Most people know what a twisted ankle feels like. But what if the pain isn’t in the ankle—or the toes—but right in the middle of the foot? That’s the “midfoot,” and it’s an area that often gets overlooked until the pain becomes too hard to ignore.

At Foot & Ankle Associates of Southern NH, we see many people who think they’ve just “sprained” their foot, only to find out it’s something more serious, like a Lisfranc injury or a fracture in the midfoot bones. These injuries can sneak up on you and, if left untreated, may cause lasting problems with walking, balance, and even shoe comfort.

Where Exactly Is the Midfoot?

Think of the foot as three sections:

• Hindfoot: Heel and ankle

• Midfoot: The arch area—made up of small bones and strong ligaments that form the “bridge” of the foot

• Forefoot: The ball of the foot and toes

The midfoot acts like a shock absorber, helping you push off when you walk or run. If it’s injured, every step can feel unstable or painful.

Signs You Might Have a Midfoot Injury

Some symptoms are easy to brush off, but here’s what should make you stop and pay attention:

• Pain and swelling in the middle of the foot

• Bruising on the top and bottom of the foot (bottom bruising is a big red flag)

• Difficulty bearing weight, especially when pushing off

• A feeling that the arch has “collapsed” or isn’t supporting you

If there’s been a twist, fall, or sports injury followed by these signs—especially bruising on the bottom of the foot—it’s worth getting checked right away.

Why Midfoot Injuries Get Missed

Many people (and sometimes even healthcare providers) mistake midfoot injuries for simple sprains. The trouble is, certain injuries—like Lisfranc ligament tears or midfoot fractures—need early treatment to heal well. Waiting too long can lead to arthritis, chronic pain, or permanent changes in foot function.

How We Diagnose and Treat Midfoot Injuries

Our team starts with a detailed exam and imaging (X-rays, sometimes MRI) to understand exactly what’s happening inside the foot.

Treatment may include:

• Rest and immobilization: Using a boot or cast to allow healing

• Physical therapy: To restore strength and flexibility

• Custom orthotics: To support the arch and prevent re-injury

• Surgery: Only if the bones or ligaments need to be realigned or repaired

The Bottom Line

Midfoot injuries may be less common than ankle sprains, but they’re often more serious when ignored. If you’ve had an injury and your foot just doesn’t feel right, don’t wait for it to “work itself out.” Early treatment is the key to avoiding long-term problems.

Struggling with midfoot pain?
The Foot & Ankle Associates of Southern NH team is here to help. We’ll figure out exactly what’s going on and create a plan to get you back on your feet—comfortably and confidently.