Cuboid Syndrome
are: locked cuboid; subluxed cuboid; cuboid
fault; calcaneocuboid fault syndrome. I will
refer to it as cuboid syndrome. Treatment for
this condition has been common in podiatric
medicine for better than 75 years.
The prevalence of cuboid syndrome in the
podiatric practice is greater than most imagine
particularly in our athletes. It has been reported
that cuboid syndrome develops in about 10%
of all ankle sprains. Cuboid syndrome occurs
in about 15 to 20% of ballet injuries, and may
account for as much as 5% of all foot injuries.
This injury is not limited to just athletics, but
can occur while simply walking down the road
and stepping on or off the curb.
"The prevalence of
cuboid syndrome in
the podiatric practice
is greater than most
imagine particularly
in our athletes. It
has been reported
that cuboid syndrome
develops in about 10%
of all ankle sprains."
50
Pedorthic Footcare Association www.pedorthics.org
So what is Cuboid syndrome? It is abnormal
motion (subluxation) of the structural
alignment of the calcaneal cuboid articulation
of the midtarsal joint. This subluxation limits
dorsiflexion and plantarflexion of the fourth
and fifth metatarsals and cuboid joint motion.
Dysfunction of the calcaneocuboid joint results
in a failure to lock the midtarsal joint resulting
in increased/excessive pronation of the forefoot
on the rearfoot. Normal function requires a
proper amount of pronation to adapt to a uneven
surfaces with ambulation. Without proper fit
and alignment of the dorsal lip of the calcaneus
and the plantar lip of the cuboid, excessive
pronation, abnormal motion of the rearfoot on
the forefoot during the propulsive phase of gait
occurs. This causes increased stress of ligaments
and joint capsule and can irritate the peroneal
tendon resulting in pain. Increased pronation
causes increased internal rotation of leg leading
to medial knee pain, hip and low back pain. Pain
can also result in the area of the fourth and fifth
metatarsal heads as a result of improper joint
motion at the cuboid. Reflex contraction of the
peroneus longus in an inversion ankle injury
can cause rotation of the cuboid with resultant
inferior and medial displacement. Foot function
affects every proximal joint in the body.
Symptoms associated with Cuboid syndrome
are pain on palpation of the cuboid dorsally and
plantarly, which can be exquisite. Pain along
the lateral column with push off/toe off can
be severe. I have personal experience with the
lateral column pain. The pain was such that I
thought I had fractured a metatarsal and would