The cuboid is a cube shaped bone on the outside, underside of the foot several centimetres from the heel.  This bone can sometimes drop out of place towards the floor.  This condition is more likely to occur when an ankle inversion strain has occurred (going over on ankle where foot rolls inwards).  This uncommon injury occurs when the foot rolls forcibly inward.

Symptoms

• Pain in weight bearing especially when putting weight on outside of the foot

What we can do

• Manipulate to put the bone back in place

The peroneal muscles run from the outside of the shin and attach to the outside border of the foot.  The muscles pull up the outside border of the foot (eversion) and point the foot (plantar flex).  These muscles can get very tight in runners. The condition may occur due to trauma – either a direct impact or an inversion sprain (going over on ankle where foot rolls inwards).

Symptoms

• Pain and swelling around the outside of the ankle and outside border of the foot
• Pain aggravated by running and walking
• Pain aggravated when foot rolled inwards
• Subluxing tendon – tendon may snap over lateral malleolus when foot is dorsiflexed and everted (bought up towards shin and rolled inwards)
• Swelling and small bruise below lateral malleolus

What you can do

• Rest
• Ice therapy
• Stretch muscle

What we can do

• Special test to confirm diagnosis
• Friction deep tissue massage to area of pain to accelerate healing
• Massage to reduce tension in peroneal muscles
• Improve foot mechanics
• Improve mechanics of leg and hip to reduce stress on peroneal muscle

Stress fractures can occur in the foot due to repetitive strain.  This can affect a variety of bones in the foot.  It is most common in the 2nd metatarsal.  This injury is most common with:

• Individuals involved in high impact sports (running, jumping and dancing) – especially when inadequate footwear is worn
• Runners who rapidly increase training levels – onset maybe 3 weeks after increasing training levels
• Individuals who walk excessively
• Individuals with an eating disorder
• Individuals who have rapidly gained weight
• Individuals who have changed their footwear

Symptoms

• Gradual onset of pain that is usually deep and nagging in character
• Pain aggravated by weight bearing
• Pain may occur at night
• Swelling possible

What you can do

• Rest and modification of training.  It may be necessary to use crutches and avoid weight bearing on the affected foot for up to 8 weeks.
• Lose weight
• Review footwear

What we can do

• Perform tests to confirm diagnosis
• Improve mechanics of foot to improve shock absorbing capability and therefore reduce stress on foot
• Improve mechanics of leg and hip to take the strain of the foot

Further treatment options

• Referral for MRI or x-ray

The extensor muscles are responsible for pulling the foot up towards the shin and pulling the toes up and back.  The muscles run from the outside front of the shin over the top of the foot towards the toenails.  Various factors can overload these tendons leading to inflammation ‘tendinitis’ including:

• Overtraining
• Hill running
• Footwear that fits badly or laces that are tied too tightly

Symptoms

• Pain and swelling on the top of the foot
• Pain aggravated by walking and running
• Pain aggravated by stretching top of foot

What you can do

• Rest until pain resolves
• Ice therapy
• Loosen laces
• Place padding in shoe underneath laces
• Change footwear

What we can do

• Direct massage to top of foot to reduce inflammation and promote healing in tendons
• Reduce tension in extensor muscles
• Improve foot mechanics to reduce stress on problem area