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Instep Dance Magazine Articles

Reprints of monthly column as first appearing in Instep Dance Magazine (no longer in print).

November 2002

Subluxated Cuboid Bone

by Rick Allen, DC

"Better health leads to better dancing."

Back in June, I discussed sprained ankles. In July and August, I diverged into enzyme therapy, which can help you recover faster and better from sprained ankles and other injuries. September was an update on glucosamine, which helps keep joints healthy. October was a side jaunt about weight control, giving you a head start on the upcoming holidays.

This month, let's return to foot injuries and look at the subluxated cuboid bone, which may occur when dancing. Subluxated cuboid syndrome is an uncommon problem but once recognized, responds well to appropriate treatment.

Functional Anatomy

Subluxed Cuboid Syndrome diagram

The outside, or lateral, aspect of the foot is a key stabilizer of the foot. The calcaneocuboid joint is a vital link in lateral foot stability. The calcaneocuboid joint is formed by the calcaneous and cuboid bones (See figure). This joint is susceptible to sudden injury or chronic strain, which can cause this joint to partially dislocate or subluxate.

When the cuboid subluxates downward, you may experience a dull ache along the central portion of the lateral border of the foot. The long calcaneocuboid ligament, extending from the heel to the cuboid, may become strained, mimicking heel spur pain along the bottom of the heel. Direct pressure at the calcaneocuboid joint often elicits the primary pain symptoms. You experience discomfort when attempting to stand on your toes or when rolling the arches toward the outside border of the foot.

This joint is involved with locking the foot for strength during various stages of the gait cycle. Any instability or dysfunction around the cuboid inhibits functional stability in the foot during the propulsive phase of gait. Naturally, you avoid forcefully pushing off with the foot. Lateral, side-to-side sports, such as tennis or racquetball, place the greatest strain at this joint. Stair climbing and lateral cutting movements aggravate the condition. Tight heel cords, causing an early heel lift, disturb the normal weight transfer through the lateral column and initiate the syndrome. Because the cuboid aids the function of the peroneal tendons by stabilizing the tendons as they pass under the foot, the subluxated cuboid may disturb normal peroneal muscle function. This can lead to tendonitis and referred pain to either the lateral ankle or the plantar aspect of the forefoot.

Treatment

Treatment for a subluxated cuboid syndrome consists of a series of manipulations of the joint and secure strapping to reduce the subluxation. The manipulation needs to be done by a professional a chiropractor or osteopath trained in extremity manipulation. However, applying a cuboid pad sometimes provides relief. This can be done by trimming a 1/4-inch thick felt pad approximately 1 inch square and taping it under the cuboid. This is the area under the outer border of the foot, just behind the bump (which is the base of the metatarsal) at about the middle of the foot. If this padding causes increasing pain, it should be discontinued. Anti-inflammatory herbs or medication may help ease any discomfort.

Prevention

Foot supports, or orthotics, may be necessary to stabilize the foot and prevent re-injury. They can be obtained from a chiropractor or podiatrist. After care with orthotic control, use calf-stretching exercises to guard against re-injury

Reference:

"Conquering Athletic Injuries" from the American Running and Fitness Association, of which Dr. Allen is a member.

Dr. Rick Allen is a chiropractor, massage therapist and dance student who splits his time between Portland, Oregon and Trout Lake Washington. Dr. Rick welcomes your questions and suggestions for future articles. However, he cannot make specific diagnoses or treatment recommendations unless you visit him in person. He can be reached by phone at 503-257-1324 in Portland, 509-395-0024 in Trout Lake, or toll free at 1-888-247-3248, email or on the World Wide Web: www.CascadeWellnessClinic.com

DISCLAIMER: The information included in this website is meant to encourage thinking concerning choices of care for and insight pertaining to possible causes of various problems. It is not a prescription for or diagnosis of any disease or condition. Suggestions are based on the assumption by the writer that a thorough examination was done previously and the reader is under care by a healthcare professional. This information is not a substitute for a live doctor.

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