Further follow-up treatment may consist of placing a cuboid pad in the shoe, attaching one to a removable innersole or incorporating one into a foot orthosis. When placing this pad on a flexible orthosis, such as a leather laminate type of orthosis, you can place it on the bottom of the device. If the patient uses a more rigid orthosis, place the pad on the top. At this time, one should address other biomechanical abnormalities, such as a limb length discrepancy or ankle equinus. Patients may gradually return to sports activity when the pain subsides. Final Notes Keep in mind that cuboid subluxation following a second-degree or third-degree lateral foot sprain requires special care in order to prevent the development of a chronic condition. If one suspects a cuboid subluxation after a lateral foot sprain, do not attempt reduction until the effusion and ecchymosis have significantly diminished and you have ruled out the possibility of a fracture. When athletes present with ankle inversion sprains and complain of lateral foot pain, one should evaluate their cuboid articulations. Appropriate assessment and treatment of a subluxed cuboid is essential in order to restore normal joint range of motion, alleviate pain and improve foot function. Dr. Caselli (pictured) is a staff podiatrist at the VA Hudson Valley Health Care System in Montrose, N.Y. He is also an Adjunct Professor at the New York College of Podiatric Medicine and a Fellow of the American College of Sports Medicine. Dr. Pantelaras is a podiatric orthopedic resident at the VA Hudson Valley Health Care System in Montrose, N.Y.
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