Cuboid Syndrome
Cuboid syndrome refers to a subluxation of the structural congruity of the calcaneocuboid joint which results in irritation or inflammation of surrounding joint capsules, ligaments and the peroneus longus tendon causing lateral midfoot pain and impaired joint function.
With the pathomechanics behind cuboid syndrome being multifactorial in nature, it can often be challenging to diagnose the condition and to formulate effective management strategies accordingly.
This necessitates a proper understanding of cuboid subluxation in order to facilitate a thorough physical examination of the affected region and consequently, an accurate clinical diagnosis; this would help in the successful implementation of conservative measures accompanied with the use of external support in the form of foot orthotics.
The disruption in the joint congruity of the calcaneocuboid joint often happens as a result of forceful eversion of the cuboid while the calcaneus is inverted, leading to lateral foot pain.
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While reviewing literature on the examination and treatment of cuboid syndrome, Chris Durall, from the University of Wisconsin, lists out excessive pronation, overuse and inversion ankle sprains as the causes that have been proposed for the condition.
Among the risk factors outlined by the author in his review, midtarsal instability, excessive bodyweight, ill-fitting or poorly constructed shoes, exercise, inadequate exercise recovery, training on uneven surfaces and foot/ankle sprains can increase the predisposition of an individual to the condition.
Erik Adams and Chris Madden, from the Midwest Sports Medicine Institute and Longs Peak Family Practice respectively, presented a case study of an 11-year-old girl with soft tissue trauma in her left foot that affected a localised area over the dorsal calcaneocuboid joint.
The authors recommended management strategies involving manipulation or mobilisation, relative rest, activity modification, physical therapy (arch and midfoot strengthening), external dynamic support and occasional immobilisation.
MASS4D® customised foot orthotics would be included in treatment modalities to help maintain proper cuboid positioning and to facilitate healing of the surrounding soft tissues by addressing biomechanical discrepancies such as hyperpronation of the feet.
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References:
- Durall, C. J. (2011) Examination and Treatment of Cuboid Syndrome. Sports Health: November 2011, Vol. 3, No. 6, pp. 514-519. DOI: 10.1177/1941738111405965
- Adams, E., Madden, C. (2009) Cuboid Subluxation: A Case Study and Review of the Literature. American College of Sports Medicine: November/December 2009, Vol. 8, No. 6, pp. 300-307.
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