Lisfranc injuries are almost always caused by a fall, slip or trauma to the foot. You might read about “direct” (high energy) and “indirect” (low energy) causes of Lisfranc injuries. These are different ways to help your provider understand the specifics of your injury. Direct causes are traumas that crush the Lisfranc joint, like car accidents or something falling on your foot at a worksite. Indirect causes are much more common and come from slips, falls and sports injuries. Anything that makes your heel unexpectedly twist or spin while you’re stepping with weight on the ball of your foot can injure your Lisfranc joint or fracture the small bones in it. What you were doing when you injured your foot is often the best way for your provider to correctly identify and diagnose a Lisfranc fracture or injury. Make sure you share as much as you can about what led to your foot’s injury or what you were doing before you noticed symptoms like pain or bruising.