Cuboid Syndrome

Recently I had the great displeasure of creating two stress fractures in my left foot which were quite painful. But what really took my breath away was the dislocation of my cuboid bone. Having gone to the podiatrist, I learned quite a lot about this injury and thought I’d share what I’d found with you.

Cuboid Syndrome is the diagnosis given  when the cuboid bone of the foot becomes dislocated or misaligned resulting in pain and irritation to the surrounding connective tissue. Take a look at the picture to see its location in the foot.

The cuboid bone help to stabilize the foot but it is prone to slipping out of place during movements that twist or invert the ankle.  Athletes who enjoy lateral or side to side sports that require intense stabilization and short stops like tennis or racquetball are easy targets for Cuboid Syndrome but everyone from soccer players to dancers can experience this painful problem. Even walking incorrectly over a period of time or stepping off a curb incorrectly can cause the bone to dislocate to a downward position toward the cuboid pad.

The pain can develop quickly or gradually over a period of time following an incident. While the pain is often located directly over the cuboid bone it can also be felt under the arch, along the center and side borders of the foot and surrounding tissue, ligaments and tendons. According to Rick Allen, D.C., “The calcaneocuboid ligament, which extends from the heel to the cuboid may become strained and can mimic heel spur pain along the bottom of the heel.”  Pain may be present during weight bearing and non weight bearing activities, when attempting to stand on your toes or inverting the ankle, and in my case, when trying to stabilize or balance on one foot during a dance move.

Cuboid syndrome is typically diagnosed via a thorough palpation by a qualified doctor as the dislocation is so minor that it can’t be picked up by x-ray or MRI.
Cuboid syndrome can be easily treated with a series of manipulations by a qualified doctor or therapist and pain relief is frequently instantaneous. Dr. Gary Prant, DPM has found that “often several manipulations are required because the cuboid may not stay in place once it is relocated. I find that most people require about three manipulations over a period of about five weeks before the ligaments around the cuboid tighten up and hold the cuboid bone comfortably in place.”

Dr. Prant suggests that in addition to manipulation, other forms of treatment including physical therapy, strappings and padding in a certain manner to force the cuboid back into position can be extremely helpful. Many podiatrists and other foot health professionals can create and orthotic with a built in cuboid pad can be very helpful in maintaining the position of the cuboid.