Chopart Joint Injuries: Why Midfoot “Sprains” Should Never Be Ignored
If you’ve ever rolled your foot, landed awkwardly, or been involved in a higher-energy accident and felt pain through the middle of your foot, you may have heard it called a “midfoot sprain.” But not all sprains are simple, and one of the most commonly missed and most serious midfoot injuries involves the Chopart joint.
Chopart joint injuries are uncommon, complex, and can have long-term consequences if they’re not diagnosed early and managed correctly. That’s why prompt assessment by a specialist sports podiatrist is so important, not just to confirm what’s injured, but to ensure the right imaging is organised, often including MRI, the right treatment plan is started early, and a surgical opinion is sought quickly if required.
What is the Chopart joint (and why does it matter)?
The Chopart joint is also known as the midtarsal joint. It sits between the back of the foot (hindfoot) and the middle of the foot (midfoot). It’s made up of two key joints:
The talonavicular joint (TNJ)
The calcaneocuboid joint (CCJ)
These joints are not “minor.” They’re central to how your foot functions. They help control pronation and supination, contribute to the foot’s ability to adapt to uneven ground, and help create a stable lever for push-off when you walk or run.
In simple terms: the Chopart joint is a major part of the foot’s stability system. When it’s injured, people can develop ongoing pain, weakness, reduced performance, or progressive collapse of the arch if it’s not treated properly.
How do Chopart joint injuries happen?
Chopart injuries can occur in different ways, ranging from ligament injuries through to fractures and dislocations. A recent review of Chopart dislocations highlighted that these injuries often occur in high-energy trauma, such as motor vehicle accidents, but they can also happen in falls and sporting incidents.
The injury patterns are usually grouped into four broad categories:
Ligament injury without dislocation
Ligament injury with dislocation
Fracture without dislocation
Fracture with dislocation (fracture-dislocation)
The more force involved, the more likely the injury is unstable, and instability is what creates long-term problems if it’s missed.
Why Chopart injuries are frequently missed
One of the biggest issues with Chopart injuries is that they’re easy to underestimate early on, especially when swelling is high and standard X-rays look “mostly okay.”
Research has shown that a significant number of Chopart injuries can be missed on initial assessment, and fractures can be overlooked when relying on plain X-rays alone. This matters because delayed diagnosis can lead to:
Prolonged pain and disability
Ongoing joint instability
Malalignment (the bones heal in the wrong position)
Post-traumatic arthritis
Flatfoot deformity (progressive arch collapse)
Need for more complex surgery later
This is one of the key reasons we encourage early assessment in clinic: a midfoot injury that doesn’t settle quickly deserves a deeper look.
Symptoms that should raise suspicion
Chopart injuries don’t always present dramatically, especially the ligament injuries, but there are common warning signs.
You should seek urgent assessment if you have midfoot pain after injury plus any of the following:
Pain through the “middle” of the foot (not just the ankle)
Difficulty weight-bearing or inability to push off properly
Marked swelling across the midfoot
Bruising on the sole of the foot (a concerning sign for midfoot injury)
A feeling that the foot is unstable or “shifting”
Pain that isn’t improving after several days
Pain that returns as soon as you try to run, jump, or change direction
Even if you can walk, a Chopart injury can still be present, and continuing sport on an unstable midfoot can make the damage worse.
Why a sports podiatrist is the right first step
A specialist sports podiatrist doesn’t just look for “where it hurts.” The goal is to work out:
Which joint(s) are involved (TNJ, CCJ, or both)
Whether the injury is stable or unstable
Whether there may be associated fractures
Whether urgent orthopaedic input is needed
How to protect the injury while it heals and prevent long-term problems
At our clinic, assessment includes a detailed history, targeted midfoot examination, gait review where appropriate, and a clear plan for imaging and management.
This is important because Chopart injuries are heterogeneous, meaning no two injuries are exactly the same, and “generic” sprain advice can be inappropriate.
Imaging: why X-ray isn’t always enough (and when MRI matters)
Initial imaging often begins with 3-view foot X-rays (including dorsoplantar, lateral, and oblique views). These are helpful, but they don’t always show the full story, particularly with ligament injuries or subtle joint disruption.
Depending on your presentation, we may refer for advanced imaging such as:
MRI: best for assessing ligament injury, cartilage damage, bone bruising, tendon involvement, and subtle fractures
CT: best for mapping fractures and joint alignment in detail
In many real-world cases, advanced imaging is the difference between “rest it and hope” versus a confident diagnosis with a clear plan.
Why early diagnosis changes outcomes
The Chopart joint plays a major role in maintaining the length and alignment of the foot columns (the medial and lateral sides of the foot). If those columns shorten or collapse after injury, gait and function can be significantly affected long term.
Evidence from the literature suggests that where Chopart injuries involve dislocation or fracture-dislocation, outcomes are generally better when anatomical alignment is restored early and joint congruency is maintained.
That’s why “waiting it out” for weeks with ongoing pain can be risky, especially if there is instability that needs urgent intervention.
Treatment: what does management involve?
Not all Chopart injuries need surgery, but many require more than basic rest.
Management may include:
Accurate diagnosis (this first step is key!)
Immobilisation (boot or cast) to protect the midfoot
Strict activity modification (sometimes non-weight-bearing)
Offloading strategies to prevent further collapse
Pain and swelling control
A staged rehabilitation plan to restore strength, mobility, and function
Orthotic support where appropriate
Gradual return-to-sport programming
The key is that treatment must match the injury type. A stable ligament injury is managed differently to a subtle fracture-dislocation.
When a surgical opinion is needed
Chopart dislocations and fracture-dislocations are serious injuries. If imaging shows significant displacement, instability, or joint incongruity, referral to an orthopaedic foot and ankle surgeon may be necessary.
Surgical goals typically include:
Restoring joint alignment
Maintaining medial and lateral column length
Stabilising the joints to allow proper healing
Reducing the risk of long-term arthritis and deformity
Even when surgery isn’t required, having a sports podiatrist coordinate the pathway, including referral, imaging, and rehab, can dramatically improve the quality and speed of recovery.
The bottom line: don’t ignore midfoot pain
Chopart joint injuries are rare, but they’re one of the most important reasons why persistent midfoot pain should be assessed properly.
If you’ve injured your foot and you’re still sore, swollen, or unable to return to sport normally, don’t settle for “it’s probably just a sprain.” Early diagnosis and the right imaging, often including MRI, can prevent long-term complications.
If you’re concerned about a midfoot injury, our sports podiatry team can assess your foot, organise appropriate imaging, guide your rehab, and refer for a surgical opinion when needed.
