Cuboid Syndrome
Introduction
A relatively obscure condition known as cuboid syndrome, or cuboid subluxation, is one with direct effect on the cuboid bone, located in the foot. This syndrome occurs when the cuboid becomes misaligned or dislocated with the calcaneus bone. Athletes across all sports are susceptible to these injuries, so let's dive into the mechanisms behind cuboid syndrome, how it can be combated, and the road to recovery following an injury like this.
Anatomy of Cuboid Syndrome
The foot consists of seven tarsal bones, one of which is the cuboid. The cuboid is located at the dorsal superficial and deep plantar part of the foot. The cuboid supports the body’s ability to arch the foot and assists in day-to-day activities such as walking. Additionally, the cuboid also acts as an attachment point for a few muscles, ligaments, and tendons in the ankle area. Hence, when the cuboid becomes misaligned, this leads to cuboid syndrome and dysfunction in the foot.
Causes of Cuboid Syndrome:
1. Overuse of the foot: An example of this could be running or exercising for long periods without periods of rest and recovery.
2. Sudden twisting/turning: Many sports and activities are fast-paced and involve quick side-to-side movements. These motions and movements have the potential to cause cuboid syndrome in the foot and are often considered extremely dangerous.
3. Direct impact on the foot: Large amounts of force exerted on the foot (ex. a fall or hard landing) can lead to cuboid syndrome and the misalignment of several bones, causing excessive pain.
Symptoms
Pain on the outer side of the foot
Increased pain in normal activities such as walking or running
Being forced to limp to avoid putting pressure on the foot
Swelling in the affected area
A popping sensation in the foot at the time of injury
Diagnosis
A physical examination is sufficient to diagnose cuboid syndrome. During the examination, the doctor may ask about past injuries in the area, signs of injury (swelling, tenderness), and in some cases test the range of motion. In some cases, imaging tools like X-rays or MRI scans may be necessary to diagnose the injury.. Using these imaging resources gives doctors an accurate visualization of the injury and will allow them to verify whether cuboid syndrome is the actual culprit behind the injury.
Treatment
If recognized immediately and effective action is taken, cuboid syndrome can heal all by itself. After you recognize the injury, applying a cast or a splint is an effective method to allow healing to take place. However, if one continues to increase the degree of injury through overuse, this may require surgery through cuboid manipulation, osteotomy, or fusion. Here is a brief overview of the surgical options available if the injury worsens:
1. Cuboid manipulation: The bone is manually shifted back into place. Anesthesia is used.
2. Cuboid osteotomy: A small piece of the cuboid bone is removed to relieve the pressure originally exerted on surrounding tissues. A large incision is needed.
3. Cuboid fusion: The cuboid bone is connected to adjacent bones to do so. Like cuboid osteotomy, anesthesia is used.
Recovery
The key to dealing with cuboid syndrome, like all other injuries, is time and patience. Resting and not overusing the injured area for a prolonged period will allow the foot to heal. Other than rest, here is a list of the most crucial factors when it comes to the rehabilitation of cuboid syndrome:
1. Immobilization: Following the diagnosis, if you underwent surgery, your doctor may provide a brace or splint to apply to the injured area. Both of these materials ensure that the cuboid injury is not aggravated in any way, and the bone is able to heal.
2. Ice: Applying ice to the injured area can speed up recovery and help the foot heal more effectively.
3. Physical therapy: Various exercises and stretches can safely strengthen foot muscles and bones following the injury. As a result, they improve flexibility and range of motion and stimulate healing.
Return To Activity
Remember, although you are healed, rushing into extreme exercises and workouts is a risky decision following a major injury to the cuboid bone. Gently easing back into action is essential, and taking “baby steps” is the best way to avoid re-injury. If you are unsure about what course of action to take, consider hiring a professional trainer to help you return to peak performance in a safe manner.
Conclusion
Cuboid syndrome is an injury with potentially long-term impacts on athletes: severely hindering confidence, performance, and mental health. Taking the recovery process step-by-step, day-by-day, and even month-by-month, is the best way to return to activity and allow your foot to fully heal. Taking immediate action after you recognize the injury is essential, as continuing to exercise through an injured foot can only do you more harm. Have faith in yourself and keep stepping through the pain!
Sources
“Cuboid Syndrome: Diagnosis & How to Treat Cuboid Syndrome.” Beaver Valley Foot Clinic, 20 Oct. 2023, bvfootclinic.com/cuboid-syndrome/#:~:text=Cuboid%20syndrome%20results%20when%20the,adjacent%20bone%3B%20the%20calcaneus%20bone.
“Cuboid Syndrome: What It Is, Treatment, and Recovery.” Medical News Today, MediLexicon International, www.medicalnewstoday.com/articles/321626. Accessed 2 Mar. 2024.
Durall, Chris J. “Examination and Treatment of Cuboid Syndrome: A Literature Review.” Sports Health, U.S. National Library of Medicine, Nov. 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3445231/.
User, Super. “Cuboid Syndrome and Possible Causes.” The Michigan Foot and Ankle Center - Foot Doctor Livonia, MI 48154 and Southfield, MI 48034, The Michigan Foot and Ankle Center - Foot Doctor Livonia, MI 48154 and Southfield, MI 48034, 26 Jan. 2023, www.michiganfoot.com/blog/item/484-cuboid-syndrome-and-possible-causes.html.