Cuboid Syndrome: A Painful Experience
Recently, I went to my favorite Freeport store to get new boots. They fit well but they had a toe-off feature that I thought might be good for my gait. Evidently not. The inflexibility of the new boot with the toe off feature made my foot vulnerable to injury. What can a bad old inversion foot and ankle sprain and new footwear add up to? A Cuboid Syndrome. “Cuboid Syndrome is typically defined as a minor disruption or subluxation of the structural congruity of the calcaneocuboid portion of the midtarsal joint.” (Stephen Patterson) The subluxation irritates the surrounding joint capsule, ligaments, and the peroneus longus tendon. Cuboid Syndrome, according to Stephen Patterson of the University of Wisconsin, can be also referred to as subluxed cuboid, locked cuboid, dropped cuboid, cuboid fault syndrome, lateral plantar neuritis, and peroneal cuboid syndrome. There is extreme point tenderness on the cuboid bone laterally just below the fifth metatarsal. The extensor digitorum brevis is likely to spasm and the entire lateral dorsal foot locks making walking a limping if not impossible experience. As the cuboid bone stays subluxed, the muscles start a spasm cycle on a cataclysmic scale. Plantar flexors referred pain to the leg and pulled with spasm onto the bottom of the foot. Since I was walking on the inside of my foot to not put pressure on the cuboid bone, my arch and the point of attachment of the peroneus longus started screaming with discomfort. And just to make it all worthwhile, if I stepped just right, it felt like I was spraining it all over again and felt and heard audible crunches. Those really hurt. What to do? I knew I had not sprained the ankle. I did not fall or twist the foot. I had originally sprained my ankle and foot in 2005 and knew at that time that I had done some damage to the cuboid area and ligaments. Truly, not many listened to me. I think now, that I could have walked around with a subluxed cuboid for some time. I found an article on the internet about Cuboid Syndrome : A Review of the Literature by Stephen Patterson. In the article, Patterson clearly reviewed the anatomy, etiology and conservative measures needed to deal with this painful problem. The cuboid bone is the only bone in the foot that articulates with both the tarsometatarsal joint and the midtarsal joint. It is a link to the transverse arch as it houses the peroneus longus tendon and gives stability to the foot. It has numerous ligamentous attachments.
My chiropractor helped. She did electric stimulation, ultrasound and acupuncture. But as suggested by the article the real help was having it manipulated by my osteopath. The longer the cuboid is subluxed the more manipulations it might require. It is also not something you can do for yourself. Massage really helps. I am grateful I am surrounded by massage therapists. Leg and foot muscles need additional treatment to recuperate from this foot condition. Once the bone is manipulated correctly, the discomfort subsides substantially. Irritated muscles will take a while to calm down, but conservative measures of massage, stretching, strengthening, and hydrotherapy are just the ticket to restore normal healthy gait and happy feet. For more information about this problem you can link to: http://www.jssm.org/vol5/n4/18/v5n4-18pdf.pdf This article is very complete about a little known problem. Thank you Stephen Patterson!
Cuboid Syndrome: A Review of the Literature, Stephen Patterson, Dept of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601
As you know the nature of a blog is to be short and sweet. Please check this article for more thorough information. NWD