The above image is from Thieme's excellent Atlas of Anatomy. Get it if you don't got it.
I met a new client this week who suffered a Lisfranc fracture in a head-on car wreck. This is when the midfoot, where the long metatarsals meet the cuneiforms and cuboid, dislocates and/or fractures. It appears that this fracture is missed probably 20% of the time. (see footnote)
The thing to watch out for with Pilates clients with this fracture is discomfort when the foot is on the Reformer's footbar, on the push-through bar or in the footstraps. Basically, anytime the foot is positioned with the weight on the arch will be uncomfortable for this client.
If you're doing the feet in straps variations, it might be helpful to steal the Gyrotonic foot-loops (not Froot-Loops) because it transfers some of the load onto the ankle.
You can get these from Balanced Body here.
Reference: (Hardcastle PH, Reschauer R, Kutscha-Lissberg E, et al. Injuries to the tarsometatarsal joint. Incidence, classification and treatment. J Bone Joint Surg Br 1982;64:349-56.)
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