Cuboid syndrome is a condition where the bone on the outer side of the foot is displaced due to either overuse or a sprain ankle. It is a common injury in athletes and ballet dancers. It represents 4% in all foot injuries and presents in 7% of patients who have sprained their ankles. It is often not recognized or misdiagnosed.
The cuboid is a bone in the shape of a cube, located on the outer side of the foot. It belongs to the mid foot section of the foot, behind it is the rear foot and in front of it is the forefoot. It has a tunnel underneath it to accommodate a very important tendon, called the peroneus longus tendon. The peroneus longus tendon, is a long tendon originating from the fibula(a long slender bone on the outer side of the lower leg), passes behind the ankle and travels through the tunnel of the cuboid bone and continues its way under the arch of the foot and attaches underneath the big toe. The function of the peroneus longus tendon is to point the ankle and toes down and pull the ankle to the outer side. The function of the cuboid bone is to stabilize the foot during walking and jumping . When this bone is displaced, it irritates the surrounding capsule, ligament and tendon, resulting in pain in the outer side of the foot, difficulty walking/running, and jumping.
The cause of cuboid syndrome is overuse activity such as continuous jumping, as a ballet dancer would do. The constant motion of pointing the toes and landing on the floor with a collapsed arch irritates the cuboid bone, because it is acting as a pulley between the two attachments of the peroneus longus muscle. Another cause of the cuboid syndrome is a severe ankle sprain. The ankle points down and turns in as the ankle sprains, the peroneus longus tendon rotates the cuboid bone clockwise. One can see a depression on top of the foot and a lump in the bottom of the foot. When one walks, one can feel like he/she is walking on a rock on the outer side of the foot. This mechanism is also true when the inside arch of the foot collapses.
The most effective treatment for this condition is a cuboid manipulation, to restore its original position, hence decreases the pain. Other treatments are taping the cuboid bone, mobilization with movement and exercises to correct collapsed arch.
Call STARS for treatment of this condition.
by Raj Issuree, MPT
References:
Patterson SM. Cuboid Syndrome: A review of literature. J Sports Sci Med 2006; 5:597-606
Newell S, Woodle A. Cuboid Syndrome. Phys Sports Med 2016; 9(4): 71-76