Sunday, October 19, 2008

Cuboid Stress Fracture

So the ankle "sprain" I had turns out to be/have become a cuboid stress fracture.

"Patients with a cuboid stress fracture experience sharp pain at the plantar and lateral cuboid area of the foot. The pain is noted during heel lift and toe off while walking or running, however in some it is noted during minimal weightbearing. Pain on palpation of this area may be minimal, and no erythema oedema or rise in temperature may be found. However there were cases where there was pain on palpation over the cuboid and the peroneal tendons along the lateral aspect of the foot with passive inversion causing pain. Differential diagnosis include cuboid syndrome, peroneal longus tendinitis, fifth metatarsal base irritation and ligamentous strain.

That's that for running a marathon this year. This is my first stress fracture. I will have a lot of time to reflect on this one... I suspect that when I get back to running the memories of this experience will keep me in check and force me to be very conservative. I will try to improve my swimming and biking skills to get rid of this focus on running. Time will tell...

200 Comments:

Blogger jon said...

Sorry about your Stress fracture. I have had 4 of them (all tibial) over the my years of training. It's CRUSHING when you get that news. But it will make you stronger, both physically and mentally. Stay patient and don't rush back. let it heal and work on all the other stuff you probably never get to put the time in for. Core, upper body, etc. And more importantly sleep and have some fun taking a break from training. You will be amazed at how strong you come back.

10/20/2008 5:24 PM  
Blogger Sub said...

Thanks Jon! I really appreciate your post. You have some great advice in there that I will try to follow.

I've noticed that runners come out of sfxs wiser and stronger! I'm hoping the same will happen with me...

10/20/2008 6:35 PM  
Blogger EspritLibre said...

I have just been dx with three stress fractures. I train on a treadmill for 9 + miles per day for the past 2 years. Even when I was ill!! I guess that's what did it (haha). Reading your posts make me feel a bit better. I have a walking cast on and have ALOT OF TIME ON MY HANDS NOW...I am very nervous about not training...any help????

3/18/2009 6:29 AM  
Blogger Sub said...

The advice from Jon above is great.

I can feel your pain... It just feels horrible not to be able to run and it kills you to see others running. Most runners have been there and have comeback stronger.

I'd say the good thing about a sfx is that you have no option but to let you leg heal. Unlike soft tissue injuries, a sfx will heal and the sfx area will be stronger that it was before. However, you have to be very careful not to rush back too quickly or build up too soon.

Meanwhile focus on something else that you've wanted to do but never had time to do... travel, music... Reflect on what you did to get the sfx and how you can change your running habits to minimize the risk of getting one again. When you do come back take the time to enjoy your runs... Often we pass the most breathtaking scenery but hardly notice it because we are too busy getting in the miles.

Don't worry about losing fitness. I hardly did anything during the period I had the boot on. I was surprised at how quickly I was able to get back to where I was...

Good luck and wishing you a speedy recovery!

3/18/2009 10:32 AM  
Anonymous carmen h said...

I have a cuboid stress fracture in my right foot after some stupid running mistakes (increasing mileage too quickly and wearing wrong shoes). It happened Jan 4th of 09 and I wasn't put in a walking air cast until about 4 weeks ago (switched doctors and got proper treatment). Does anyone have any input on the outcome of a cuboid fracture and it's healing process (how long it might take,and what stages of pain I might expect)? There is very little on this on the internet. Weird.
Thanks! carmen H

4/26/2009 1:30 PM  
Blogger Sub said...

The cuboid sfx. is indeed a rare one that's why you find so litte on the net.

This is one of 3 sfx. where you need to stay off weight bearing activities completely. The good news is that this area gets a lot of blood supply so the sfx heals quickly. So 4-6 weeks after immobolization you should be about healed and ready to begin your rehab to weight bearing activities. A sfx takes 90 days to heal completely.

Of course consult your doc before doing anything.

4/26/2009 8:48 PM  
Blogger Billy Burger said...

Hey Sub - I did a google search on cuboid stress fractures and came upon your blog. I recently got diagnosed with a "developing stress fracture" on the cuboid (probably more 'healing' since I haven't run in about 8 weeks) and a "stress reaction" on the lateral cuneiform bone.

I'm encouraged by your relatively quick recovery from it and hope it goes the same way for me too. In my case, I started experimenting with barefoot running and that's what led to this (too much, too soon). I don't have a boot yet, but because I spend a lot of time on my feet at work, think I'm going to get one.

Anyway, keep kicking asphalt out there man. hope that will be me soon.

9/19/2009 9:48 AM  
Blogger emma said...

I dont know if any one is still on this blog. But I have just been diagnosed with a cuboid fracture I have been in a boot for 2 weeks and not running for three. Its one of the most depressing times of my life. I have run since i was 12 and had to learn the hard way to see my body needs a brake. I have been at the gym doing the gliding machine and swimming and cycling but your right I get so enveous of all the runners I see, I would do anything to run anything at one stage I was running on it strapping and taking pain killers.

Its where I get my self confidence from its how I keep in shape its everything I have always done and now it feels like a huge punshiment. Every one says its good to have a rest and you will bonce back. It easy to say. How do you get through this ?

4/25/2010 8:13 PM  
Blogger Sub said...

Hey Emma,

I can totally relate to what you are going through!

You have almost gotten through most of the healing period. You perhaps have another 2-3 weeks to go!

Be careful when you come back. There will be a lot of pent up energy when you get back to running. You don't want to re-injure this!

You will be surprised at how quickly you get your fitness back - you maintain quite a bit of your fitness...

Meanwhile use this spare time to reflect on things (why you got injured, what you will do differently, life, your career) and do things you never had time for - music, theater etc.? After experiencing this when you get back to running you will be thankful for the gift that is the ability to run!

Wish you a speedy recovery!

4/26/2010 1:26 AM  
Blogger want2run said...

should i still have pain three weeks later . the pain comes in the morning then goes after i start walking. only in bare feet though
?

4/26/2010 10:06 PM  
Blogger Sub said...

It's normal for it to ache but it should not hurt. If it's hurting, you might be setting back the healing so try to keep off your leg (especially without the boot) as much as possible.

4/26/2010 11:43 PM  
Anonymous XC/Track runner said...

Hey I have had a cuboid stress fracture and my foot still has aching pain every now and again. I got it on Sept. 29, 2009 and was not diagnosed till 2 1/2 weeks later. I had to wear a boot for 5weeks. I run for a division I school at a university, so I have been doing about 2hours of cross training on it everyday. Its been 7 months now and I'm finally getting back into running more. About 30min a day. Really take the healing process slow. I know its tough, runners never want to take weeks off at a time. Hang in there it will make you a lot tougher in the end.

5/02/2010 9:28 AM  
Anonymous XC/Track runner said...

Hey I have had a cuboid stress fracture and my foot still has aching pain every now and again. I got it on Sept. 29, 2009 and was not diagnosed till 2 1/2 weeks later. I had to wear a boot for 5weeks. I run for a division I school at a university, so I have been doing about 2hours of cross training on it everyday. Its been 7 months now and I'm finally getting back into running more. About 30min a day. Really take the healing process slow. I know its tough, runners never want to take weeks off at a time. Hang in there it will make you a lot tougher in the end.

5/02/2010 9:29 AM  
Blogger want2run said...

Hey thanks for your reply.
Are you meaning to tell me after 7 months your only doing half hour runs now. There is no way I na wait that long . After 5 weeks I am going to try a half our run . Its cracking me ahy, just need to run real bad. Im in no pain. The only pain is in the morning or middle of the night when I get up after lying for a while. but then pain goes in like 5 mins. Just want to run ahhhhhhhhhhhhhh

5/02/2010 8:56 PM  
Blogger want2run said...

Does anyone take supplements to make the bone heal faster ?

5/04/2010 5:24 PM  
Blogger Sub said...

I did not take any supplements. Most of what I had read focussed on Ca & Vit D levels.

http://www.drpribut.com/sports/stress_fracture.html

"Dietary calcium should reach recommended levels. Supplements may assist in this. Make certain to also meet your daily requirements of Vitamin D which aids in both absorption of calcium and in the development of bone."

5/04/2010 6:59 PM  
Anonymous Anonymous said...

Question, Just got a Cuboid SF in my right foot. Doc gave me a boot and 6 to 8 weeks. So my question is if i dont wear the boot and walk softly will it heal. i need to be on my feet all day for work.

HELP!!

6/19/2010 7:12 AM  
Blogger Sub said...

If it hurts to walk without the boot then it's probably not going to heal...

It's best to "struggle" though the time with the boot. You don't want to have to spend 6 weeks and then realize that your sfx is not healing and you need to spend 6 more weeks in the boot.

6/20/2010 9:50 PM  
Blogger Maiya Willits said...

Week 8 in the boot for a cuboid sfx, worried that it's not healing enough, sick about not running...but ran across your blog today and the comments have been helpful, thanks!

8/02/2010 12:19 PM  
Blogger Sub said...

8 weeks with the boot :( If this continues to not make progress perhaps you could try crutches for a couple of weeks. That feels horrible but really does help with the healing...

Good luck with the recovery!

8/03/2010 1:33 PM  
Anonymous Steven P. Waldon said...

Apparently this is the place for people with cuboid stress fractures! I just found out I have a stress reaction of the cuboid, but have yet to speak with my podiatrist about whether I'll need a boot.

Does anyone have an idea how long a cuboid stress reaction takes to heal?

8/27/2010 1:09 PM  
Blogger Sub said...

A stress reaction is the stage before a stress fx. So if you stay off it hopefully you'll be good to go in 4 weeks... Good luck!

8/30/2010 12:49 AM  
Blogger LauraDee said...

hi, I've found it very difficult to get info about cuboid stress fractures so this blog is great. I was diagnosed 13 weeks ago (3 weeks after the injury) and have been easing back into running and am now up to 20 mins running. I didn't get put in a boot so was able to do a lot of cross training including aquajogging. Unfortunately I still get pain in my plantar (which is where it all started) which my physio is trying to sort. Has anyone else had the same thing and how did you deal with it? It's holding up my recovery now.

9/05/2010 4:21 PM  
Blogger Sub said...

An ache might be normal but if it hurts/there is significant pain then you should probably be more concerned. Also, do take the time to figure out why you got the sfx in the first place...

9/05/2010 10:54 PM  
Blogger Mary said...

I'm supposed to be training for the NY Marathon, but was sidelined with what was diagnosed as plantar fasciitis. But it didn't get better, and I finally had an MRIE and just got diagnosed with a cuboid stress fracture, a partial tear of the plantar fascia, and some sort of arthritist of the LisFranc area of the midfoot (weird). Oddly, I'd started feeling better and almost skipped the MRI, and I ran 20 miles on Saturday (slow, painful). So now my doc wants me in a boot for 4 weeks. I just don't know why I'm feeling better though, and wonder if I should just go with my symptoms.

9/27/2010 7:41 PM  
Blogger Sub said...

I know how tempting it must be to train for/run NYCM... The safest option long-term would be to defer your entry to next year and gradually ramp up after the 4 weeks on the boot... If you think it's now or never for NYCM/or another marathon you could wait out the 4 weeks in the boot. Get in a run or 2 before NYCM and tough it out through the marathon. You will probably hit the wall, might have another sfx but should finish. If your MRI says you have a sfx don't run on it - it'll become a complete break! Good luck!

9/27/2010 8:34 PM  
Blogger want2run said...

Dont run, wait the four weeks it drives you crazy I know I have been there , but if you run before your ment to, you will probably never run again. up to you !

9/28/2010 11:31 AM  
Anonymous Anonymous said...

I have a irregular defect in the lateral margin of the cuboid consistent with a fracture with displacement of the fracture fragments. I am walking around with no pain is this normal, i have ordered a walking boot but will or should i be using one.

11/03/2010 9:28 PM  
Blogger Sub said...

You should probably go with what your doc suggests... You might be able to do without a boot if it *really* does not hurt to walk but why take a chance. Wear a book for 3-4 weeks and get it done with rather than risk a longer recovery time.

11/03/2010 11:22 PM  
Blogger Tonya said...

I have a cubiod sfx in my left foot after doing 3 marathons in 6 months. I was misdiagnosed with plantar faciatis for 3 months and kept running until I could no longer take it. Did a 9 mile run back on December 12, 2010, and have not been able to walk since. Two weeks after the run my doc finally did a MRI and got the cubiod sfx diagnosis. I was placed in a boot and using a bone stimulator every evening. I had the boot on for 8 weeks and took it of a week ago...and still cannot walk without pain. A few months ago I was chomping-at-the-bit to run again...now all I want to do is walk again without pain. I am going to see a new Ortho next week to get a second opinion but for now I'm swimming and biking a lot. How long do these sfxs take to heal? I'm amazed at how much pain I am in after 8 weeks in a boot...

2/26/2011 12:42 AM  
Blogger Sub said...

Sorry to hear :( A cuboid sfx should take 4-6 weeks to heal if you stay off it. Maybe getting an X-ray now will tell you if this has healed... If not perhaps, a couple of weeks in crutches would help expedite the healing. Good luck - I'm sure you will be hitting the roads soon and you'll get to appreciate every run even more after this!

2/26/2011 2:43 AM  
Anonymous ChrisT said...

Wow great advice I wish i'd read when i got my sfx through over-running 3 months ago!!
I started trying to get around town in soft trainers but a physio told me to absolutely avoid this and wear solid footwear - ideally cat boots etc. I've been using ibuprfn gel on my foot and wrapping in cling film which helps the pain. The key is to KEEP OFF IT which is the complete opposite of what you want to do when you are fit, active and have a time limit for marathon training.
The marathon is in 2 weeks and have been swimming 5 times a week for months so am in great shape. However haven't been able to run AT ALL!! I will try a test run or two and on the day will just have to walk or poodle along to finish. LESSON LEARNT!!!

3/26/2011 9:59 PM  
Blogger Sub said...

Chris, I know exactly how you feel since I was in awesome shape when I got my sfx and it was really tough to walk away from my marathon. If you must run your marathon for some reason try to be as conservative as possible but it won't be fun. You will feel like crap. The best thing for the long-term will be to bag the race and start back slowly. It will be horrid to have another sfx and go through recovery again. Good luck!

3/26/2011 10:43 PM  
Anonymous Lisa said...

WOW! Finally, some good info on cuboid sfx. I too have been a runner for 30 years without injuries. 8 weeks ago I inverted my ankle and got both an avulsion fracture of the cuboid and calcaneus. I felt pretty good the first week in my boot, started weight lifting and made my foot worse, had to use crutches for 6 weeks. I get re-x-rayed this week. Goodness, I hope I am healed but still have a great deal of swelling and stiffness. I hope my story turns out to be a good one because I haven't heard many positive outcomes.

4/02/2011 6:01 PM  
Blogger Sub said...

I think 6 weeks on crutches would have healed it for sure!

It might take you a little while to gradually build back to where you were but I'm sure you will... Icing should help with the swelling.

Here's to many more years of injury free running!!

4/02/2011 10:54 PM  
Anonymous Anonymous said...

So happy to hear about other runners with a cuboid stress fracture and that this post keeps on going. Was just told today I have a cuboid stress fracture along with a torn fascia and lots of fluid in my foot. No running and in boot for at least 6 weeks. Dr won't even let me on a bike. I am 2 weeks out from the Ogden Marathon and was having the best training cycle I've even had. So this was/is crushing to me. Dr also told me to stop taking anti inflammatories and he wants me to use the bone stimulator. This was not my idea of tapering! HAHA

5/10/2011 6:21 PM  
Blogger Sub said...

I totally feel your pain. When I had my sfx I was in such awesome shape and so close to my marathon. It was just frustrating not to be able to run. In the long run you'll come out stronger from this. The layoff will let you think about what you did wrong and fix it. For instance I just ran my marathon PR last month... Good luck and heal fast!

5/10/2011 9:10 PM  
Anonymous Anonymous said...

Hi all... can't believe this blog is still going! I have been considered out of running since 11/10 and just started back after being diagnosed with a stress fracture and tear of the plantar fascia 3/17/11 via MRI diagnosis. Weird because I had been taking it really easy for a few months... anyway, no boot and I just started running a very little again. I am not sure how I am supposed to feel... I get the ache and after I run a tingle through my foot right thru my toes... I agree with you all that there is not alot out there on this problem... Does anyone know how long before you feel normal or will it always be different? the only way they can see if I still have the sfx is if I get another MRI and this will be my 3rd in 2 years (for a multitude of running injuries) so I don't know if they will go there... xray did no show the injury... anyone know? I am really going slow with the running... am scared to get a big set back, you know!

6/06/2011 5:28 PM  
Anonymous Anonymous said...

Hi all... can't believe this blog is still going! I have been considered out of running since 11/10 and just started back after being diagnosed with a stress fracture and tear of the plantar fascia 3/17/11 via MRI diagnosis. Weird because I had been taking it really easy for a few months... anyway, no boot and I just started running a very little again. I am not sure how I am supposed to feel... I get the ache and after I run a tingle through my foot right thru my toes... I agree with you all that there is not alot out there on this problem... Does anyone know how long before you feel normal or will it always be different? the only way they can see if I still have the sfx is if I get another MRI and this will be my 3rd in 2 years (for a multitude of running injuries) so I don't know if they will go there... xray did no show the injury... anyone know? I am really going slow with the running... am scared to get a big set back, you know!

6/06/2011 6:49 PM  
Blogger Sub said...

The ache and tingle is normal, especially after coming back after such a long layoff. The thing to note is that it should not hurt. And yes it will feel normal again and you'll get back to running like you once used to. You'll be wiser and have a new appreciation for running. Good luck!

6/06/2011 7:41 PM  
Anonymous Anonymous said...

i had a cuboid stress reaction almost a year ago in october. ive had no problems with it until recently. can these kinds of fractures return? ive had some tingling in my foot (especially under my 4th and 5th toes). no pain...it just feels funny and the arch is crazy tight. any suggestions?

8/18/2011 3:42 PM  
Blogger Sub said...

These things can return but does not sound like you have a cuboid stress reaction/fx. Trying icing and try cutting back for a bit. Key being don't run through pain... Good luck!

8/18/2011 4:10 PM  
Blogger Jarathon said...

Hello,

Unfortunately, my MRI results just came back and I have a cuboid stress fracture. I begin training for Boston 2012 in late December and was wondering if this gives it enough time to heal? I'm not in a boot yet. Does wearing a boot make it heal faster? Can I do the elliptical machine? Also, what causes a cuboid stress fracture. I was not training too hard. Is it more of an overuse injury or due to wearing the wrong shoes? I just don't know how I got it so I'm not sure how to change my training so it doesn't happen when I begin training for Boston. I sure hope this blog is still going.

9/14/2011 7:42 PM  
Blogger Sub said...

Cuboid stress factures are generally are quick to heal... If you stay off it, you should be back to running in 4-6 weeks. Then you'd probably need another 2 months to get back to where you were in training. That would still give you about 4 months to train for Boston which is more than enough.

For sure wearing a boot will make it heal faster since it would minimize the impact.

Ask for doc for guidance but it would be best to stay off it for atleast 2 weeks (no elliptical).

Stress fractures are overuse injuries. However, it does not necessarily mean that your training was wrong. It could be due to - too many miles on your shoes/wrong shoes/need for orthodics etc. Best to go to a good running store and get them to check out your stride...

9/14/2011 7:55 PM  
Blogger Jarathon said...

Thanks for the advise, Sub. I've never taken more than a week off of running (after marathons) but I know I need to now if I'm to get back to running healthy. I do tend to pronate a little, but nothing excessive. However, I wear a very lightweight, neutral, and low profile shoe (minimal heel to toe drop). Maybe I should be wearing more of a stability shoe for long runs and save the "minimal" shoes for speed and tempo work? Anyway, thanks again.

9/14/2011 9:12 PM  
Blogger Sub said...

That would make sense... Each of us are so different it's kind of a discovery process to figure out what works. Though if you have access to a coach, running store folks or a podiatrist it would be good to get their opinion... Good luck!

9/14/2011 9:40 PM  
Anonymous Anonymous said...

just stumbled across this blog....I'm not a runner - I fence...was going up for my match and I did one more practice manuever which I landed on my ankle twisting and crunching it....still fenced 5 matches...then took my shoe off and wa-la....lots of pain and swellig......i can walk on it pretty well and have a heavy duty velcro wrap my ortho gave me.......going for an MRI tomorrow...this happened on 9/10....still sore and swells now and then......not sure if it's healing correctly or I can tolerate allot of pain......i hate not doing any kind of physical activies nor any fencing......

9/30/2011 2:48 PM  
Blogger Sub said...

The MRI would definitively tell you what is going on. Once you know your doc can figure out what to do next. So at this point icing would be helpful to reduce the swelling. Ibuprofen is believed to impede bone healing so prehaps safe to stay off it unless you're in pain. Good luck and wish you a speedy recovery!

9/30/2011 6:53 PM  
Blogger Jarathon said...

Hi Sub,

It's Jarathon again. I just went in for a two week check up for my cuboid stress fracture. My sport medicine doctor said I no longer need the boot since I don't feel any pain when walking. I was only in it for two weeks so I guess that's a good sign. He said the boot is mainly for those who have pain. He also said some weight bearing will actually promote bone growth so he cleared me for the elliptical machine and stationary bike but doesn't want me to run for 6 more weeks. Just wanted to give you an update. Have you heard of someone being taken out of the boot this early since this blog started? I'm hoping it doesn't delay healing. My sports medicine doctor is highly respected and works with the university here so I think he'd know best.

10/01/2011 8:19 AM  
Blogger Sub said...

Hi Jarathon,

Yup. Getting out of the boot in 2 weeks is nothing to be concerned about. After 2 weeks quite a bit of healing should have occurred. Some are even able to start running after 4 weeks though the bone does not completely heal for about 6 months. So you need to ensure you don't go crazy once you get back to running. Good luck!

10/01/2011 11:44 AM  
Anonymous Anonymous said...

Hi I was diagnosed with an avulsion cuboid fracture yesterday and have a cast on for probably 4-6 weeks I'm worried abt the future of my foot... Do the bones really heal? If I rest properly and don't weight bear...when bones break in your foot do they join again ? Will I have future complications as I am 32.

10/21/2011 4:56 PM  
Blogger Sub said...

Hi,

If you let it heal properly it will get back to normal. No sign of the fracture. No future complications. Of course if you don't figure out why you broke it you risk breaking it again...

Some claim that it will heal stronger that it was to begin with but that's been disputed:
http://www.nytimes.com/2010/10/19/health/19really.html

Good luck!

10/21/2011 5:18 PM  
Anonymous Susan said...

Hi Sub,
I found out about a week and a half ago about my cuboid sfx. I am in a boot and was told I could not do any weight bearing exercise for two weeks not even pool running. This really bothered me because I had MCM, which of course I have given up. I am hoping for good news .. I want to run a marathon in December, of course just to enjoy. Do you think that is unrealistic? I have another one in February 2012? Then possibly another that I would actually want to put speed to in between March and May. I had been training hard to increase speed, I believed I was in the right shoes. I am still trying to find the why so that I can modify. I have had someone say people who run 4 to 5 days a weeks risk higher incidence of injury? Thanks for you blog, I am very grateful I found it!

10/23/2011 6:58 AM  
Blogger Sub said...

Hi Susan,

Probably the Feb marathon is more practical. You're going to take 2.5-4.5 more weeks at the miminum to heal. After that you need to gradually increase your mileage. So if you run a Dec marathon it won't be enjoyable and you risk re-injury.

Running 4-5 days is probably the minimum required to run a marathon properly. Running multiple marathons close to each other, even when run as a "training run" would increase the risk of injury. If you really want to realize your potential then running 1-2 marathons/year would be optimal.

Good luck with your recovery!!

10/23/2011 8:29 AM  
Anonymous Anonymous said...

Wow! Really helpful thread as I was just diagnosed with a cuboid SFX (MRI) this week. Upon initial onset of pain, went to Ortho who took x-ray...found nothing and thought it was arthritis. After 4 more weeks of increasing mid-foot pain (towards lateral side), the MRI confirmed a cuboid stress fracture due "edema of bone marrow" in the cuboid. I'm in a boot for 6 weeks and must say it has helped reduce the pain to almost nothing. Yesterday was the first day I made it without Ibuprofen in some time. I'm cleared for swimming and stationary biking (no mtn. biking on trails) so I'm hopeful for a positive outcome. Bummed to withdraw from the NYC marathon but am hopeful I will be able to run Boston---if only at a relaxed pace. Incidentally, this was the injury Deena Kastor experienced and she bounced back 100% (and more). Appreciate all the info here.

10/28/2011 9:02 AM  
Blogger Sub said...

Glad you found the info here helpful. When I posted this I had no idea that this page would get so much traffic everyday...

You got me curious. I looked up the stress fracture Deena Kastor got. She broke her 3rd metatarsal. That would have taken more time to heal than a cuboid sfx.

Sucks about NYCM but you can always run it again someother year. I'm sure you'll recover soon enough to get in a decent training cycle for Boston.

Good luck and stay off the ibuprofen!!

10/28/2011 3:25 PM  
Blogger ideafarm designs said...

You guys ALL sound pretty dang optimistic...Maybe too optimistic. You can NOT go back to normal training and rush anything w/ this injury! I got 2 stfx in cuboid July 2, was on it/off it/ in boot until Aug 1 when I got a diagnosis from a better doctor, was in the boot for 2 weeks, it didn't get any better..was on crutches for a month, absoloutely no weight baring, went off crutches and walked and rode my bike and a DAY AND A HALF LATER it recracked. Did I mention I'm an elite competitive ultrarunner whose specialty is the 50 mile?
Back on crutches for a month. I've been off of them for 10 days, walking and occasionaly riding stationary bike. Everything was fine until yesterday. I swear to god I think its recracked.Give yourself 2-4 weeks after the doctor says you can try running! It is not worth it to keep recracking it.
BTW I totally, totally get the depression. This has been an incredibly hard few months, and I gave up several races (that I hoped to win. The one thing that has saved me the most is deepwater running WITHOUT a vest - just jump in the deep and "run" to the other side. My first day, I could do apx. 4 minutes. And I was in great shape! Now I can do 1.5 hrs, w/ 45 minutes of that being all-out 15 min. sprints. It will save your sanity and keep you in shape - trust me!

10/30/2011 7:18 PM  
Blogger Sub said...

Thanks for your post! I am sure it will help future visitors to this page. I hope you get back to your routine and racing soon!

10/30/2011 7:34 PM  
Anonymous Beanker said...

Just got back from a 2nd MRI scan on a cuboid fracture diagnosed 12th July. (injury occurred mid June). It showed that the stress fracture still hasn't healed properly. I've been running for about two months now, building up from walking to a 3-5km run, my medical team wouldn't let me increase it further because I still experienced discomfort the morning after running.

So now, four and a half months after the injury, how much longer is it going to take before it's completely healed? And will I make my goal of a 56k ultra in April?

11/01/2011 9:16 AM  
Blogger Sub said...

So looks like you had been running on it before it healed completely so that pretty much gets you back to square one as far as healing goes. You need to figure out from your doc why you did not heal the first time around so that you don't have a repeat. Calcium/Vit D deficiency? Crutches? Air cast/boot? Focus on getting healed up. Take the time off and stay off your legs. You might still make your ultra but first things first. Good luck!

11/01/2011 12:07 PM  
Anonymous Tanya said...

I too have suffered a stress fracture to the cuboid by 'rolling' my ankle approx 3 months ago, although it was not diagnosed until 4 weeks ago. I was in a knee to foot cast for 3 weeks, then put in a boot for another 3 weeks, I have been in the boot for 1 week, so another 2 to go. I am able to take the boot of for sleeping, bathing and swimming.
I am going to see a physio when I am due to get out of the boot for some advice re returning to running (wanting to run marathons). I am quietly going insane having not run for about 8 weeks now :(
I still do have pain sensation going through the foot, especially at night when flexing it. I am weight bearing on the boot, should I be? Or should I be still relying on the crutches?

11/06/2011 2:18 AM  
Blogger Sub said...

A cuboid sfx usually does not require crutches since it's not a load bearing bone. You're almost there - I know the mental impact of not being able to run! Wishing you a speedy recovery!

11/06/2011 3:56 AM  
Anonymous Tanya said...

Thanks ever so much for your words of advice, this thread has been a blessing for me in relation to advice as there is just not much in relation to this injury on the net.
I am hoping I am almost there, got some training I need to get done :)
And very glad to hear I can ditch the crutches, nasty things those! lol

11/06/2011 2:25 PM  
Anonymous Tanya said...

Ok, I am so sorry to come back to you on this one but I really have no where else to go for advice, seems this is the best place :) So, have been back to the Physio today and am still in pain walking even with the moon boot on after an initial 3 weeks in cast and 3 weeks in boot. Physio has advised going back to non-weight baring with sticks/crutches for another 2 weeks then back for review. My question is...at what point do I request for further indepth testing in case there is other complications as to why still in so much pain? I don't want to waste another 2-4 weeks only to find out there are other complications?
Thanks for your advice :)
Tanya

11/17/2011 4:40 PM  
Blogger Sub said...

I am assuming you had an MRI taken or your X-rays clearly showed that you had a cuboid sfx. You need to definitively know what's going on. Also, I'm assuming by Physio you mean orthopedist/podiatrist since it's not the job of PTs to diagnose sfxs. Apart from that unless you have a Calcium + Vit D deficiency, crutches + staying off your legs is probably all that you can do at this moment... I know it's frustrating and I feel your pain :( Hopefully it won't be much longer. Good luck!

11/17/2011 10:14 PM  
Anonymous Tanya said...

Thanks so much again for your reply :) Actually, no, my x-rays didn't show the stress fracture so I had a bone scan done, and to be honest, I don't know how they diagnose from that, but they did. Both my doctor and orthopedic surgeon checked the bone scan results, so, I am assuming they know what they are diagnosing. And by Physio, I mean physiotherapist, I went to see him as my orthopedic specialist said that by yesterday I should be ready to get out of the boot and start rehab exercises.
I have since contacted my orthopedic specialist again and they have advised to follow physio's advice, a further 2 weeks off the foot and if still not better, then I go see him for a CT scan and further assessment.
Yes, it's all frustrating....haven't run for almost 11 weeks now and it's killing me inside and out :(
And it's also disappointing that after 6 weeks of almost complete immobilization, it doesn't seem to be any better at all!
Thanks again for your advice, guess I just have to hang in there best I can :)

11/18/2011 4:44 PM  
Blogger Sub said...

Yeah, bone scan works too (I think some docs prefer a bone scan and others a MRI). Looks like you have it all covered. Happy thanksgiving and hope you're back on the road soon.

11/18/2011 4:59 PM  
Anonymous Anonymous said...

Hi... I have as couple of stress fractures (of the cuboid bone and the bone next to it) that I obtained this past summer after jogging outside following recovery from a plantar fascitis relaease surgery.

Well... I have been in a walking boot for 2 weeks and a plaster cast for 8 weeks.... and my foot is still swollen and sore!

Has anyone had surgery for a cuboid stress fracture that wouldn't heal? And if so, what did they do?

I am having MRI done tonight... I can't want to get some direction from my doc!

12/01/2011 1:28 PM  
Blogger Sub said...

Your MRI will give you an idea of what is actually going on. Fingers crossed that it will show that your fracture has healed since 10 weeks in a cast is quite a bit of time. I have not heard of anyone needing surgery for a stress fracture. Fracture maybe but never stress frac. Good luck!

12/01/2011 10:41 PM  
Anonymous Julie said...

My 10 year old daughter is a gymnast and was dx with a Cuboid sfx on October 14th after an MRI. She was put in a boot on 10/19/11 and then added crutches 2 days later. She has been in the boot and using the crutches or crawling faithfully...no weight bearing at all. It has now been 7 weeks and still no improvement. We went for a second opinion and that Dr. said give it another 6 weeks and then they will do a second xray. Shouldn't she be showing some improvement...like being able to get rid of the crutches or something? I just hate that this is taking sooooo long, when most things I've read say 4-6 weeks. I really thought that being a child she would heal faster too! UGH! Any suggestions?

12/10/2011 7:58 PM  
Blogger Sub said...

It would be useful to visit her PT and get her tested to ensure that a nutritional deficiency is not a factor in the slow healing:

http://runningtimes.com/Article.aspx?ArticleID=13490

I wish her a speedy recovery. Happy holidays!

12/10/2011 8:19 PM  
Anonymous Anonymous said...

I am going tomorrow to find out if I have a cuboid stress fracture..had the MRI on wed. I am fine forth most part wearing my sneakers, which are motion control, but the pain comes back if I walk with out shoes.

I am so worried that I have a fracture...I am a new runner...started in March and have been building up to my goal of the Disney half marathon in Feb. I am so afraid this is going to totally derail me from running.

How bad is your pain from this? I haven't needed to take pain mess other than the first day or two...but I also haven't taken off my sneakers either. It's only been a week since I hurt myself, so I am hoping I caught it early...

12/11/2011 3:51 PM  
Blogger Sub said...

In the early stages there can be very little pain. However, it keeps getting worse and it hurts more as you try to run through it. Fingers crossed that the MRI results don't show a sfx and you can run Disney. Good luck!

12/11/2011 4:06 PM  
Anonymous Anonymous said...

Thanks! Got the results back...no sfx....but my peroneal longus tendon is injured...in a brace now and going to see a PT in a day or two...happy it's not a fracture, but I understand injuries to that tendon can also take a long time to heal....I am hoping its just an inflammation not a tear, but they couldn't tell from the MRI. The fun never ends!

12/12/2011 4:19 PM  
Blogger Sub said...

Good to hear! Hope you can get back to running soon - good luck!

12/12/2011 8:51 PM  
Anonymous Anonymous said...

Posted my first comment on 10/28 and wanted to provide an update. Wore cam boot for 8 weeks and then transitioned to a regular (stiff) hiking boot when completely free of any pain symptoms. My cuboid has been pain-free for the past month and my doc has given me the go-ahead to resume running ("slowly") on January 1st. Yesterday, I went on an extended cross country ski and was curious if there would be any sensitivity today as the boots do flex somewhat. None at all! I'll post again in early January. Best of luck everyone.

12/21/2011 2:09 PM  
Blogger Sub said...

Thanks for taking the time to post such a detailed update! Glad to hear you're going to get to kick off the new year with a run :) Happy holidays!

12/22/2011 5:23 PM  
Anonymous Anonymous said...

My previous update:

Posted my first comment on 10/28 and wanted to provide an update. Wore cam boot for 8 weeks and then transitioned to a regular (stiff) hiking boot when completely free of any pain symptoms. My cuboid has been pain-free for the past month and my doc has given me the go-ahead to resume running ("slowly") on January 1st. Yesterday, I went on an extended cross country ski and was curious if there would be any sensitivity today as the boots do flex somewhat. None at all! I'll post again in early January. Best of luck everyone.

As of 1/9/2012: Following Peter Pfitinger's "Resuming running following an SFX" plan (week 2). Logged about 10 (very easy) miles last week following a walk/run format. So far----A-OK. Here's the link for Pete's plan:

http://pfitzinger.com/labreports/stressfracture.shtml

1/09/2012 1:28 PM  
Anonymous Anonymous said...

Wanting input...after having crags that didn't show anything, I had an MRI & was diagnosed with a cuboid stress fracture late Nov 2011. I spent 2 wks non-weight bearing and an additional 6 weeks in the boot. My dr told me I could begin to transition into my shoe (good supportive running shoe with custom inserts) and it's hurting (sharp pain) again! Now, I'm back in my boot, using bone stimulator & taking calcium & vit D supplements. What else can I do? Im sooo tired of this!!!!

2/12/2012 8:39 AM  
Blogger Sub said...

I know how much it must suck! An additional thing you can do (which is probably not necessary and will be overkill) is to spend a couple of weeks on crutches. That will force to to keep all load off. Keep yourself busy with something else and let your leg heal... Good luck!

2/12/2012 8:54 AM  
Blogger anonymus said...

I feel like the most efficient way to recover from this fracture is to COMPLETELY stay off of it for the 6 weeks. I have been on crutches/boot for the six weeks and am now putting some weight on it. I haven't felt any pain whatsoever since I started using crutches so this looks like the best option for a somewhat speedy and thorough recovery. The only problem with crutches is you kind of feel helpless in public and at home. But boy do I feel great because my bone is healed, and I have my handicapped parking pass for another six months!

2/17/2012 9:58 AM  
Blogger Sub said...

I have to agree... We generally tend to waste WAY more than 6 weeks first discovering that it is a sfx, then trying to stay active and then trying to get back to running too early. If we could just stay off our feet for 6 week (on crutches) :)

Great to know you're on your comeback... Good luck!

2/17/2012 10:12 AM  
Blogger mince said...

16 days in and MRI confirms a cuboid SFX. I've been walking in a sneaker and it has been healing. Now doc has me in boot and crutches. Are crutches really necessary? I feel no pain or discomfort trudging around in my boot.

2/21/2012 5:25 AM  
Blogger Sub said...

The crutches are probably not necessary but there's no harm being extra cautious. What sucks most after spending time off running is to discover that your sfx did not heal. Good luck with your recovery!

2/21/2012 7:07 AM  
Blogger mince said...

Thanks for your feedback. I have been biking on a stationary bike and cheating with my crutches. I had no swelling at all so my assumption is that the fracture was very minor. Since I have no pain at all at rest or in the boot, I recently tested my foot and felt some soreness in the area as well as aches and pains all over my foot. Is it normal after removing the boot, to have this soreness? Thanks again

3/05/2012 6:41 AM  
Blogger Sub said...

Great to hear that your recovery is going well!! Soreness and random aches are normal but you should not be doing anything that hurts. There should be no pain especially localized in the area of the sfx. Good luck!

3/05/2012 2:29 PM  
Blogger Lauren Marie Duffey said...

This seems to be the place to go for "therapy" regarding cuboid stress fractures. I myself developed a cuboid stress fracture about two weeks ago and have been in the walking boot for almost a week. As a medical student and the daughter of an orthopedic surgeon, I think I was quickly and painfully aware after experiencing mild soreness after a run that this was what I would be facing. Only a few days of denial and attempting more weight-bearing activities until I was in for x-rays. The reason I am writing to this blog is that I am worried I have not really solved the mystery as to exactly why I developed this. I am not a competitive runner, but I do workout almost every day (spin, interval training, plyometrics, weight-lifting, yoga, etc) and I do pump out the occasional 6 mile run a couple of times a week. I had begun a fitness program called Insanity, which requires a lot of jumping, something I'm not used to. However, I was about 5 weeks into this when the stress fracture developed. Does anyone know the behaviors that more commonly lead to cuboid stress fracture specifically? Also, I am worried how much pain one should experience in the foot at all. I don't feel much pain but get nervous when riding my bike or doing abs that even the slightest ache is me delaying my recovery, which my emotional state I fear cannot handle. Any advice specific to my circumstances would be greatly appreciated! This is killer for someone like me addicted to really working up a good, heart-pumping sweat on a daily basis, as I'm sure you all can relate to. Thanks!

3/06/2012 2:48 PM  
Blogger Sub said...

As a med student and with a dad who is an orthopedic surgeon you must know almost exactly what is going on.

It's always safer to err on the side of caution. I know it's easier said than done but staying off your foot for a 2 weeks is safest. Something like swimming would minimized your risks of prolonging the recovery.

The Insanity - jumping coupled with your normal run load could have triggered the sfx (overuse)

Good luck with your recovery!

3/06/2012 8:07 PM  
Blogger mince said...

Sub- thanks again for the reply.

Lauren- I did insanity barefoot off and on without any issue. That's not to say that it didn't contribute to your sxf. How many weeks are you to be in the boot for?

3/09/2012 9:30 AM  
Blogger mince said...

Lauren-I'm in the exact same state of mind as you. I'm 5 weeks from the original injury and almost three weeks in the boot. I have no pain at rest and really very little when I test my foot. I've been biking also. But the aches and soreness scare the crap out of me. I feel like my doc was way, way too conservative, yet at the same time any little ache has me back on crutches. I think many of my aches are from being in the boot.

3/09/2012 9:33 AM  
Blogger SuCasa said...

I am not a runner, but a nurse of 19 years with all but 2 years spent in the OR. I stepped in a dog hole 5 years ago and a fracture of my right 5th metatarsal was diagnosed. My left foot continued to hurt. Plain film xrays were negative. I was given steroid injections multiple times through the next year with a diagnosis of peroneal tendonitis. Finally, after my meltdown with my family doc, an MRI was ordered. Bingo! Cuboid bone marrow edema indicating fracture, probably traumatic and not stress I was told. Got in to my favorite Ortho that day, 11 months post injury. Casting then fracture boot along with 16 weeks non weight bearing and a bone stim, and then another 6 weeks of partial weight bearing graduating to full weight bearing, it appeared healed via bone scan. Finally! I say that to let you guys know, it can take a while. My right foot healed by my 4 week mark and I was told my bone structure was fantastically healthy. So I cruise along for 4 years and guess what?!?!?! My symptoms have returned. It started with plantar and arch pain in January and by 1 week ago I knew what my problem was again. My appointment with my favorite Ortho doc is tomorrow morning. I'm bummed. I did nothing that I know of to re-injure it. I can put my finger right on the catalyst of pain and it is the cuboid. How many of you have had bottom of the foot pain with your scf's tho?

3/11/2012 2:05 PM  
Blogger Sub said...

Sorry to read about your re-injury :( I have nothing helpful to add but I wish you a quick recovery!

3/11/2012 2:34 PM  
Blogger mince said...

I am wondering if I along with others actually have cuboid subfluxation. I have every symptom and it was never a thought by my doc. From what I read it can appear similar to a cuboid sfx on an mri.



I felt great in a shoe all day Saturday. Then Saturday night my symptoms returned. Then on Sunday after some rest it feels fine. Needless to say, back on cructches and in boot, but I think I am going to switch from a sports medicine doc to an ortho.

3/12/2012 4:59 AM  
Anonymous Alex said...

I had a stress fracture on my cuboid calcaneus joint in my left foot in October which prevented me from running my first 10K. I got better in about two months after seeing an ortho and podiatrist and I got custom-fitted orthotics. However, I had weird foot issues for a while after before everything stopped -- during that time, doc said it was normal and that I could carry on cross training.

I started training gradually again and signed up for the NYC half next weekend. I ran my 10 miles no problem last week (I even do the run/walk program to help prevent injuries). Then, yesterday, I ran 6 miles - my legs felt less tight than normal - and now it feels like I have the same stress fracture in my other foot (right) -- feels exactly the same as the last one -- I need to put more pressure on my arch or walk on my toe to alleviate the pain. I guess that means no NYC half for me. Anyone know how long I it will take before I go back on the bike at least? And anyone have a doctor they feel treated them well with this injury in the NYC area?

Thank you

3/12/2012 7:46 AM  
Blogger mince said...

Alex- be sure to rule out the Cuboid syndrome. Do a search for it. I may be completely off base, but since the symptoms are nearly identical and it's an easy fix, it's worth a look for sure. For your first injury, were you in a boot?

The ortho I consulted with, whom I am going to see said I could stationary bike.

3/12/2012 8:27 AM  
Blogger Sub said...

Alex - hopefully, you do not have another sfx. Its probably smarter to not run the half given that you've never run 13 miles before and it's not been long since you recovered. Give it some rest and see how it goes. Of course if it's a sfx your recovery is going to look similar to the first sfx. Good luck!

3/12/2012 11:15 AM  
Anonymous Anonymous said...

I am curious as to the level of pain experienced for those of you diagnosed with a cuboid stress fracture.

My story is that I got an injury 6 weeks training into my first marathon training plan. That was about 3 months ago. I stopped running the 2nd day I had the issue. My self diagnosis with tendonitis. My local orthopedic specialist also diagnosed tendonitis b/c he did see a fracture on an xray and thinks my pain level would be greater. He didn't think I need a boot.

However, its been 3 months with no real improvement. I have biked a few times and played doubles tennis which both of these seemed to aggravate it slightly.

I live in a remote area with no podiatrist, no sports medicine. However I have made plans to travel and go see a podiatrist. Hopefully he can help.

To me, after reading the info. on cuboid stress fracture,this sounds very similar to my symptons- its isolated to the cuboid area- comes and goes, but its always there.

3/15/2012 10:34 AM  
Blogger mince said...

I had my visit with an ortho today. I am happy to say that he has me out of the boot. He believes significant healing has occurred over the last 5+ weeks. He also re-examined my MRI from 4 weeks ago and believes the images indicate more of a stress reaction vs. a fracture. Last week's setback has me worried, but he claims since I felt fine 48 hours later that there was no re-crack. He wants me focused on the long term improvement and not to get caught up day to day.

He strongly suggests mountain biking shoes to spin or actually to go biking. Perhaps others can benefit from this as well since the sole doesn't allow push off.

I want to thanks sub for this forum. I wish others would follow up as I found it very helpful. I will continue to update progress for future readers.

Overall, I am very cautiously optimistic. The doc says I won't fully heal for 90 more days, but I am grateful to be out of the boot and to be able to ride. I'm not sure when I'll try to run again?

3/15/2012 12:41 PM  
Blogger Sub said...

Anonymous - My pain level when I was not running was pretty minimal. It was only when I attempted to run that it hurt. Essentially, I could not run. At some point you could consider an MRI especially if your insurance covers it. That would be the definitive way to figure out what is going on. Good luck!

3/15/2012 1:15 PM  
Blogger Sub said...

Good to hear mince! Being out of the boot and being able to bike must be great. Maybe you can get in some swimming in as well. Yeah, it's the long term that matters. Even if it take 90 days to get back to running, once you're back you want to be healed once and for all!

3/15/2012 1:20 PM  
Blogger mince said...

Well as promised, I am continuing to update my progress. It has been 10 days that I have been out of the boot. I definitely have not been taking it easy enough. Last week I attended a hockey game, mowed the lawn, went on a 20 mile bike ride, did p90x, got on a ladder and washed siding on my house, rode the stationary bike, went shopping, etc. My doctor told me if I get sore or feel pain to throw the boot back on for a day or two so I spent most of yesterday back in the boot and I have had significant discomfort. My pain varies in location quite a bit. Somtimes I feel pain on the bottom of my foot. Sometimes toward the front of my 5th metatarsal and sometimes in my ankle and also the lateral cuboid-like pain. I am beginning to thing that my larger issue is with my peroneal tendons. My plan next week is to take it much, much easier. My doc insisted not to get too caught up in either good or bad days so I am trying to remain even keel. Even though I have been down the past couple of days. Also, I can't say enough about how great biking shoes are. They almost feel like mini-boots. I have been wearing them to walk in quite a bit. I will note that if I take anti-inflammatories, that I feel 90%+.

3/25/2012 6:30 AM  
Anonymous FSD said...

Day two in the boot after hoping the pain would go away. I tried stretching, standing on my toes (maybe my foot was "weak", so finally went to podiatrist and got the cam boot. Curious what kind of orthotics folks end up with post-boot. I'm thinking that might be good for me.

4/06/2012 1:33 PM  
Blogger Sub said...

My insurance covers orthotics so I got custom fiber glass ones. You go to your podiatrist, they take a cast and custom order orthotics for you. However, these cost $400 odd so I would not have gotten them if I had to pay for them. Over the counter ones are cheaper but obviously less effective...

4/06/2012 3:19 PM  
Anonymous Anonymous said...

Hey there,
Thanks for this helpful blog!
I’ve injured my foot on 01/25/12. I stopped running, but still kept on a lot of weight bearing activities (hiking, weightlifting etc.). Thought it was just some minor injury.
Finally, on 03/25/12 I went to see a doctor, because it didn’t get better. MRI diagnosis is a cuboid stress reaction. Well I think it might have been a stress fracture back in January. My doc said a cast or a boot is not necessary. I should be wearing a stiff hiking boot and it should heal in about 4 to 6 weeks.
4 weeks are passed and I feel some improvement. But I am still kind of limping, because I think it helps to reduce the weight on my foot as well as some ache/pain. Weird thing is, I feel an ache in the plantar region, when I walk and even when I rest!! It’s not a sharp pain, but a dull ache. I went to see the doc again this week. He said to walk as little as possible to boost recovery.
Do I really have to rest so much, because of the dull ache and to help the heeling process? Does the ache have to be gone completely to be able to start an active lifestyle again (running, hiking, plyometrics)? Should I’ve gotten a boot in the first place to heal the stress reaction?

4/24/2012 4:01 AM  
Blogger Sub said...

Hey,

The good news is that you had a stress reaction (the stage before a sfx) and not a stress fracture. That's probably the reason your doc did not put you on a boot. The dull ache might be OK but the limp is worrying. Be cautious (and go with what your doc's guidelines) and you'll probably be running pretty soon.

Good luck with your recovery!

4/24/2012 11:12 PM  
Blogger Unknown said...

This blog has been very helpful to me...thanks Sub!

I am a casual runner (10-20 miles/week) and do various activities to try and stay in shape. About 9 days ago I started experiencing very sharp pain in my left foot consistent with what others are describing here. I am waiting on the results of an MRI, but am 90% certain I have a cuboid sfx. Initial X-ray and ultrasound were inconclusive - I was given a boot as a precaution which does not help at all. It actually might be more painful in the boot. The only thing I can do to get around is to walk on the toes and ball of my left foot and there is minimal pain. Otherwise it is unbearable and cannot even walk down the hall. I am expecting a more permanent recommendation from the podiatrist after the MRI results hopefully tomorrow. I have been barely functioning even around the house for the past week due to this injury.

Is there a boot that will allow this injury to heal properly, or am I looking at crutches and completely keeping weight off the foot??

Thanks again for all of the great posts - I look forward to your response Sub.

Thanks,
Dan

Is there a boot

5/28/2012 7:56 PM  
Blogger Sub said...

Hi Dan,

Sorry about your injury :(

Boots tend to be general purpose for the most part i.e. getting something customized for your injury is unlikely to happen.

I'd say wait for the results from the MRI and see what your doc has to say.

Crutches aren't all that bad. Get in your 2 weeks odd on them and at least you'll probably heal enough to be cleared to do other non-impact stuff.

Good luck with your recovery!

5/28/2012 8:38 PM  
Blogger Sub said...

This comment has been removed by the author.

5/28/2012 8:38 PM  
Anonymous Anonymous said...

I fractured my cuboid on my right ankle on September 16, 2011. I was in a wheelchair for 3 months and a walking cam until February. I have not been as lucky as the others on this blog. My bone was not regenerating, even thouth I was in a wheelchair until Christmas. I wore a bone stimulator from December 15 until March 16. It has not totally healed, and now going on 9 months I am still feeling burning and some days I can not step on it without pain. I now wear a brace and a Lidoderm patch. These do help, but when will the pain end": I am not a runner, and have followed my doctors instructions to a tee. HELP!!!

6/07/2012 4:57 PM  
Blogger Sub said...

Hey,

Sorry to hear about what you're going through :(

Most of the folks who have posted here have had a stress fracture, which is a tiny crack in the bone. You've had a complete break in the bone which does take significantly longer to heal.

Sounds like in another 3 months or so you will be almost healed. Don't hesitate to seek out another orthopedic surgeon for a second opinion if you're seeing complications.

Hang in there! Best wishes!

6/07/2012 11:07 PM  
Anonymous Anonymous said...

This blog is fantastic!! I've got a fracture on my cuboid in a light motorcycle accident. I'm glad that there was nothing severe apart from this. I was all good in 2 weeks and went was putting weight on the leg much earlier. Last weekend, decided to go out, but not ride or drive, thanks to friends. In a span of few hours, I was constantly standing for about an hour while I was sitting rest of the while.

This seemed to have stressed the injury and I got a swelling and pain the next day. It's really frustrating to have this kind of injury since your most basic day to day tasks are hampered and can't go to work easily as well.

Will be visiting the doc again tomorrow to see what he's got to say. There's been no cast all these days or the boot which you folks have been talking about(probably not prescribed in this part of the world. Hehehe...) I will keep you guys posted. I REALLY, REALLY need to get back on my feet in 3 weeks and I'm trying my best to keep my leg completely off the ground. Using a walker now. Lets see how it goes. All the best to the other athletes out there. Cheers! :)

6/17/2012 10:41 AM  
Blogger Sub said...

Good luck with your recovery! I hope your doc's appointment goes well and you're back on your bike in 3 weeks!!

6/18/2012 11:43 AM  
Anonymous Anonymous said...

Hi I've just spent the best part of a couple of hours reading the whole of this blog and found it helpful, at least in the fact that I now know other people have the same injury that I was diagnosed with 2 days ago. I originally felt pain in my left foot at the end of April after 4 days of walking about 4 miles a day in the Lake District, England, including a climb, approx 2 miles up then down again. I am not a runner, but I am a keen walker and these distances and challenges would normally be classed as a 'stroll' except for the fact that I had surgery in February to fuse the big toe joint of my left foot using 2 staples. The joint is now permanently stiff. I was therefore easing myself back to my normal walking routine by gradully increasing the length and difficulty. The way I walk has had to change, and in trying to avoid walking on the fused big toe joint, I over compensated and walked on the outer side of my foot. When the pain started in April I assumed it was just something I had to endure as part of the healing process from my surgery, so therefore did not visit my doctor. Over the next 4 weeks I walked a bit and it hurt, so I rested a couple of days, then it felt better so I tried walking again only to have to return after a mile or so as the pain got unbearable and I was limping badly. After 4 weeks I realised that it could not possibly be right, saw my doc, had an xray, saw my specialist (who'd done my surgery). Nothing showed on my xray but he said I'd fractured a metatarsal and to rest. After 3 weeks and by Tuesday this week I was desperate with the pain and lack of any improvement(in fact it felt worse, as I was still on my feet just doing day to day tasks - NO long walks)I went back for another xray (I can't have an MRI because of the metal in my toe)and it showed a stress fracture to my cuboid. I am wearing an air boot now for 2 weeks then a follow up appointment on July 5th. So many questions I should have asked but only thought of when I got home. Maybe you can help. Does the healing process/recovery time start from the initial injury or from the start of wearing the boot? I was swimming 1km front crawl 3 or 4 times a week this last month when it was too painful to walk, it seems now that I should wait for the removal of the boot before I resume swimming again, not sure, don't want to do any more damage. I tried sleeping with the boot on last night. Impossible. It's far too heavy and clumbersome. Hope I'm ok to take it off. Keeping my foot very still in bed, not flexing it and I put my boot back on immediately this morning. I find the boot doesn't stop the pain in the cuboid bone area because the foot still strikes the floor, however carefully you put it down. I've just ordered some crutches fron the internet, as when I asked for some at the hospital they said I didn't need them, and that the boot was meant to be walked in normally. Reading your blog, I think complete immobilisation sounds the best way forward. I too miss my exercise and fresh air, and am envious when I see other people out walking. I cancelled a touring holiday to Italy due to start 29th June, and am worried I'm going to have to cancel a trip to Greece on Aug 10th. Need to check that with my doc. It's just for a week, relaxing by a pool. Can you fly with an air boot (if I still need it by then)? I know you aren't allowed to fly with a cast. Thanks

6/21/2012 5:15 AM  
Blogger Sub said...

Hey, The healing time starts from the point when you begin immobilization i.e. from when you started wearing the air boot. Swimming would not be putting impact on your cuboid as long as you could get to the pool without causing damage. Removing your boot while sleeping will be fine. You should be fine going to Greece in August. Planes will let you get in with an air cast. You might need to put it through an x-ray. If you're having issues walking you can even request wheelchair assistance. Good luck with your recovery!

6/21/2012 8:53 AM  
Anonymous Anonymous said...

Was on a hike, jumped across a creek and did a pretty serious inversion sprain. Felt a sharp pain and was sure it was a Grade 1 or 2 sprain. Could walk on it without too much pain as long as my foot stayed pretty flat and didn't tilt. The sad thing is that I had to hike out 15km on it (which I'm sure did more damage). By the time I arrived home after driving 2 hours it was pretty swollen and couldn't walk on it (ironic after being able to walk 15km a few hours before). Had an x-ray, CT scan and confirmed stress fracture on the cuboid bone. This result after a week but lucikly I had crutches that I had been wearing since the initial injury. I haven't really been wearing the air cast for the 2 weeks I'm supposed to because it puts pressure on the bone and I basically haven't put my foot down for almost 3 weeks now. I have ortho/surgeon appt in a week but am concenred that I also have tendon/ligament damage from the sprain as well. Doctor won't order an MRI though but I'm worried because my big toe doesn't bend much at all and the swelling isn't really that different from day 1 after 3 weeks! Doc said yesterday that I could put some weight down in the boot and rid the crutches but after reading these stories I think zero weight bearing is more effective than weight bearing with the boot. Thoughts?

8/24/2012 8:22 PM  
Blogger Sub said...

Sorry to hear about your injury :( It's kind of weird that after 3 weeks of putting no weight on the leg your swelling has not gone away... Icing it should help. If the crutches don't bother you it's obviously better than an air boot. The key is to back off anything that causes pain. Good luck!

8/24/2012 11:54 PM  
Anonymous Jerry said...

6 weeks and i finally went to a padiatrist. took an xray that clearly shoed a cuboid break. He wraped my foot and a few inches up my leg in a soft cast. 6 hours later my leg swelled double size. I took off the wrap and put ice back on it. The ice feels goood! Tomorrow I will finally by crutches after reading this entire blog. My doctor said no crutches. Is he a quack or what?

9/07/2012 9:01 PM  
Blogger Sub said...

I hope you have a sfx and not an actual cuboid break... That would take much longer to heal.

There's no harm in crutches, it can only expedite the recovery by staying off the leg completely if you can. Good luck!

9/07/2012 9:14 PM  
Anonymous Jerry said...

My favorite to do and for health was walking. Any advice on that. Second I will refuse a cast at this point but did well with my own removable ACE wrap. I am not so interested in wearing a boot either. Currently I use the kind that the middle is the lowest part like a boat but i know now i should not put pressure on that put of the foot. What type of walking shoe do you recommend when i decide to start walk on it again?

Thank you for your blog ;)

9/08/2012 7:34 AM  
Blogger Sub said...

Once this heals up, gradually build up your walking distances and pace. Key is that it should not hurt. As far as shoes you could go to a specialty running store and have them check out your gait and recommend shoes... Cheers!

9/08/2012 11:51 AM  
Anonymous Anonymous said...

After months of a gradual worsening pain while running, it finally got the best of me and I was at the doc getting xrays. No sign of a sfx on the images so they sent me to PT. After examination, PT wasn't convinced that it wasn't a stress reaction or sfx of the cuboid, so they put me in a boot on crutches, no weight bearing. As a single mom of 2 toddler boys, this was equally, or more frustrating than not being able to run.

I stayed off of it completely for a full week with some signs of improvement. On day 9 I ended up taking the boot off and ditching the crutches, simply because the discomfort in my shoulders, wrists, hip and other foot were annoying me more than my foot was, after attempting to chase after my kids all week with such limited mobility. I was so irritated by it all it was the kids or the boot!

From day 9-12 I found it more comfortable walking in high cusion shoes than I did limping around in the boot (w/o the crutches). So, at my 2nd PT appt they re-examined and still wouldn't rule out a sfx...and so they said to wear the boot for another week with light weight bearing (using at least one crutch). Before PT sent me on my way, they did some gentle manipulations of the cuboid and there was a very small pop (that did not hurt), but we both felt it. About 10 steps out the door my foot was hurting me worse than it had in a week.

I used the boot and crutches for another day, but I still find it less painful to wear high cusioning shoes than that stupid boot. I'm so frustrated and am wondering...at what point do I just demand an MRI and quit wasting time?? If it is 'cuboid syndrome', then lets get on with fixing it already, I'm going crazy!!! If it IS a sfx, I'd rather just be put in a real cast that I can't take off (because I know I will)...let's heal this already! :(

11/01/2012 9:19 PM  
Blogger Sub said...

Sorry to hear about what you're going through :( If your insurance covers most of the MRI you should probably get it done with and figure out what is going on. For a sfx I doubt they'll put you on a solid cast but you'll at least be more motivated to stay on an air cast and crutches... Good luck - I hope you're back running soon!

11/02/2012 3:03 AM  
Anonymous Anonymous said...

Hi, about 8 months ago I was diagnosed with some ligament tears and a cuboid stfx after a long jump (i'm flat footed). A few days ago, I was playing soccer with my friend, and we were playing barefoot. The ball hit the center of my foot, but for some reason I have pain mild pain on my cuboid and under my foot. I am able to run with minimal pain in the beginning to no pain after like 30 seconds, I ran a mile twice this week with insoles and there was minimal pain in the first 30 seconds. I can even run barefoot with very little pain. There is no swelling and the minor tenderness is from me pressing on it to check for tenderness lol, but I'm worried I might have a re-fracture! I'm only 13 and I love sports. PLEASE TELL ME WHAT THIS IS!!

11/04/2012 4:43 PM  
Blogger Sub said...

Hey, From your description of what's going on I don't think it's likely you've re-fractured your cuboid. Just take it easy for a week or so and ice the area... If there is substantial pain during any activity stop right away. If the pain gets worse and does not go away in three weeks or so you might want to see a doc. Good luck!

11/04/2012 4:50 PM  
Anonymous Jj said...

Ok, what would you say are the symptoms of a cuboid stfx. Even though I had one, I'm not sure if I noticed them because i tore many ligaments and had bruised metatarsals. So i couldn't even walk. But as of now, i can run with slight pain. Thanks! As I said I'm only 13 and love sports. So i love martial arts, northern shoaling. I can move might foot around and kick the air easily. So yeah symptoms of a cuboid stfx would be great!

11/05/2012 7:19 PM  
Blogger Sub said...

The symptoms are pretty much what I have described in this blog post. In general with a sfx running would be painful and would get worse as you run on it.

11/05/2012 10:18 PM  
Anonymous Anonymous said...

I also am getting pain in my heel. It was hurting for a minutes, while running then it stopped as i said before. Thats the only area now hurting. Do you mind looking at the symptoms again and re assuring me it isn't? I mean I ran a mile with most of it painless. Again, I'm only 13, and don't want to be in crutches! I wear insoles btw.

11/10/2012 10:50 AM  
Anonymous Anonymous said...

Anyone? Please answer!

11/14/2012 4:01 PM  
Blogger Sub said...

You should get your mom to take you to a doc or see the nurse or coach at school. I doubt anyone can say for sure online...

11/14/2012 4:23 PM  
Anonymous Anonymous said...

I am going to see a doc on Tuesday. But before I go, can you tell me the amount of swelling you see with the STFX? And the pain the amount of pain you get when you press on the injured area.

Thanks!

11/15/2012 5:15 PM  
Blogger Sub said...

A reliable symptom of a sfx is that the pain is localized along the bone i.e. if you press a spot on the bone it hurts. The pain gets worse with activity such as running (muscle issues can get better when warmed up). Swelling may or may not be present with the sfx. Hope your doctor's visit goes well and you're able to get back to stuff you like to go. Good luck!

11/15/2012 5:30 PM  
Anonymous Anonymous said...

Hey guys,im not a runner I'm a hockey player I am captain an got a cuboid fracture playing volley ball the first doctor said 2 weeks then we went again an a week later an another said 6 its been almost , feel nothing except a little aching sometime so I really want to get going again I have to watch all the time what should I do

11/21/2012 10:12 PM  
Anonymous Tropicalrunner said...

Hello, I wen't to my Orthepedist yesterday, and was diagnosed with a bone bruise in my cuboid/5th metatarsal area. Is there any chance this can turn into a stfx??

11/22/2012 9:15 AM  
Blogger Sub said...

@Anonymous: You're going to have to ease back to the level you were in before the sfx. After 4-6 weeks you could try to gradually test the recovery. If you're in a boot you're going to want to give it some time without the boot before getting back to hockey. Try walking 5-10 minutes (increasing the time interval gradually). Ice after activity. Good luck!

11/22/2012 12:50 PM  
Blogger Sub said...

@Tropicalrunner - Did you ask your doc the same question? Marrow edema is the stage before a sfx. So if you continue to apply the stress it will convert to one. Ease back things a bit. Cutting miles, running on softer surfaces, taking more days off during the week and icing after runs. Good luck!

11/22/2012 12:53 PM  
Anonymous Tropicalrunner said...

Thank you sub, for your reply and hope you had a great thanksgiving, yesterday, I was playing with a friend, we were just trying to keep the ball in the air and i stepped back and felt pain in my heel, after my doc told me i had a bone bruise, I am worried this has turned into Stress fracture. Does Cuboid stfx require crutches? Do you think I have a stfx?

11/22/2012 4:29 PM  
Anonymous Tropicalrunner said...

Also, the doctor said it was a bruise, he didn't say bone bruise so i'm not sure if he meant bone bruise, because I got this pain from a trauma 3 weeks ago, then of course it got worse yesterday when playing with a friend, so I'm wondering if this is now a stfx

11/22/2012 4:33 PM  
Blogger Sub said...

Some docs put a patient on just a boot for a sfx, others put them on crutches (which is more prudent). Let your leg settle for a week or so (ice it) and see if the pain re-occurs. If it does and is worse than it was when you went to the doc the first time around, get checked out again. Good luck (does not sound you have a sfx)!

11/22/2012 10:23 PM  
Blogger Megan Wordelmann said...

Oh my goodness, I am so happy to have found this!!! Thank you so much Sub for all of your help and encouraging words. I was just diagnosed with a cuboid sfx and put in a boot. I trained for and ran the Philadelphia marathon (with no particular pain, thankgoodness), and the pain began a couple of days later. It was much worse when I tried to run. Anyways, I'm really very nervous about losing my fitness level and gaining weight (my dr said no elliptical or biking for 4 weeks), but your advice reminded the logical part of my brain that it's better to heal completely now, and then be able to rebuild (hopefully quickly?) from there! But I have to ask if anyone has gained a lot of weight...or if they have suggestions for cardio (non-pool) that I can do?
Thanks again! This was a God-send!

11/27/2012 7:08 PM  
Blogger Sub said...

Hey Megan, Congrats on Philly - I hope you had a great race! As much as it sucks to get a sfx, in the scheme of sfxs, this is probably as good a time to have it as any. You've just been through a long training cycle and you're anyway going to want some time to recover mentally and physically before getting back to it again. Don't worry about any weight gain. The loss of fitness will be minimal and you should get back to where you were in about a month after you get back to running (as long as you are good about allowing this to recover - very difficult to do!!). I was going to recommend swimming or pool running but that's not going to work for you... Enjoy the holidays and come Jan you'll be ready to hit the roads again - good luck!!

11/27/2012 11:44 PM  
Anonymous Theathlete222 said...

Hi Sub, I like Tropicalrunner was diagnosed with a bone bruise the other day, and today, I was playing a game with a friend, and I felt pain at the back of my heel. The difference is, the bone bruise I got, was closer to the 4th metatarsal, and this one was near the calcaneus and ankle area, but still on the cuboid. Can you tell me if this converted into a stfx? Thanks

11/30/2012 3:06 PM  
Anonymous Theathlete222 said...

Also, some pain is coming from the back of my calcaneus, but i can still run on this.

11/30/2012 3:07 PM  
Blogger Sub said...

Hi Tropicalrunner, Probably not a sfx yet. If this is indeed a sfx the pain level would increase as you run (and progressively get worse). You'd feel localized pain along the bone. Let this rest for 2 days to a week. Ice the area as well. After that ease up your workload. Don't run though pain. If it does not get better of course get checked up again. Good luck!

11/30/2012 4:09 PM  
Anonymous Anonymous said...

Hi sub, merry Christmas! Last night, on christmas eve I was walking on the side of my foot for just like a little bit and i felt pain. Now I feel pain on the bottom of my cuboid. No swelling, no bruising, I sometimes get pain when running, sometimes I don't get any pain. Walking does not give any pain at all. I have tenderness right over the spot. So could you tell me whether this is just a sore cuboid, bone bruise or stress fracture. Hoping for good news, because I am in Puerto Rico vacationing!

12/25/2012 4:54 AM  
Blogger Sub said...

Hi, This does not sound like a sfx. If it were a sfx you'd have gotten to the point where you'd have had to stop running because the pain would continue to get worse... If this does not get better with rest/continues to get worse do get it checked out. Enjoy your vacation and Happy new year.

12/30/2012 6:40 AM  
Anonymous Ted said...

Hi Everybody,

I just encountered this blog after searching for cuboid stress fractures. I ran my first half marathon yesterday and finished well in 1:42 with no pain (other than tired legs etc). Later that day, I realized my left foot was killing me! Today I got up to go to work and really struggled to walk the 1/2 mile to my bus stop. I've self diagnosed a cuboid sfx, as my fifth metatarsel feels perfectly fine when i grab it, but when i poke into where the cuboid should be its very tender and hurts to walk.

I'm heading to the doc tomorrow to get a professional opinion. I've never had a sfx before, even though I ran track and field for a division I college, although I did long jump and very short events.

My question is do you think I can still ride my road bike? I am an avid cyclist and am signed up to do a half ironman in early May. I know I can still swim, running is out of the question, but any thoughts on cycling?

It makes sense that I hurt my foot, as the longest run before the half marathon was only around 8 miles. I guess I need to train a bit better next time!

2/04/2013 6:14 PM  
Blogger Sub said...

Hey, Congrats on your first half! If you indeed have a sfx if will be safer to not bike for 2-4 weeks. Besides biking in a boot might not be much fun. That said you might just be very sore from your run and may not have a sfx. If that's the case in 3-7 days your soreness and pain should go away. Good luck!

2/04/2013 6:58 PM  
Blogger nitsua said...

hey, hate to beat an old topic. i've read all the post on the cuboid and have my on questions. i'm probably just being stubborn and should sit out but being stubborn is a good running quality, right? here's my issue. 6 miles into an 11 mile run my left foot started dull ache, mostly when turning(gradual turns, road running). i kept on and my mile 10 pretty bad pain... tough to walk that night but 50% better the next day. 3 days later, and ever since zero pain. i've done no running since incident but have worn nothing but my shoes and done all of my other daily activities 100% normal. i've even kicked the soccer ball lightly with kids. when incident occurred i thought i was done, but quickly after there was no pain. i never had swelling or discoration. i never felt the need to take meds... i have a 9.3 mile race sat that i'd like to run with my wife just for fun. would that be stupid? i was assuming stress fracture but now possibly not?

2/07/2013 10:11 AM  
Blogger Sub said...

Hey,

The only definitive way to know would be get checked out for a sfx. Alternately, you can try a test run before the race. Pick a soft running surface (grass, dirt), run for 2-3 minutes. If it does not hurt try getting in 2 miles odd. If it were a sfx you'd probably have to stop (or run through pain - which you shouldn't)... If it hurts you're probably going to make it worse by running 9 miles and it will take that much longer to get back to running after the race. You'd have to take a call on whether the race is worth say not being able to run for a month or two.

Hopefully, it's a minor niggle and you're good to go.

Good luck!

2/07/2013 12:25 PM  
Anonymous Anonymous said...

Hi, just needed an opinion on what you think of what happened to my foot. On tuesday, this kid threw his backpack at me and I stepped on my foot hard. I was wearing insoles though, custom made ones for my previous cuboid stress fracture on May 9 2012. I have fully recovered from that, but from that incident I am having cuboid pain and am worried its a recurrence. Could you state your opinion on what this is? If it's a sfx or a bruise. Thanks!

2/09/2013 10:15 AM  
Blogger Sub said...

Hi, Hopefully it's just a bruise. Ice it and take it easy for a week or so. If it does not get better see a doc and get it checked out. Good luck!

2/09/2013 4:25 PM  
Anonymous Anonymous said...

Im in some serious pain right now and I think that it is my cuboid. I started running 2 months ago to prepare for my recruit training for USMC. Funny thing is, I hurt it in my sleep a night ago caused by bad positioning, but i thought it wasnt much to be worried about. Then we had to do our IST test the morning after that night which was yesterday. Ran 1 1/2 miles in a bit less than 9 minutes (decent time I think) and was still fine after that, until I went to sleep. Woke up with a throbbing pain on my right cuboid 2 hrs later, which is right now and still hurts like hell. Not really sure what to do other than getting it checked out later in the morning but its a sunday. I read on here that it will take 4-6 weeks hopefully til it heals which is not good at all for me since I get shipped to bootcamp in 2 months. I hope that I diagnosed my self wrong and that its only a pinch nerve, otherwise it might take longer time to heal and ky shipment date might get canceled and move to a later date. :(

4/07/2013 2:43 AM  
Blogger Sub said...

This does not sound like a sfx. Try icing the area and taking some ibuprofen. See if it improves in a week or so with this. Even if it were a sfx you could always keep up your fitness with pool running while it heals and be ready for boot camp. Good luck!

4/07/2013 11:15 AM  
Blogger Viper said...

wow what a blog - i almost started crying reading this but i am fearful i am in the same boat with everyone. developed my pain the day after a 50 miler in Virginia (Bel Monte). Pretty sharp pain during walking, almost considered it on the lower, outside of the foot. Didn't think it was a sfx because there was no swelling, no discoloration, no incident that seemed to cause it. but it has not healed well, after a few days, i started trying some jogging; ran some easy mileage last thurs thru sunday & it is not responding. have a doct appt tomorrow AM & am curious to see what he says.

odd thing is, foot is fine in many movements, even is fine going upstairs, being on the ball of my foot, but anything flat-footed, walking can be quite painful at times, really sounds like the cuboid pain you guys describe in the above posts. i've probably been averaging 10-13 miles a day for the last 2-3 years, so if i am laid up for weeks things might get ugly!

4/29/2013 3:43 PM  
Blogger Sub said...

Yeah - a cuboid sfx would well match these symptoms.

Good luck for your doc's visit tomorrow! I hope you don't end up being grounded from running and it's not a sfx... I can imagine how tough it will be for you to have to take time off but it's better to find out than prolonging the recovery.

4/29/2013 4:26 PM  
Anonymous Anonymous said...

Dang, I love you all. Just saying thanks for the extensive posts here.
Just diagnosed with cuboid avulsion after a gorgeous, awesome, easy half marathon. Sigh. It was a beaut.
Felt like a sprain post race, iced and carried on. It honestly doesn't hurt hardly at all at day 17. Just a nag.
Got diagnosed 12 days post race by regular X-ray and got me a boot. Waiting to see a super star foot orthopod in 8 days. Hoping to hear good news!
Anyways, fingers crossed to be back running by July. I'm using a recumbent bike with my boot on now, as I am going crazy without my runs!
Thanks again! Sandra D

5/15/2013 5:13 PM  
Blogger Sub said...

Congrats on the great half marathon Sandra! Sounds like you're doing all the right things and are well on the road to recovery... I'm sure you'll be back on the roads by July. Good luck and wishing you a speedy recovery!

5/16/2013 8:43 AM  
Blogger Allison said...

Hi everyone,

This blog is great. I'm happy to keep the possible cuboid stress fracture discussion going. Haha

I completed a Tough Mudder on Saturday. I did it on minimal running training, as I had been focusing on weight lifting, spinning and teaching BodyPump. I think the lack of running may have been a (huge) factor. In any case, during the actual Mudder I didn't experience any foot pain or potential injury moment. The night of, I was sore all over but no specific foot pain. The following day, I started getting sharp pain in the lateral part of my foot, in the cuboid area. I thought it was related to my flip flops, but it definitely got worse with walking/putting weight on it. I've been icing it at night. There is no other pain really, except after long periods of walking. If I press down on the cuboid it is tender.

I went for an x-ray yesterday, and have to wait for the results until today. They did inform me that X rays often don't show the fracture until 2 weeks later. I think I will be getting a boot today, because no matter what they come back with, I've had zero improvement since Sunday. Plus I'm in Canada, so any further tests will take forever, and I believe it is best to be proactive and get the boot if it sounds just like a stress fracture. I just worry about recovery time as I teach Group Exercise classes at the gym! Not only will I lose gym time, I will lose money. Lol

Hope everyone else has recovered well!

7/03/2013 9:38 AM  
Blogger Sub said...

Hey Allison, Congrats on finishing the Tough Mudder! From the sound of things you may not have a sfx. The pain from a sfx is usually immediate. Being proactive with a boot will do you no harm for sure :) After all you may have a sfx and the x-ray may well not show it even after 2 weeks. Only an MRI will confirm for sure. Good luck getting back to things!!

7/03/2013 1:29 PM  
Anonymous Anonymous said...

Yesterday, I had an x-ray and have been diagnosed with a cuboid fracture. I was put in a cast and using crutches.

I felt cuboid pain about 4 months ago and the pain went away then came back until last week when I decided to massage my foot and make it better. Then since my massage I was not able to walk on that food again, which prompted me to go to the doctor and sure enough I now have a cuboid fracture.

The question I have - is it normal to have pain around the cuboid while wearing my cast? I hurts a lot and I take Ibuprofen to stop it from hurting. At the rate the pain is going it sounds like it may never heal...

My other question is - while I sleep my foot jerks and the tendons and ligaments contract while I sleep and find myself that I move my foot and it hurts the cuboid. This happens only to my injured foot and when I am asleep. This jerking movement has happened since I first injured my cuboid a few months ago.

My last question, since I have had this injury for 4 months, how much damage could have been done since I did not have the cuboid in crutches? Mind you the pain came and left and was able to walk fine before with just a bit of pain.

Your help is much appreciated. Carol.

7/05/2013 10:45 PM  
Blogger Sub said...

Hi Carol,

If I read your comment correctly you have a cuboid 'fracture' and not just a *stress fracture*. A fracture is a complete break so the pain is to be expected. Do check with your doctor before taking ibuprofen (since it's believed by some to impede bone healing).

If indeed you have a complete fracture you probably aggravated your injury in the 4 months and thus prolonged your recovery period.

I know it seems pretty demoralizing at the moment but you'll have a complete recovery! As difficult as it is, you'll need to be patient. Find new activities to focus on while you heal. You'll be back mentally and physically stronger from this injury!

Good luck with your recovery!!

7/08/2013 11:41 AM  
Anonymous Anonymous said...

Just and update on what was thought to be a cuboid fracture. I just saw the doctor and he said it is not the cuboid. It is the sesamoid bone next to it. He could not see a fracture. So he gave me an option to keep the cast on for 2 more weeks or not. I chose to keep it on for 2 more weeks. He also mentioned that it is soft tissue damage and maybe my ligament was affected.

I do not know if I chose well to keep the cast on for 2 more week. I felt this doctor was disinterested and I was like a production line. In and out. Not sure what to do...

Do I keep some weight on my foot or not. Do I just keep it elevated and do nothing...

The pain is unbearable. Does the sesamoid hurt this much?!

He did not order an MRI either...
Carol

7/19/2013 2:27 AM  
Blogger Sub said...

That indeed sucks :( Not knowing what exactly is going on isn't very helpful! Would your insurance cover a second opinion from another podiatrist? If so maybe you should do so. If it's a soft tissue issue then a doc might be able to refer you to some PT sessions to speed up the recovery. If this does not heal up soon you should insist on an MRI! Good luck!

7/19/2013 5:30 PM  
Anonymous Anonymous said...

Hi Sub, I was just practicing soccer in my house when i did a sort of a move, and I felt my the back of my cuboid sort of pull. Ever since, I have been having pain at the back of my cuboid bone (this happened last night). I had a cuboid stress fracture last year in May, and recovered after going to a physical therapist. I just finished with him and am still doing calf excercises. But now I'm afraid this could have been a recurrent stress fracture. Would like to get your opinion on this before I ask my parents to send me back to the doctor because I am going to a Red Bulls Soccer training program. So thats the jist of it.

8/04/2013 8:09 AM  
Anonymous Anonymous said...

Sorry, I meant to say that my red buls prgram begins on august 18 and don't want to go to a doctor because my parents will cancel the program.

8/04/2013 9:31 AM  
Blogger Sub said...

Hey, This does not sound like a sfx rather a soft tissue/muscle issue. You do have a couple of weeks before soccer training starts. Give it a week and see if it improves. So for 1 week stay off it, do the stretches your PT gave you, ice the area, take ibuprofen twice a day. If you see no improvement in a week go see a doc. If it's gotten better keep at it till it heals.

Good luck! I hope you have a fun soccer training season!

8/04/2013 3:24 PM  
Anonymous Anonymous said...

Looks like I read your comment slightly late, because I went running and playing soccer with my friends yesterday, but thank god my foot was fine. But then when I came home my legs were aching, and my dad pressed my laptop onto my legs with his whole wait, and after that, when I walked, the back of my cuboid near the cuboid-calcaneo joint aches and kinda hurts. Could it be a stress fracture now? Or is it just strained?

8/05/2013 7:54 AM  
Anonymous Anonymous said...

Actually now, it's turned into an ache next to my cuboid not on it, and the pain near the joint is gone for now, and the ache is tolerable it's like a muscle ache or something, my whole body has been aching since yesterday, since we played for three hours. I think if I rest my body for a few days the aches will go away otherwise I will go to a doctor. If you think it's a sfx now, then I'll go to the doctor.

8/05/2013 9:43 AM  
Blogger Sub said...

This appears to be a muscle/soft tissue inflammation to me. I'd let it rest as I mentioned in my previous post. See a doc if it does not get better with rest. Good luck!

8/05/2013 10:18 AM  
Anonymous Anonymous said...

Ok thank you so much, I'll try to rest! Thank you!

8/05/2013 10:57 AM  
Anonymous Anonymous said...

Hi sub, today about 30 minutes ago, I was with some friends, playing with the ball. When I was about to kick the ball, my friend came and accidently kicked me really hard at the bottom of my foot. I have had a stress fracture on my cuboid before, and I'm hoping he hasn't caused it again. Luckily I had insoles and shoes on so it took some socks. I'm really scared and don't want my summer ruined again!!

8/08/2013 5:33 PM  
Blogger Sub said...

Hi, Ice the area and keep off it while it hurts. If there's swelling take some ibuprofen. Hopefully it will get better soon. See a doc if it does not get better in a week. Good luck!

8/08/2013 8:49 PM  
Anonymous Anonymous said...

But does it sound like a fracture or stress fracture? Or a bruise. Also what do you mean buy keep off it?

8/08/2013 9:43 PM  
Anonymous Anonymous said...

Also, there's no swelling/

8/08/2013 9:47 PM  
Blogger Sub said...

It's probably a bruise but you will have to see how it recovers to know for sure. By keep off it I mean don't run or play through pain. Allow it to recover and don't cause more damage. If it does not recover see a doctor.

8/08/2013 11:12 PM  
Anonymous Anonymous said...

Do you know how bad tenderness along the cuboid is during a sfx? And how bad the pain is? Also, is there usually any swelling?

8/12/2013 6:28 AM  
Blogger Sub said...

The tenderness tends to be localized to the point of the sfx. The pain really isn't something quantifiable and depends on your pain threshold. There may or may not be swelling initially. You should see a doctor to get definitive guidance.

8/12/2013 10:57 AM  
Anonymous Anonymous said...

Hi, I have pain under my cuboid after trauma. Any ideas? Not too bad, but just worried, because I;m going to do a lot of running next week,

8/13/2013 2:01 PM  
Blogger Sub said...

Hey, Assuming that this is a soft tissue issue/inflammation, try the usual stuff to manage the injury - ice, anti-inflammatories, PT time (if possible). Good luck for next week!

8/13/2013 2:51 PM  
Anonymous Anonymous said...

You don't think this is a stres fracture though?

8/13/2013 4:38 PM  
Blogger Sub said...

Based on what you've written here it's quite impossible for anyone to tell if it might be a sfx...

8/13/2013 5:15 PM  
Anonymous Anonymous said...

Well it's not swelled up, tenderness is minor if any, and pain may also be at the very back part of the cuboid.

8/13/2013 6:01 PM  
Anonymous Anonymous said...

Hello,
Not so sure why but do to prolonged weakness in my calf from a full foot fracture last year, I'm having pain near my cuboid. Unfortunately I am unable to distinguish it from the cuboid and peroneal tertius, could you help me distinguish this? Thank you

9/02/2013 6:49 AM  
Blogger Sub said...

Hello, It can indeed be tough to distinguish between the two and I have no suggestions to offer. Hopefully, a PT or Podiatrist can help. Wishing you a speedy recovery!

9/03/2013 5:26 PM  
Anonymous Anonymous said...

Hey, about 1.5 months ago I was dancing outside while barefoot (drunk, whoops) and the next morning had a good bit of foot pain that lasted a week. I figured I rolled my ankle and didn't remember. Then a few weeks later jumping barefoot on my tip toes irritated it again. Since then it's been bothering me almost every day. I'm an avid runner, training for a half ironman in a month, and strangely it doesn't hurt when I run, only when I walk. I haven't dared to do anything on my tip toes. It's sharp pain on the outside of my foot, around/near the bottom of my ankle. Think it's a cuboid sfx?

9/10/2013 6:48 PM  
Anonymous half ironman trainer said...

To add to my previous comment, no swelling or bruising noted, as well as no tenderness whenever I try pushing on diff parts of the foot.

9/10/2013 6:50 PM  
Blogger Sub said...

Hey, Does not seem like a cuboid sfx. You would not have been able to run through it. It would hurt on heel strike. Though running might be aggravating it. Once you're done with the HIM it might make sense to layoff the running for a week or so to see if that helps. Good luck!

9/11/2013 1:47 PM  
Blogger VAGuy said...

hi. during a run twisted my foot (turned it on the outside. not the ankle. Went to ER - xrays showed no farcture. went home with crutches. wen to podiatrist, agreed with xray and given a brace. pain didn't get better and got an MRI (8 days out) and came back as diffuse moderate edema in distal lateral aspect of cuboid. there is no definite fracture. then in conclusion: contusion and/or stress reaction within the cuboid.

went back to podiatrist and put in walking boot. during those 10 days I did try to cycle and spin.

podiatrist is calling radiologist to find out if it is a fracture or not. dx seems kind of vague.
stress reaction or contusion means how long in my boot? I am going to swim and try not to push off too hard.

can I cycle, elliptical? dr. said do anything that doesn't hurt. most things do hurt. maybe do them in the boot???

will a contusion and/or stress reaction heal faster? follow-up appt. is in 3 weeks to discuss getting out of boot.

any advice, thanks

10/25/2013 5:51 AM  
Blogger Sub said...

Hey, Given that a stress reaction is not a fracture (the stage before it) it should heal faster - perhaps within 3 weeks. If cycling or the elliptical is hurting don't do it - play safe (it will just prolong your healing and you'll end up loosing more time/fitness). Good luck with your recovery!

10/25/2013 4:49 PM  
Blogger VAGuy said...

hi. quick follow-up. podiatrist called imaging center and spoke to another radiologist and they looked at the film. confirmed it's a fracture.
one question - i am in a walking cast - should i go to an orthopedist to talk about a hard cast? no way can i do the crutches thing.

what time are we looking at now! ouch!

10/27/2013 7:36 AM  
Blogger Sub said...

Hey, I assume by walking cast you mean an air boot. For a cuboid sfx I don't think you'll get more value from a fixed cast. No harm checking with your orthopedist though.. Crutches OTH may be helpful. They will keep you off your foot and are an awesome workout... You're looking at at 4-6 weeks to heal and another 6 weeks to gradually build up to running a normal load...

10/27/2013 7:45 PM  
Anonymous Anonymous said...

In September 2012, my 6 year old broke his 2nd, 3rd, & 4th metatarsals and bruised his cuboid. He healed and we moved on. This year, in September, for no apparent reason, he would wake screaming in the middle of the night. We went back to the APRN who treated the break last year...she XRayed and CTscanned, but nothing came up. The pain was constant & intense. Life turned upside down as we were led down the path of different forms of arthritis and chronic pain. After 8 weeks, PT, visits to acupuncture and acupressure, rheumatology, etc. we had an MRI which showed the stress fracture of the cuboid bone. He is 3 weeks into recovery.

Don't give up folks. Don't give in. It does get better, regardless of the diagnosis. Getting the diagnosis is the hardest part.

11/15/2013 11:03 AM  
Blogger Natalie said...

Hey guys,
Firstly just wanted to say thanks SO much Sub, what a great community you have created here!
I ran the Philly marathon just over a month ago, it felt really good, and I took a week off to recover afterwards. Excited after Philly, I set my sights on running a sub-3 hr in my next marathon in April. So I started back pretty hard and 3.5 weeks into my new training cycle (building mileage rapidly) I got struck down with excruciating foot pain. 5 days later (today) I got diagnosed with a cuboid stress reaction off an MRI.
The ortho called me with the diagnosis after seeing the MRI and told me to come in in 2 days to get a boot for 2.5-3 weeks, and then I can build up slowly on the treadmill from there.
I am a little concerned about this doctor, as I'd researched before I went to the consult and so to me it seemed clear it was a cuboid problem, but on consultation (before the MRI) he initially told me it was plantar fasciatis which seemed a completely lazy diagnosis simply because it didn't look like a metatarsal fracture which is the most common other option!
I asked about riding and swimming and he told me I could spin "so long as I'm not going like Tour de France style" but I could not swim.
This seems strange to me.
I am keen to try some water running, do you think this is a bad idea? Has anyone else's doctor had an objection to them getting in the water?
Also, are his timelines unrealistic? I'm thinking of using crutches for 2 weeks just to be sure... but he seems a little overly loose in his guidelines... he actually asked me if I even wanted a boot or not... I am definitely going to get a boot!
Would appreciate your thoughts!

12/24/2013 4:10 PM  
Blogger Sub said...

Hey Natalie, Sorry to hear about your sfx. It's lucky though that you had a great run at Philly and this is towards the beginning of your next training cycle. Pool running should be fine and would help you maintain your fitness level. Crutches for 2 weeks is a good idea. I think the sfx would take atleast 4 weeks to heal. Don't run through pain. Try a test run and if it hurts back off for another week or two. Merry Christmas and good luck!

12/24/2013 10:03 PM  
Blogger mediumlatte said...

After five weeks of "it's not a stress fracture", an MRI shows "possible stress fracture of cuboid bone." I never wore a boot, because after three days, when I saw a doctor, I had no pain with walking, and he didn't think it was a stress fracture. I had tried running after one week and after three weeks, but developed mild swelling of my sole. Hence, the MRI. I actually started running 3 and 4 miles after 4 weeks before the MRI without pain, though I got an achey sole two days later. Doc says wait three more weeks, at least. I'm so disappointed, but I guess I should not rush this.

How many weeks did you take off before starting to run again, and when you did, did you do the whole 9-minute walking, 1-minute running thing? How quickly did you advance?

2/08/2014 5:26 PM  
Blogger mediumlatte said...

After 4 weeks of "it's not a stress fracture", MRI now shows "possible cuboid stress fracture" which I guess means it might be a stress reaction. I tried running at 3 weeks which felt okay, but got mild sole swelling and pain the next day, which prompted the MRI. After 4 weeks, I was actually ran 3 and 4 miles with absolutely no pain, but got a tiny bit of swelling of my sole two days later. Then I got the MRI result and the doc says no running for three more weeks. I never got a boot because it didn't seem like a sfx and was walking without pain after 5 days. My question is how many weeks did you wait before starting to run, and when you started, how gradual did you make it? I've seen "9 minute walk, 1 minute run" which seems like a snail's pace, but at the same time, I don't want to reinjure myself. Thanks!

2/08/2014 5:37 PM  
Blogger Sub said...

For me it was four weeks of no running. This starts from the point when you STOPPED running. So unfortunately the time you've already spent is reset. After that I started running very gradually. So a day of running followed by two days of not... Starting from 1 mile and increasing it gradually. If it hurt I backed off. Patience is key - you don't want to reset the clock! Good luck and wishing you a speedy recovery!

2/08/2014 5:41 PM  
Blogger mediumlatte said...

Thanks so much for your reply - I know that everyone is different, but it's comforting to hear from someone who has made it through this. There's really not much evidence based medicine out there on stress fractures, so anecdotes are all we have, it seems. I will try my best to be patient and try to keep the big picture in mind. Thanks, again.

2/08/2014 5:55 PM  
Anonymous Sarah said...

I have just been diagnosed with a cuboid stress fracture due to overuse from running... What types of exercise can I still do ? I am not that strong of a swimmer but can try if that's the safest.... Otherwise biking? What about bikram yoga?

8/13/2014 2:01 PM  
Blogger Sub said...

Swimming and pool running will be the best options. For Bikram about 50% of the postures would be a no-go. Anything putting load on the cuboid would be a no-go like the balancing stuff... I would not bike for the first 4 weeks just to be safe.

8/13/2014 2:44 PM  

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