Overuse injuries are a common problem in runners and those who use running as part of their training for other sports. They are more common in those runners who commit a training error such as not breaking in new running shoes slowly. To prevent this happen the transistion to new shoes and new training routines needs to be slow. It has been estimated that over a half of all runners will get an injury in a 12 month period.

A not so common overuse injury is one that is known as cuboid syndrome. The cuboid bone is a small bone, just in front of the heel bone, about halfway down the outside of the foot. There is a muscle on the outside of the leg (known as peroneus longus) that has a tendon which passes down the outside of the ankle area and passes under this cuboid bone to travel to the other side of the foot. Its uses the bone as a pulley to change direction. When this muscle contracts the tendon is going to want to pull up on the cuboid and move it out of place. If the bone moves too much, this can strain the joints around it. We are designed so that this bone is very stable. In some people, for a number of biomechanical reasons, the bone is not very stable, so the if movement is excessive and if activity levels are high, cuboid syndrome can result.

The symptoms usually start of as a mild ache on the outside of the foot but progress to being painful enough to interrupt with the training program. The treatment for cuboid syndrome usually starts with a modification in the training program, usually the substitution of the running for another activity such as cycling. Strapping can be used to stabilise the area, so the movement of the bone is reduced. As there is usually some subluxation present, a gentle cuboid manipulation is often carried out by skilled practitioners. Foot orthotics will need to the used long term to keep the cuboid bone more stable.

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