by Kurt Turchan ... Downhill mountain bikers already look like hockey players or gladiators about to do battle. It started with armor for legs and arms. Gloves. Then came a full-face helmet, and, more body armor. Padded pants help, and full body armor completes the package.
But have you ever noticed in pictures of riders flying off logs and ramps, that the foot is completely unprotected and often times just a flimsy running shoe separates rider from ground.
Riders beware. There is a nasty injury you don't want and have probably never heard of called a "Lisfranc Fracture". I know, I have one - had one. I'd like to say had one, except that the surgery to re-align and fix the bones of the midfoot wasn't 100%, giving me pain after a long day of hiking, my other favourite activity. And I won't risk a similar accident again (well, I say that now). It could be worse though, and there's the long year it takes to recover from a Lisfranc injury, the rehab, the surgery itself - did I mention painful. Physiotherapists are nice people, but it's a bad sign when they outnumber your main group of friends. Worse when they think your foot is fused but it's not, and prescribe the wrong therapy. Just don't go there, i.e., don't take chances on suffering from this kind of injury. If you do suffer a Lisfranc dislocation, as many readers of this article have (trust me, enough of you have e-mailed me), see the bottom of this article for some suggestions.
What you may not realize is that the foot has a joint half-way between your toes and your ankle, even though nothing moves in the mid-foot. But in fact, this part of the foot is a bunch of little bones held together by ligaments to make it solid. It's what allows you to walk, run, jump, land. Without these ligaments - you might as well go to the boneless chicken ranch.
Now enter medical terminology - Lisfanc. Why is this complex of bones in each foot called the Â‘Lisfranc Joint'. Well it turns out Dr. Lisfranc was a surgeon in Napoleon's army and got very good at amputing a foot in under 3 minutes. Many officers were falling off their horses (rides) you see, and, this joint complex was easiest to send a knife up through.
Similarly, this joint is rather fragile if one were to say, land on it at hi-speed on an un-intentional fall from a mountain bike (modern ride). I cringe when I see riders up in the air with nothing more than a running shoe which will pass all the force of the impact straight into a rider's foot. I happened to blindly land on a log, not knowing what I was hitting. Um, it was also after falling off a small cliff of sorts, maybe a ledge is more accurate. The force of the impact completely fractured the Lisfranc joint. Very painful, have I mentioned pain enough in this article? Thinking I had merely sprained my ankle, I was quite surprised when I first heard the word "surgery" from a foot Doctor. Say that again Doc.
Six screws later, both in, and then later out, I am able to ride, even the shore. But never again will I risk a Lisfranc injury, and neither should you.
Ride with very stiff soled hiking boots that will transmit force along the base of the boot. Add some shock absorbers and an orthotic to further minimize the distortion of your foot on impact. Hiking boots also give your ankles support, and may prevent ankle injury. Take care of your feet, don't armor up and forget about the two things at the bottom of your body that are likely to land first. (Use the contact us form at bottom of page to reach me).
And if you have a Lisfranc injury, e-mail me, I am all ears.
- ensure your physiotherapist has treated this kind of injury before
- same goes for your surgeon, ensure he or she has done more than one of these operations
- get orthotics right away after surgery, well, after your physio is complete
- wear a walker boot and use a cane if necessary after surgery, don't worry about looking like a weeny
- do all of your physio, and more
- immediately toss all of your old shoes away that you bought at bargain prices, invest in good shoes with a better rocker and great support
- recognize and accept that this is not a 6-8 week full recovery injury, it could take a year or more to build back up from
- modify your lifestyle, you may have to give up DH biking, can you imagine going through all this twice! lose the ego, and with lifestyle modifications, all will be fine again! I promise.