Massage therapy · Kitchener–WaterlooCuboid Syndrome

Cuboid syndrome describes a condition thought to result from a small disruption of the joint between the cuboid bone and the heel bone (the calcaneocuboid joint), on the outer side of the middle of the foot (Durall, 2011). The cuboid is one of the seven tarsal bones in the foot. The condition usually shows itself as pain on the outer (lateral) side of the foot, often with weakness when pushing off (Durall, 2011; Patterson, 2006). Cuboid syndrome is not well recognised or defined, and there is no definitive test for it (Durall, 2011).

Cuboid Syndrome Anatomy

Signs & Symptoms

• Pain along the outer side of the foot, which may spread across the foot and can feel like a ligament sprain (Durall, 2011)
• Pain or weakness that is most noticeable when pushing off, or with side-to-side movements, sometimes causing a limp (Durall, 2011)
• Pain that increases with weight bearing and eases with rest (Durall, 2011)

How to Treat Cuboid Syndrome

Tips

• Cuboid syndrome is seen in active people such as athletes and dancers (Patterson, 2006; Durall, 2011).
• It can be missed or mistaken for an ankle sprain. If pain on the outer side of your midfoot continues after the rest of an ankle sprain has settled, mention this to me (Durall, 2011).
• It may be more common in people whose feet roll inwards (pronated or flatter feet), although it can also happen in people with high arches (Durall, 2011).
• Other problems, such as a fracture of one of the foot bones, can cause similar pain on the outer side of the foot (Durall, 2011), so see your family doctor or nurse practitioner if your pain started after an injury or is not settling.

Treatments you may want to discuss with your family doctor or nurse practitioner

Cuboid syndrome causes pain on the outer side of the midfoot. My aim is to settle the pain, get the joints of your midfoot and ankle moving well, and build the strength and balance that help keep it from coming back.

I start by assessing your foot and ankle: where it's tender, how the joints move, how you walk and push off, and the strength of your lower leg. If anything suggests a fracture or another problem, I'll point you to your family doctor or nurse practitioner first.

When It's Sore

• Hands-on work for the calf, the muscles along the outer shin and the sole of the foot, to ease tension around the cuboid
• Gentle, low-velocity mobilisation of the cuboid, midfoot and ankle, with no quick thrusts
• Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
• Taping to support the outer foot, and I'll show you how to tape it yourself
• Cutting back the activities that bring on the pain, such as running or hopping, rather than stopping everything

As It Settles

1. Durall, C.J. (2011) 'Examination and treatment of cuboid syndrome: a literature review', Sports Health, 3(6), pp. 514–519. doi: 10.1177/1941738111405965
2. Patterson, S.M. (2006) 'Cuboid syndrome: a review of the literature', Journal of Sports Science & Medicine, 5(4), pp. 597–606.