Management Of Cuboid Subluxation

Management Of Cuboid Subluxation

Symptoms Of Cuboid Subluxation

Cuboid subluxation will classically present as pain on the outside of the foot, where the pain is typically worse with weight-bearing activities. This is particularly so first thing in the morning, or when moving across uneven ground, jumping, hopping, or twisting such as quickly changing direction. The foot may feel weak in the push-off phase of walking, running and jumping, in the more severe cases people may even walk with a limp in an attempt to keep weight off the outside of the foot, trying to shift weight away from the cuboid bone area.
The pain may radiate with a cuboid subluxation injury from the cuboid into the sole of the foot, the front of the ankle, or into the toes. Palpation of the foot will frequently find the area to be painful to touch over the cuboid bone and the area may even be red and swollen. Symptoms of cuboid subluxation tend to ease with rest and avoidance of weight bearing activities.

Diagnosing A Blocked Cuboid

Cuboid syndrome is often missed when attempting to diagnose pain in the foot and ankle area. The diagnosis of cuboid subluxation is often made via the information gained from a subjective and objective examination. Taking a history of the condition and then assessing foot loading and biomechanics, as well as the presence of any pain and movement differences between the sides at the level of the cuboid is often satisfactory to make a diagnosis. Imaging the foot is useful for ruling out other causes of pain mimicking cuboid syndrome and can be used to help with making a diagnosis. However because there is currently no agreed upon conclusive test for diagnosing a cuboid subluxation it isn’t uncommon for the condition to go undiagnosed.

Treatment Options For Cuboid Subluxation

The goal when treating cuboid subluxation is “reducing” the cuboid back into position and ultimately maintaining it as such.

  • Physiotherapy treatment for a blocked cuboid will frequently involve mobilsation, or manipulation of the cuboid bone in an attempt to achieve just that “reduction” of the cuboid bone. Following manual therapy techniques a physio may use taping, or padding techniques to help support and maintain “correct positioning” of the cuboid bone.
  • As well as taping techniques, your physio may well suggest you consider making some changes to your footwear to assist in more effective longer term support of the cuboid during loading. Coupling shorter term taping, padding techniques, with footwear changes and adjustments to activity levels to give the tissues time to recover and assist correct support and positioning going forward is a fairly standard approach to managing cuboid pain.
  • This approach is frequently coupled with a home program of exercises to address and improve mobility, strength, foot posture and biomechanics as deemed necessary.
  • It isn’t uncommon for orthotics (insoles to support the arches of the foot) to be prescribed with cuboid syndrome, orthotics as relevant where taping techniques, padding and/or footwear changes have provided relief in the short term and either a longer term solution, or more aggressive support is deemed necessary. Orthotics, semicustomised such as a physio can provide, or customised through a podiatrist can be a very effective approach in cuboid pain management, especially in chronic, stubborn situations that fail to respond to any of the above mentioned approaches.

The good news is the majority of patients diagnosed with cuboid syndrome heal with appropriate physiotherapy treatment, and graduated return to sport and activity can occur once symptoms settle.

Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Management Of Cuboid Subluxation should consult his or her general practitioner, physiotherapist, sports medicine specialist, orthopedic surgeon or otherwise appropriately skilled practitioner.