured area may appear swollen and exhibit discoloration due to bleeding beneath the skin.

Difficulty Bearing Weight or Walking:

  • Midfoot sprains can make it challenging to bear weight on the affected foot. Walking or putting pressure on the midfoot area may cause discomfort and pain.

Intensity Variations in Midfoot Sprain Symptoms

The intensity of midfoot sprain symptoms can vary from person to person and depends on the severity of the injury. Mild sprains may present with minimal pain and swelling, allowing individuals to bear weight with slight discomfort. In contrast, moderate to severe sprains can lead to intense pain, significant swelling, and difficulty walking or bearing weight on the foot.

It is important to note that midfoot sprain symptoms can overlap with other foot injuries, making an accurate diagnosis essential. Consulting a healthcare professional is recommended to determine the exact nature and severity of the injury and to receive appropriate treatment.

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Diagnosing Midfoot Sprains

Physical Examination by a Healthcare Professional

When a midfoot sprain is suspected, a healthcare professional will conduct a thorough physical examination to assess the extent of the injury. This examination typically includes evaluating the affected foot's range of motion, checking for areas of tenderness and swelling, and assessing stability.

Imaging Tests for Accurate Diagnosis

In some cases, imaging tests may be necessary to obtain a more detailed and accurate diagnosis of a midfoot sprain. These tests can help identify any associated fractures or assess the extent of soft tissue damage. The two commonly used imaging techniques for diagnosing midfoot sprains are:

X-ray to Assess Bone Integrity:

  • X-rays are commonly performed to rule out any fractures in the midfoot area. They can provide valuable information about the condition of the bones and help determine if there are any associated injuries.

Diagnosing Midfoot Sprains

MRI or CT Scan to Evaluate Soft Tissue Damage:

  • Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans may be ordered to assess the soft tissues, such as ligaments and tendons, in the midfoot region. These imaging tests can provide detailed images that help identify any tears, sprains, or other soft tissue injuries.

By combining the findings from the physical examination and imaging tests, healthcare professionals can make an accurate diagnosis of a midfoot sprain. This information is crucial for developing an appropriate treatment plan tailored to the individual's specific needs.

Treatment Options for Midfoot Sprains

Pain Relievers and Anti-inflammatory Medications

  • Over-the-counter pain relievers like acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and reduce inflammation associated with midfoot sprains. However, it is essential to follow the recommended dosage and consult a healthcare professional if there are any contraindications or concerns.

Physiotherapy and Rehabilitation Exercises

A key component of midfoot sprain recovery is undergoing physiotherapy and rehabilitation exercises. These exercises aim to restore flexibility, strength, and range of motion in the affected foot. A physiotherapist or healthcare professional can design a personalized exercise program that may include:

  • Range of motion exercises to improve mobility and flexibility.
  • Strengthening exercises to rebuild muscle strength and stability in the midfoot.
  • Balance and proprioception exercises to enhance coordination and prevent future injuries.
  • Gradual return to weight-bearing activities and sports-specific exercises under professional guidance.

Surgical Interventions (If Necessary)

In severe cases of midfoot sprains where conservative treatments fail to provide adequate relief, surgical intervention may be considered. Surgical options depend on the specific nature and severity of the injury and can involve repairing torn ligaments, realigning bones, or stabilizing the midfoot. The decision for surgery is typically made by a healthcare professional specializing in foot and ankle conditions after a thorough evaluation of the individual's condition and response to non-surgical treatments.

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It's important to note that not all midfoot sprains require surgery, and most cases can be effectively managed with non-surgical approaches. A healthcare professional can determine the most appropriate treatment plan based on the individual's specific circumstances and needs.

Tips for Managing and Preventing Midfoot Sprains

Proper Care and Management During the Healing Process

When recovering from a midfoot sprain, it's crucial to follow these care and management tips:

  • Adhere to the treatment plan: Follow the recommended treatment plan provided by your healthcare professional, including rest, medications, and rehabilitation exercises.
  • Use supportive devices: If advised by your healthcare professional, use crutches, walking boots, or braces to provide additional support and protect the injured foot during the healing process.
  • Gradual return to activity: Once cleared by your healthcare professional, gradually reintroduce weight-bearing activities and sports. Start with low-impact exercises and progressively increase the intensity and duration.

Preventive Measures to Reduce the Risk of Midfoot Sprains

Taking preventive measures can help minimize the risk of midfoot sprains and protect your feet from injury. Consider the following tips:

Proper Warm-up and Stretching Before Physical Activities:

  • Prior to engaging in any physical activity or exercise, perform a thorough warm-up routine that includes dynamic stretches to prepare your muscles, tendons, and ligaments for the activity. Focus on stretching the muscles in your feet, calves, and ankles to improve flexibility.

Stretching for Preventing Midfoot Sprains

Wearing Appropriate Footwear:

  • Choose footwear that allows your feet to strengthen and be more mobile.  We recommend a range of zero-drop shoes. You can find our Gait Happens recommendations for footwear here

Maintaining Foot and Leg Strength and Flexibility:

  • Regularly perform exercises that target the muscles in your feet, calves, and lower legs to improve strength and flexibility. This can include toe curls, calf raises, ankle rotations, and balance exercises. Strong and flexible muscles can better support the foot and reduce the risk of injury. If you want a 12-week program for optimum foot health, try our Fit Feet Program, designed by clinicians and tailored to your feet.

Remember to consult with a healthcare professional or a qualified physical therapist for personalized advice and guidance on preventive measures and exercises specific to your needs.


In this article, we have explored the topic of midfoot sprains, understanding their causes, symptoms, diagnosis, and treatment options. Key points covered include the definition of midfoot sprains, common causes such as physical trauma and sports activities, recognizing symptoms like pain and swelling, and the importance of accurate diagnosis through physical examination and imaging tests. We have also discussed various treatment options, including initial home treatments, physiotherapy and rehabilitation exercises, and surgical interventions if necessary. Additionally, preventive measures such as proper warm-up, wearing supportive footwear, and maintaining foot and leg strength have been highlighted.

Consulting a Healthcare Professional

If you suspect a midfoot sprain or experience any foot-related concerns, it is essential to consult a healthcare professional, such as a podiatrist or orthopedic specialist, for an accurate diagnosis and personalized treatment plan. They can provide a comprehensive evaluation, recommend appropriate imaging tests if necessary, and guide you through the recovery process. Your healthcare professional will tailor the treatment approach to your specific needs, ensuring the best possible outcomes and minimizing the risk of complications.

By understanding midfoot sprains, recognizing their symptoms, and seeking timely medical attention, individuals can take proactive steps toward their recovery and long-term foot health.

Remember, this article is meant for informational purposes only and should not replace professional medical advice.

Frequently Asked Questions (FAQs)

What are the symptoms of a midfoot sprain?

The symptoms of a midfoot sprain include pain, tenderness, swelling, difficulty walking, and bruising in the midfoot area.

How is a midfoot sprain diagnosed?

A healthcare professional can diagnose a midfoot sprain through a physical examination and imaging tests such as X-rays, MRI, or CT scans.

What are the treatment options for midfoot sprains?

Treatment options for midfoot sprains include initial home treatments like rest and elevation, pain relievers, physiotherapy, and, in some cases, surgical interventions.

What exactly is a midfoot sprain?

A midfoot sprain refers to an injury to the ligaments or soft tissues in the midfoot area, typically caused by physical trauma or sports activities.

Remember to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan for a midfoot sprain.

*Please note that the answers provided here are for informational purposes only and should not replace professional medical advice. It is essential to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan based on your specific condition.

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