Cuboid Syndrome

Cuboid Syndrome is a common cause pain on the outer side of the foot. This condition is often misdiagnosed and can affect all types of athletes, especially runners.

The condition develops when the Cuboid bone which is one of the eight mid-foot bone in the foot subluxes i.e. partially dislocates. This often happens due to a ankle sprain but can also occur due to long standing repetitive trauma.

When the Cuboid bone is not in in alignment then it can block or rather limit the movement and function of the bones surrounding it.

Often the patient will present with pain along the outside of the foot which is worse first thing in the morning and while jumping & hoping, it may ease with rest. The patient may subconsciously walk with a limp to take pressure away from the outside of the foot. It can be misdiagnosed as plantar fasciitis if the podiatrist does not isolate the exact location of the pain.

One of the  most common causes of this condition is inversion sprain of the ankle.  When this type of ankle sprain happens, the outer, or lateral, ligaments are stretched too much. The anterior talofibular ligament is one of the most commonly involved ligaments in this type of sprain. Approximately 70-85% of ankle sprains are inversion injuries. This is when the foot and heel bone are forced inwards while the Cuboid is forced outwards.  This damages the soft tissues which support the bone in place causing it to partially dislocate.  In this instance, pain usually comes on suddenly.

Another possible causes is repetitive Strain. The peroneus longus muscle which originates from the fibula and attaches to the base of the 1st metatarsal and medial cuneiform bone, Its a very important muscle as helps in everted the foot i.e outward moment. If excessive  tension is placed through this muscle from certain sports it may cause excessive traction on the bone causing it to move from its position. 

An important predisposing factor to getting Cuboid syndrome is having flat feet or rather excessive moments of pronation while walking.

There are a number of different treatment options for Cuboid Syndrome we can recommend such as mobilization and manipulation. A podiatrist will perform a manipulation, which uses small thrusts to the cuboid to relocate it and restore normal function of the joint. 

Taping of the foot and ankle is often used to support and stabilize the bones in the foot and hold the Cuboid in place while the surrounding soft tissues heal.  Orthotics which support the arch and also have a special Cuboid wedge to alleviate pressure to the area in longstanding conditions may be of great benefit.

Exercises may also be prescribed to increase strength of the tendons and muscles around the joint and increase balance to prevent future problems.