Cuboid Syndrome: A Source Of Lateral Foot Pain
Cuboid syndrome is a fairly common cause of pain on the outer side of the foot. This injury involves the subluxation of the cuboid bone which is one of the small bones of the midfoot positioned on the outer side of the foot articulating to the heel bone (known as the calcaneus). Connective tissue comprised of a number of strong ligaments and joint capsule help the calcaneus and cuboid bone form the calcaneocuboid joint. Subluxation (a partial dislocation) of the calcaneocuboid joint may occur suddenly due to trauma such as suffering an ankle sprain, or develop more gradually overtime from repetitive load through the foot. Forces gradual and repetitive or sudden and violent may damage the supporting soft tissues of this joint causing the cuboid bone to move out of position. Once the cuboid is subluxed it may act like a block in the foot, limiting movement of the surrounding bones. Hence other names cuboid syndrome is sometimes referred to in the medical world is blocked cuboid, dropped cuboid or cuboid subluxation.
During weight bearing activity, stress is placed on the cuboid bone and the surrounding connective tissues. It is considered that contraction of the peroneus longus muscle and certain movements of the foot and ankle beyond what the body can withstand may lead to tearing of the supportive connective tissue. This excessive load and connective tissue stress may cause the cuboid to shift from its normal alignment or sublux leading to cuboid syndrome.
Causes Of Cuboid Syndrome
There are a few common causes considered to contribute to developing cuboid syndrome:
- Repetitive Stress: Repetitive contraction of the peroneus longus muscle may create cuboid syndrome through the excessive traction this muscle can place on the cuboid. The peroneus longus muscle runs down the outside of the lower leg passing behind the lateral ankle bone crossing the outside of the cuboid, and then runs on the under surface of the cuboid in a groove finishing up under the base of the foot towards the big toe side.
Jumping and running engage this muscle hence ballet dancers and runners are somewhat prone to cuboid syndrome. In this situation the symptoms come on gradually over time rather than immediately as the result of trauma such as following an ankle sprain.
- Injury: A common cause of cuboid syndrome is from spraining your ankle. An inversion ankle sprain where the foot and heel are turned inwards excessively and the cuboid bone is forced outwards can damage the connective tissues supporting the cuboid. This may potentially cause cuboid subluxation or impared ability for the body to maintain the cuboid in its correct position under load following the sprain.
- Altered Foot Biomechanics: Such as having overly pronated feet (flat feet) or lateral ankle instability (unstable ankle as a result of previous ankle sprains) can increase someone’s likelihood of experiencing cuboid syndrome.
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 What Is Cuboid Syndrome? should consult his or her general practitioner, physiotherapist, sports medicine specialist, orthopedic surgeon or otherwise appropriately skilled practitioner.