Cuboid Syndrome – Causes, Symptoms, Treatment & Exercises
Cuboid syndrome also known as cuboid subluxation. It is a common foot injury found in athlete & belle dancers.
What is cuboid bone?
Cuboid is one of the five bones that together make up the midfoot others are navicular and three cuneiform bones.
It is cube shaped and found in outer side of midfoot. Posteriorly it connects with calcaneus bone while anteriorly it forms a joint with fourth & fifth metatarsals.
Function of cuboid bone
Cuboid bone plays an important role in providing stability to outer side of midfoot. It stabilise foot and along with other midfoot bones distributes the weight of body to help people walk comfortably.
What is cuboid syndrome?
Severe trauma, ankle sprain or repetitive physical activities of foot leads to the subluxation (partial dislocation) of this bone resulting into dull aching pain around outer side of midfoot and difficulties in walking. This condition of subluxation is also known as cuboid syndrome.
This condition is also commonly known as cuboid subluxation, cuboid fault syndrome, blocked cuboid, lateral plantar neuritis and dropped cuboid.
During walking or running, lower leg muscles go under certain movements causing contraction of muscles like peroneus longus. This contraction puts stress on small bones of midfoot & surrounding tissues, especially on cuboid bone.
When these forces are excessive and beyond the limit of what this small bone & its surrounding tissue can tolerate, a tear in these tissues may occur resulting into abnormal alignment of cuboid bone causing subluxation.
Ankle sprain can also be a cause of dropped cuboid. Especially an inversion sprain of ankle, where ankle along with the foot excessively turns inward.
Repetitive Movements of lower leg muscles
Repetitive contractions of lower leg muscles can put extra stress on soft tissues that hold cuboid bone in place & may lead to its tear resulting into subluxation of bone.
Apart from sprained ankle other foot injuries involving middle part of foot may cause tear of connective tissues resulting in to cuboid fault.
Dancing & Running
A repetitive dancing move (especially in belle dancing) that puts pressure on foot can cause this problem. Running bare foot may also lead to altered biometrics of foot and lead to dull aching pain middle part of foot.
Cuboid Syndrome Symptoms
This syndrome represents some typical symptoms like
- Acute or chronic dull aching pain at later side of foot.
- Difficulties in walking
- Pain increase when a patient start to walk of put pressure on foot.
- Pain usually reduces after complete rest.
- Lateral part of foot becomes tender to touch, red and swollen.
- Some patient may walk on their toes to avoid weight & pressure on cuboid bone.
Diagnosis of dropped cuboid
It is often possible to misdiagnosis this syndrome as even advanced imaging sometimes fails to provide a clue to subluxation of cuboid.
After thorough examination of foot, your doctor may ask you to undergo advanced imaging to see if there is cuboid fracture or just a subluxation. Advanced imaging is useful to rule out the other causes of foot pain.
Usually simple x-ray of foot cannot able to capture of small fracture in bone so MRI might be advised. Recent history of ankle sprain & co-relation of clinical findings with MRI report can confirm the diagnosis.
One can consider cuboid syndrome if pain does not subside for more than three months following an inversion ankle sprain.
Cuboid Syndrome Treatment
Relocation or manipulation of cuboid bone is the most important part of treatment. It involves relocation dislocated cuboid bone to its anatomically proper position.
This procedure involves a fast thrust that push dislocated cuboid bone to its original position. This procedure must be carried out by only trained professionals like podiatrist, orthopaedic doctor etc. & should never be tried in home.
Once the manipulation is over, other part of supportive treatment should be started.
No wonder rest is first choice of supportive treatment for any foot ailment.
Rest prevents excessive stress being put on the foot bones and help body to heal the injured connective tissues surrounding cuboid bone.
If complete bed rest is not possible, one can use crutches or wheelchair to avoid pressure of cuboid bone.
Ice pack application
Application of ice compressions to affected are can help to reduce congestion, swelling and pain.
Place a thin towel over foot and apply ice cold compressions to the mid part of outer foot. Keep it for 5 to 6 minutes at a time then remove and repeat for three times a day.
Compression bandage can be used to minimize movement of foot.
After applying compression bandage, elevation of affected leg and rest is useful for speedy recovery.
Cuboid Syndrome Taping & Padding
Taping is useful to stabilize cuboid bone and allows soft tissues to recover by minimizing movement of ankle and foot.
Wedge or padding can used to support cuboid bone which will help to prevent recurrence of subluxation in future.
Orthotics provides support to foot and can be worn inside of shoe. It helpful for proper alignment of foot bones & reduces over-pronation of foot.
During acute phase of injury, exercises should not be practiced to avoid aggravation of pain and inflammation of soft tissues.
Once healing process starts and pain subsides, you should start exercise for strengthening