Outer Foot Pain – Everything You Need To Know About Cuboid Syndrome

Pain on the outside of the foot right here is challenging to get rid of insoles rarely work medications only help temporarily and braces, just take the edge off. In this video I’m going to show you everything you need to know to diagnose yourself and begin to treat your outer foot pain.

Specifically, I’ll be talking about something called the cuboid syndrome and other problems that look like cuboid syndrome and that can cause outer foot pain. Now first, let’s answer the question what is cuboid syndrome? Well in the foot, I’m going to bring my skeleton over here in the foot, right here on the outside, you have this bone called the cuboid.

This bone is quite large, especially on the bottom of the foot, it takes up all that space there between my fingers. And then on the outside of the foot. It’s nearby where these long bones are on the side of your foot. And it also takes up some space on the top of your foot right in here. So on your foot, if you look down, it’s going to be hard to tell where all these bones are when you have your foot please.

But it’s going to be in this general area right in here. In cuboid syndrome, that cuboid bone has the ability to shift up or down. And the joints were connects to the heel bone right here. And these, these are called metatarsal right here, these long bones, those joints can get stuck and become painful. And there might even be painful spots that if you poke around on the top on the sides, and even on the bottom of the foot, where it’s particularly painful, and that’s usually the joint line area.

Now this can cause pain, and it can change from day to day. So let me borrow your foot here again, you might be saying well today to hurts more in this area right here. And then another day might hurt more out here you can feel the long bone is right here and then there’s a bump right there and just past that bump closer to the heel is where that cuboid lies and then below the foot right in this area right in here.

That’s where the cuboid is there. That area can be painful, especially to walk on and stand on for longer periods of time. Now there’s other reasons for our foot pain, things like tendinitis can cause pain in the area, nerve problems, or there’s nerves that run through that area and can also cause pain in the exact same area.

And then there’s also pain from ankle sprains, it is possible to roll your ankle and get the pain on the outside of the ankle but also get pain that goes down lower into the area where the cuboid bone is. And just to complicate things a bit more, it’s possible to get a cuboid problem on top of all those other issues and nerve problem and ankle problem or tendinitis.

Now let’s talk about how to diagnose cuboid syndrome, where you’re definitely going to have pain on the outside of the foot just like where I showed you, it can be on the top of the foot on the outside of the foot and even under the foot, there may be swelling in the area and there may not be swelling because it’s a smaller joint.

It’s harder to identify swelling, but some people are very attuned to it. And also if you have a skinnier foot, if you just don’t have a lot of meat on your foot, it’s a lot easier to see the swelling in that situation. This tends to get worse with more physical activity. Almost every time when people come in with cuboid syndrome.

They say my foot hurts more and more as the day goes on as I’m busier. And if I go try to exercise especially do an exercise on my feet like walking running any sort of sports activities, hiking, those types of activities tend to aggravate it, but not as much with things like cycling or activities that are not on their feet directly.

There comes a point when if it continues to get aggravated throughout the day and with exercise, and you don’t back off enough to get it’s time to recover. It begins to hurt all the time. And it will even hurt at rest. Because most people when they’re when this is starting out, they can get off their feet and feel fine, the pain goes away. It doesn’t bother them.

They’re okay it only bothers them when they’re up on their feet. But there comes a point where it starts to just hurt all the time. If you aggravate it enough cuboid syndrome generally gets better with rest. So if you’re in a situation where you’ve aggravated it quite a bit, if you take a week off from doing things on your feet as much as possible, it tends to improve, but it will come back if you don’t fix the underlying root problems, or get the joint to shift back into its proper position.

This tends to affect people in their 20s and 30s. That’s what I see the most usually, but I have seen people of all ages get a cuboid syndrome, even people in their 50s 70s and beyond. And I have not seen anybody in their younger years like less or younger than a teenager get this. But I have seen some teenagers that are like in track sports. Cross Country sports come in with this kind of problem. But it’s less common in that younger population.

I definitely see it more commonly in their 20s and 30s. If you go get an x ray or an MRI, it often looks normal. Let’s talk about common treatments for cuboid syndrome people typically see A doctor or a podiatrist, which is a foot doctor, they might see their general physician or a foot doctor for this problem.

And those doctors will almost always start by giving you an x ray, a CT scan or even an MRI, because they want to make sure that nothing’s broken because it is possible to get things like a stress fracture in that area are other broken bones and they want to rule that out. So it’s a good thing that you get that X ray or CT scan or whatever your healthcare professional recommends.

If there’s nothing wrong on your imaging, there’s no fracture. In other words, there’s no visible deformities, which they won’t be able to tell that it’s cuboid syndrome based off the imaging, then they’re going to tell you that you have normal results despite you having pain and discomfort and all the problems you’re going through.

They’re going to instruct you next to rest from exercises, especially if that’s what’s flaring up your foot pain, and they may even tell you to use ice or heat on your foot to help mitigate the pain.

Doctors will often tell you to use over the counter pain medications like ibuprofen, Tylenol, naproxen, those kinds of medications acetaminophen, but if those aren’t effective, especially you’ve already been using them, by the time you see the doctor, then they may offer you prescription strength medications.

If you see a foot doctor, they’re probably going to recommend that you begin to use insoles, or they may call them orthotics. Same thing. In the medical field. We call them orthotics in the general public, we call them insoles, but it’s the things that you put inside your shoes, just like these. Now, if that doesn’t work, you know using an insole, or using the prescription strength medications.

Of course over the counter medications probably haven’t worked at this point, they can offer you an injection to the side of your foot, where they’re injecting something like a cortisone steroid, they call it a cortisone shot. And that helps to provide pain relief in the area temporarily, it tends to be a little bit more long lasting than taking medications by mouth like prescription medications. But it still is not solving the root problem of cuboid syndrome.

If you’re still not improving by this point, you’ve gotten injections and tried medications and insoles, orthotics all that stuff. There are a few surgeries out there that you might find a podiatrist who specializes in surgery might offer you now the success rate of these surgeries is not very good. And they’re variable.

There isn’t a consistent surgery. That’s done. There’s some doctors that like to do surgery one way and some another way. And what I would tell you is I highly discourage you from jumping into surgery, I bet even the surgeon is going to tell you, surgery is not going to be a first good option for you or something that you want to move into quickly.

There’s many other things to try before you consider going to have surgery for this problem. And we’ll talk more about that in just a second. Now, before going to a surgeon, they will likely recommend you go to physical therapy for this problem. Usually in physical therapy, you’ll be focusing on stretching and strengthening exercises for your ankle and foot.

These exercises and stretches that are given to patients with cuboid syndrome often miss the problem, they don’t focus on addressing the root problem. And although they can give you some temporary relief, especially doing certain stretches, it just gives it feels nice to do them. And even some of the exercises, it may not be addressing the root problem that’s causing the bone to shift in your foot.

Some of the common exercises done are a runner stretch, like where you lean up against a wall, and you put one foot back and the other foot forward and your heels going down. And you’re stretching the back part of your ankle right here to stretch the ones or were you moving your ankle up and then down and then sideways inwards and outwards sometimes against the resistance band as well.

And there’s other exercises for your toes, where you might be picking up marbles with your toes and putting them in a cup or in a different place. And there’s another one where they’ll do with the toes where they where you have to grab a towel. Those exercises, of course well intentioned, they may not be the precise exercises that you need to fix the muscle imbalance.

So let’s talk about that next. What is the root problem of cuboid syndrome? Well, let me show you on my friend’s foot here. The root problem that causes this bone out here to shift around the cuboid is poor strength in the muscles that cross over that area. And when you’re talking about the specific muscles that stabilize that bone, it’s the muscles that go to the fourth and fifth toes.

So when doing that marble pickup exercise, it’s very often focused on using the first two or three toes because those are the ones that people tend to have the best control over, but not the fourth and fifth toe.

So one quick way to see if you have a muscle imbalance. When you have your foot here is to curl your toes all the way down and see how your toes curl down. Do they come down? Don’t evenly or is there a fourth or fifth one, let me just try to not curl these down and curl these, do your toes curl more like that where the big one comes down, the second one comes down, and then these out here just don’t come down as good.

If that’s the case with you, then that is where your muscle imbalances and you’ve likely got to get more strength in these toes to get them to curl all the way down. And you’ll feel the muscles working right on the outside of the foot that provide the most stability to this area of the foot where your cuboid is.

Hey, stay tuned to our channel, subscribe if you haven’t already hit the notification bell as well so that you get notified when we release the next video because I’m going to be talking about all the exercises and treatments that you can do to fix your cuboid syndrome, including how to fix that root problem. I’ll see you in the next video. Bye