What is Cuboid Subluxation?
Cuboid subluxation occurs when the bone in the foot is partly dislocated which cause pain and instability.
The cuboid sits on the outside mid part of the foot. It is supported by strong connective tissue which forms the joints and arch of the foot. The major tendon that affects the cuboid is peroneus longus. If there is disfunction of the surrounding tendon and connective tissue then the cuboid can sublux or fall out of alignment.
What Contributes?
If there is tension and tightening of the peroneus longus with repetitive strain from running with poor biomechanics or an acute trauma after an ankle sprain then it can cause the subluxation. It often co-exists with inflammation of the peroneus longus tendons.
Presentation
Pain is usually felt in the mid outer foot. It can cause instability and feelings of weakness. It may cause limping even when walking. If this is the case however a differential diagnosis of a stress fracture should also be considered. The cuboid will be very tender to touch and the patient will feel better when they are non weight bearing. It is usually worse with the first steps in the morning or after sitting for a long period. It is usually diagnosed by the health practitioner as imaging often doesn’t assess the cuboid subluxation. It may be important to scan to eliminate or include other differential diagnosis which may be masquerading.
Management
You PhysioPro will mobilisation and/ or manipulate the cuboid to encourage better positioning. They will then tape and support the cuboid and work on the surrounding soft tissues. Moon boot is not usually required however crutches may help with the rest phase (first 48-72 hours). Anti inflammatories can also assist. Footwear, orthotic and biomechanics are essential to discuss before returning to training.
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