Isolated cuneiform fractures are rare and are often missed on plain radiographs, leading to delayed diagnosis and delayed return to sport. The authors of this study present a 32-year-old male ice hockey player who sustained trauma to his dorsal midfoot from a slap shot. Radiographs were negative for fracture. After inability to wean out of the controlled ankle movement boot, magnetic resonance imaging was ordered, demonstrating a middle cuneiform fracture. The patient was seen in physical therapy, where aquatic therapy, strength training, and cardiovascular conditioning were progressed. He was able to wean out of the controlled ankle movement boot at 7 weeks after injury and return to playing ice hockey. Here, we outline rehabilitation and a diagnostic and rehabilitative algorithm for those who sustain trauma to the dorsal midfoot with suspected fracture.