What Is Cuboid Syndrome
The cuboid is one of some 26 small bones in the foot. It plays an important role in helping the foot transfer weight and providing stability.
When this small bone is partially dislocated (subluxed) the condition is known as Cuboid syndrome.
Cuboid Syndrome is surprisingly common but frequently misdiagnosed. Other names for Cuboid syndrome include subluxed or locked cuboid, dropped cuboid, lateral plantar neuritis, and peroneal cuboid syndrome.
Who Does It Affect?
Acute injuries and chronic conditions can trigger this partial dislocation of the cuboid bone. Cuboid syndrome can typically affect any adult but those in high activity sports are most prone.
However, sometimes the symptoms and pain can appear to move around and so it can be difficult to diagnose.
It is important to seek early treatment for this condition. If you allow the bone to remain subluxed for too long it may cause damage to surrounding areas of the foot.
A wide range of events can knock the cuboid bone out of position. It may be a sudden trauma or foot injuries such as landing badly, especially on the outside of the foot or an ankle sprain.
Repeated inversion ankle sprains can also dislocate the cuboid bone. Training on uneven surfaces that place strong lateral pressure on the foot can exacerbate any weakness in this area.
Poor and unsupportive footwear may also be a causative factor. People with flat feet (Pes planus) are more likely to develop Cuboid syndrome because the lack of a strong arch places significant pressure on the bones and ligaments of the foot.
Chronic overuse conditions appear to trigger an overtightening of the peroneal tendons (particularly the peroneus longus tendon) and this can cause the cuboid bone to flick or rotate out of position.
Cuboid Syndrome is notoriously hard to diagnose because symptoms can vary from patient to patient and according to the nature and severity of the dislocation.
X-rays are of little value in the early stages because this type of injury often won’t show up. However, when lateral foot pain is significant we may recommend an X-Ray to rule out hairline fractures or other injuries.
Patients may complain of either a dull ache or sharp pains in the lateral side (outer) of the middle region of the foot (in the cuboid area).
There is usually a rapid onset of lateral midfoot pain, which will typically intensify with activity and may not necessarily disappear with rest.
Sometimes the joint may even feel locked in place. Swelling may also be present but all of these symptoms may vary according to the severity of the injury.
RICE (Rest, Ice, Compression, and Elevation) will help to reduce initial inflammation and pain but you need to see your podiatrist as soon as possible.
If you do not treat Cuboid syndrome promptly the displacement can cause damage to the surrounding tissue and bones. Your podiatrist will use a range of advanced tools as well as expert knowledge to make a correct diagnosis.
Gentle manipulation is often required to realign the bones as part of the treatment of cuboid syndrome. This mobilisation technique (cuboid squeeze) will often relieve pain immediately.
Once the bone is back in place, taping or foot strapping will help stabilise the foot, reduce pain and inflammation. Strapping can also help to transfer weight away from the cuboid area.
More Treatment Options
NSAIDs (non-steroidal anti-inflammatory medication) such as Ibuprofen may help reduce pain and inflammation. Dense foam padding in your footwear will add support and cushioning for your foot.
Your podiatrist will devise a stretching/ strengthening programme to reduce tightness of the peroneal muscles that can contribute to the problem. Dry needling, massage and shockwave therapy can be very effective in this area. We may also recommend a strengthening programme to target weak muscles if they’re not giving your ankles the support they need. A Moon boot may be necessary in severe cases to protect your foot while it’s healing.
Custom orthotics can transform the way your feet, knees, legs and hips function. Improving your biomechanics and gait with orthotics can effectively reduce the chances of this problem reoccurring. We’ll also discuss your footwear with you to ensure your feet are well supported during all your favourite activities.
Shockwave is a great alternative to treatments such as dry needling if you’re needle phobic and not keen on dry needling. We also have effective treatment offers for kids.