Pain in the Lateral Foot: Cuboid Syndrome

If you have pain on the outside of your foot, it may be cuboid syndrome. This is often misdiagnosed and is not well understood, but we do know that it is common following an inversion sprain, or “rolling your ankle. 

The cuboid is a bone that is situated between your heel bone and your fifth metatarsal; the bony bump on the middle/outside of your foot. The bone can be slightly out of place and will be very acutely painful. Walking or any weight bearing will be painful. The good news is that there is usually a quick fix, which we’ll get to later.

So why does this happen? It’s a combination of dysfunctions. If the subtalar joint is pronated (think flat foot), then the whole ankle/foot structure is less stable. Then other muscles have to work harder to stabilize the foot. In this case, peroneus longus. This muscle starts on the upper part of the fibula (not the shin, the other one), and wraps under the cuboid. So if this muscle has to forcefully contract, it can theoretically stress the cuboid and pull it slightly out of position. This begs the question, why is the subtalar joint pronating? This is usually due to lack of dorsiflexion which could be a capsular and/or muscle restriction. 

How do we treat it? There are a couple of manual techniques you can do to correct the position and you may get immediate relief. First, have it checked out because there are other more insidious diagnoses that you’d want to rule out. Once you’ve done that, you can see a physio or try to treat it on your own like this:

Then you want to restore dorsiflexion like this:

Got Flat Feet? Check out our program specifically designed to restore your arch.