Midfoot Conditions

Structural Problems

Joint and Bone Conditions

  • What it is:
    A Lisfranc injury involves damage to the bones or ligaments in the midfoot, specifically at the tarsometatarsal (TMT) joints where the metatarsal bones connect with the midfoot. This injury can range from ligament sprains to fractures and dislocations.

    Causes:

    • High-impact trauma (e.g. car accidents, falls)

    • Sports injuries (especially twisting the foot while it's planted)

    • Missteps off curbs or stairs

    • Crush injuries to the foot

    Symptoms:

    • Pain and swelling in the midfoot

    • Bruising on the top and bottom of the foot

    • Difficulty bearing weight or walking

    • Widening of the foot or visible deformity

    • Tenderness over the TMT joint

  • What it is:
    Midfoot arthritis is the degeneration of cartilage in the middle portion of the foot, affecting joints between the tarsal bones and the bases of the metatarsals. It often leads to stiffness and pain with walking or standing.

    Causes:

    • Wear-and-tear over time (osteoarthritis)

    • Previous injuries (like Lisfranc injuries)

    • Inflammatory conditions (rheumatoid arthritis, gout)

    • Flatfoot deformity

    Symptoms:

    • Pain in the middle of the foot, especially when standing or walking

    • Swelling and stiffness in the midfoot area

    • Difficulty with foot movement or arch support

    • Bony prominences or changes in foot shape

    • Pain that worsens with activity and improves with rest

  • What it is:
    A navicular stress fracture is a small crack or break in the navicular bone, located in the midfoot. It’s a common injury in athletes and runners due to repetitive stress or overuse.

    Causes:

    • Repetitive high-impact activities (running, jumping)

    • Sudden increase in training intensity

    • Poor footwear or training surfaces

    • Bone insufficiency or poor biomechanics

    Symptoms:

    • Gradual onset of vague midfoot pain

    • Pain worsens with activity and improves with rest

    • Tenderness over the top of the foot (navicular area)

    • Swelling may be minimal or absent

    • Difficulty with high-impact activities

  • What it is:
    Accessory navicular syndrome occurs when an extra bone or piece of cartilage (accessory navicular) near the navicular bone becomes irritated or painful. Not everyone with an accessory navicular has symptoms, but it can cause issues when aggravated.

    Causes:

    • Trauma or overuse (especially in young athletes)

    • Flat feet or abnormal biomechanics

    • Ill-fitting footwear

    • Irritation from shoes or repetitive motion

    Symptoms:

    • Pain or swelling on the inner side of the foot (arch area)

    • Visible bump near the navicular bone

    • Pain when wearing tight shoes or after activity

    • Difficulty with foot movement or supporting the arch

    • Tenderness over the bump, especially with pressure

  • What it is:
    Flatfoot is a condition where the arch of the foot collapses, causing the entire sole to come into complete or near-complete contact with the ground. It can be flexible (arch appears when non-weight bearing) or rigid (arch is absent even when off the ground).

    Causes:

    • Genetics (inherited foot structure)

    • Weak or stretched tendons (especially the posterior tibial tendon)

    • Arthritis or joint degeneration

    • Tarsal coalition or other congenital issues

    • Injury or trauma to the foot or ankle

    Symptoms:

    • Pain along the arch, heel, or inner ankle

    • Fatigue or aching in the feet and legs after standing or walking

    • Flattening of the arch (especially noticeable when standing)

    • Difficulty fitting into shoes

    • Rigid flatfoot may cause stiffness and limited foot motion

  • What it is:
    Cavus foot is a condition where the foot has a high arch, causing more weight to be placed on the ball and heel of the foot. This imbalance can lead to pain and instability.

    Causes:

    • Inherited foot structure

    • Neurological conditions (e.g. Charcot-Marie-Tooth disease, cerebral palsy)

    • Muscle imbalances in the leg and foot

    • Spinal cord or nerve disorders

    Symptoms:

    • High arch that remains even when standing

    • Pain or calluses on the ball, heel, or outer edge of the foot

    • Instability or frequent ankle sprains

    • Clawed toes (hammertoes)

    • Foot fatigue or imbalance during walking

  • What it is:
    Tarsal coalition is a congenital condition where two or more of the tarsal bones in the foot are abnormally connected. This can be a bony, cartilaginous, or fibrous connection that limits motion and can lead to pain and stiffness.

    Causes:

    • Congenital (present at birth, often discovered in adolescence)

    • Can be associated with flatfoot or limited foot flexibility

    • Rarely, can result from trauma or arthritis

    Symptoms:

    • Stiffness and pain in the foot (often in adolescents)

    • Difficulty walking on uneven surfaces

    • Frequent ankle sprains

    • Rigid flatfoot that doesn’t improve with arch support

    • Limited side-to-side motion in the foot

Soft Tissue Disorders

  • What it is:
    Tendonitis is inflammation or irritation of a tendon, the thick cord that connects muscle to bone. Tibialis posterior tendonitis affects the tendon that supports the arch and runs along the inside of the ankle and foot.

    Causes:

    • Overuse from walking, running, or standing

    • Flatfoot or abnormal foot mechanics

    • Improper footwear

    • Sudden increase in activity

    • Injury or trauma

    Symptoms:

    • Pain along the inside of the ankle or foot

    • Swelling or warmth in the affected area

    • Arch collapse (in more advanced cases)

    • Difficulty standing on tiptoes

    • Worsening pain with activity or prolonged standing

  • (Can also affect the forefoot)

    What it is:
    Plantar fasciitis is inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot from the heel to the toes. It's one of the most common causes of heel pain.

    Causes:

    • Overuse from running or prolonged standing

    • Flat feet or high arches

    • Tight calf muscles or Achilles tendon

    • Inadequate arch support in footwear

    • Sudden increase in physical activity

    Symptoms:

    • Sharp, stabbing heel pain (especially with first steps in the morning)

    • Pain that improves with movement but returns after rest

    • Tenderness along the bottom of the foot

    • May cause forefoot discomfort if walking pattern is altered

    • Tightness in the arch or heel