Cuboid Syndrome/Dropped Cuboid

On my last post, I mentioned that I injured my foot right when I crossed the finish line of the Nike race.

Here’s what it looks like right now!

That’s right… I gave myself cuboid syndrome. It’s apparently a semi-common injury that can be mistreated as a different injury like a stress fracture or tendonitis without a proper diagnosis.

Cuboid bone of the left foot. Courtesy of

What is it?

Cuboid syndrome – aka dropped cuboid, which sounds so much cooler and easier to remember – is when something dislocates and slips the cuboid bone out of alignment. It can be really painful and it weakens the ankle and foot quite a bit.

How did it happen?

People with previous ankle injuries (like me, who’s successfully injured both ankles on separate occasions in the past), flat feet, overpronation, and/or switching from highly cushioned shoes to more minimal shoes will be more prone to developing a dropped cuboid.

Also, it’s more likely to get a dropped cuboid if you suddenly change from flat, even ground like road or track running to uneven ground like trails or grass.

For me, it was a combination of bad ankles and training primarily on even surfaces before the Nike Race. Oops?

What does it feel like?

The initial pain comes from the outside edge, around the middle of the foot. I had my ankle and foot taped up right after I realized I was injured, but I had a significant limp since I couldn’t put any weight on my left foot at all.

However, I could limp along pretty well with a medium amount of pain. On a scale of 0 to 10, where 0 is normal, pain-free life, I would say that the 24 hours after the injury was about a 4.5 on average.

Of course, there’s a pretty high chance that I’ve got a high pain tolerance, so take my gauge with a huge dose of electrolytes.

Post-injury and pre-treatment days were extremely uncomfortable and annoying. My ankle had regained some strength and much of the pain had gone away, but it was nowhere near normal and I was walking with a very noticable limp even with the KT Tape on.

How should I treat it?

My best recommendation would be to get an appointment with your athletic physiotherapist ASAP! Even if it’s not a dropped cuboid, it’s so important to get yourself properly diagnosed so you can get back on the road faster and safer.

While you’re waiting for your appointment, take it easy. You might go insane from not running around, but try not to walk too much, either!

Get a lot of rest and do some massaging on your ankle and the outside of your leg. There’s a very thin, superficial muscle called the fibularis tertius (also known as the peroneus tertius) that’s directly connected to the cuboid bone and gets overused with a dropped cuboid.

Courtesy of F. Netter, MD

You could also tape up your ankle as I did before with a strip of athletic tape to help support your muscles. It definitely won’t heal it, but it’ll help stabilize it a bit.

The best way to wrap it is the way I did it with the green tape above! Start by securing the full-length tape to the bottom of your foot and wrap TOWARDS your cuboid to simulate the cradling tension for the cuboid. Just make sure that the end of the tape is secured to your skin instead of the tape itself or else it’ll come off with a shower.

How was physiotherapy?

It was good, thanks for asking!

This was actually my first time going to physiotherapy and I was really pleased! My physiotherapist is also a runner, which was really beneficial since she knows exactly what I was talking about.

After basically confirming that it was a dropped cuboid (the guy who did my initial taping had heavily suggested it was the case), she had me lie down on my front and did something called a high-velocity manipulation on my cuboid. It went from about 50% range to 75% in a few moments!

But, I was definitely feeling a little sore for a day because of the sudden realignment. Luckily, she told me that it was completely normal and to simply ice it for about 20 minutes.

What’s next?

My foot feels a lot better now but I can tell it’s still a little weak. I’m planning on going on a short interval run tomorrow, which my physiotherapist said that I could try if I feel like I can do it.

I also have a follow up physiotherapy session on Friday morning, so hopefully I can dive right into my sub-hour 10K training soon!