Last week I got a call from number one son, ensign Alex Berg of the U.S. Coast Guard. He was away from his base in Portsmouth New Hampshire training in San Diego when he had sudden onset of foot pain. Using his iPhone, he sent me a picture of the location of the pain on the bottom of his foot.
He described it as sharp pain brought on by running. He was miserable whenever he had to stand for prolonged periods, a frequent occurrence in his job with the U.S. Coast Guard. Knowing his lower extremity anatomy fairly well, which is unfortunately similar to mine, I knew that his calf muscles were extremely tight. He runs duck footed and mostly on his heels.
My phone/video diagnosis was “Cuboid Syndrome”. The pain with this syndrome is well forward of the heel not quite to the middle of the foot, where there is a bone shaped like a cube. Because of the location, it is not plantar fasciitis or heel pain. The lateral side of the foot (side toward the baby toe) has a muscle that comes down from the leg (peroneus longus) dives under this bone in a groove, and travels all the way over to the base of the first metatarsal bone, (long bone behind the great toe connecting to the middle of the foot).
In Alex’s case his tight calf and flat foot caused the tendon to be overworked and constantly inflamed. It’s like his foot was saying “Hey it’s time to get out of the barn and on the road to propulsion, and you guys back in the calf won’t let me move forward. I’m going to give you something to remember!”
Thanks to my father and his vintage podiatrist training, he taught us to use a simple pad 1/8 to ¼ inch thick specially placed on the bottom of the foot to push up on the cuboid bone. This relieves the tension on the peroneal tendon and the pain can be reduced almost immediately. My son could only get thin moleskin, some kind of padding and probably duct tape, but with the help of my diagrams, his pain resolved immediately and ensign Berg didn’t have to report to the infirmary.
Amazing what we could do via phone, texting pictures, and web based learning. Of course I advise caution in treating yourself without consultation, but I do encourage learning about common foot problems before you come in for an evaluation.
Finally, it’s important to keep our country safe and that means keeping our servicemen and women healthy on the job.