Cuboid syndrome: Relief For Mid Lateral Foot Pain

By Dr Ken Nakamura+

Cuboid Syndrome: Downtown Toronto Chiropractor Dr. Ken Nakamura

Do you have pain on the outer (lateral), middle part of the foot?

 

Do you have trouble putting weight on the outside (lateral) part of your foot especially when you are pushing off to step?

 

Cuboid Syndrome: Downtown Toronto Chiropractor Dr. Ken Nakamura

Then you may have cuboid syndrome. The cuboid is one of 26 bones in your foot. The bones along with the ligaments and muscles need to hold up your body weight when you stand and absorb the shock from walking, running and jumping.

 

Your cuboid is pretty stable when you consider all the ligament attachements. A muscle tendon called the peroneus longus also forms a a sling around the side of the cuboid. The cuboid becomes the pulley for the peroneus longus pulling it up and over towards the middle. A movement called eversion.

 

Cause Of Your Cuboid Syndrome

 

Despite all the ligaments and the peroneus muscle tendon your cuboid can become unstable causing pain of your cuboid which is called cuboid syndrome.

 

Research hasn’t discovered the cause but I can say that some people I have treated have had their foot stepped on, and one had their foot run over by a car. Most of the others sprained their ankle and caused their cuboid to shift.

 

Some academics think that cuboid syndrome is from excessive body weight, training on uneven surfaces, bad or ill-fitting shoes, orthotics, or pronated feet. Pronated feet are feet that flatten out when you walk.

 

Cuboid syndrome are common among ballet dancers with foot and ankle injuries (16.7%) and 6.7% of people with ankle sprains.[1]

 

Cuboid Syndrome is also called cuboid fault syndrome, dropped cuboid, subluxed cuboid, locked cuboid, peroneal cuboid syndrome, and associated with lateral plantar neuritis.

 

Diagnosis of Cuboid Syndrome

 

Cuboid Syndrome: Downtown Toronto Chiropractor Dr. Ken Nakamura 

 

The only two tests that seems to show up are the midtarsal adduction test and the Midtarsal supination tests according to the research. Even these test aren’t really proven.

 

I personally look for a slight depression around the cuboid from the top of the foot and a protrusion of the foot from the bottom. That is kind of subtle but sometimes there is tenderness of the peroneus longus tendon, or at the origin of the extensor digitorum brevis muscle.

 

Furthermore simply pushing on the cuboid from the top of the foot, seems to be a good possible indicator when combined with the other tests.

 

X-rays, CT and MRI are not very useful when it comes to cuboid syndrome, most of the time. They are really only helpful to rule of other, more serious problems in the foot.

 

Treatment For Cuboid Syndrome

 

A clinician can locate the cuboid and push it back in place so, you can put weight on your foot again. Pushing the cuboid back in place has neurophysiological mechanism and is thought to help with the pain.

 

In other words the pain in the foot is helped by having the nerve function better again. The thinking goes that the nerve is stretched and so irritated and so doesn’t function well. Put the cuboid back in place and the nerve can function properly and so doesn’t send pain signals anymore.

 

A felt pad underneath the cuboid is often helpful. Using a 1/8 or 1/4 inch (3-6mm) pad you may be helpful to decrease the pain enough for you to get to your neighbourhood chiropractor for manipulation.[2]

 

Heel raise exercises were used by one practitioner along with taping to hold the arch up combined with deep tissue work on the triceps surae (calf muscles). [3]

 

Tell us what you think in the comments below and like us on Facebook. I will answer all questions in the comments section here at this downtown Toronto Chiropractic clinic.

References

 

  1. Chris J. Durall, DPT, ATC, MSPT* Sports Health. Nov 2011; 3(6): 514–519. Examination and Treatment of Cuboid Syndrome
  1. White SC. Padding and taping techniques. In: Valmassy RL, editor. , ed. Clinical Biomechanics of the Lower Extremities. St Louis, MO: Mosby-Year Book Inc; 1996:367-390
  2. Matthews MLG & Claus AP Two Examples of ‘Cuboid Syndrome’ with Active Bony Pathology: Why Did Manual Therapy Help? Manual Therapy 2014; 19(5): 494-8. doi: 10.1016/j.math.2013.11.007. Epub 2013 Dec 19.

 

 


Author

Dr Ken Nakamura

Who is Dr. Ken? I’m a father, spouse, chiropractor, and I love what I do! I created Bodi Empowerment to bring you and everyone-else safe and effective methods for self-treatment by basing my articles on research to everything I can. Still many parts will be based on 18 years of experience, seminars, and collaboration with other health experts; which means you will get opinions as well. Sometimes my articles won’t agree with what is currently accepted, but I am not here to please everyone. I’m here to empower you through the knowledge that I give you. Dr. Ken works at Rebalance Sports Medicine in downtown, Toronto.

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