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The subject is a 35 y/o male who skateboards daily, for the last 25 years.
X-ray report notes an osteophyte on the inferior aspect of the cuboid at the calcaneo-cuboid joint of the right foot , the trailing foot.
What would the likely etiology be and what symptoms would such lesion result in?
Any responses appreciated, mark

 

Would an osteophyte on the inferior aspect of the cuboid at the C-C joint limit plantarflexion of the cuboid on the calcaneus and / or be painful if any such force was applied? A contra-indication for an external longitudinal arch?

 

Maybe the osteophyte would limit motion. However, since you have the patient, try and plantarflex and dorsiflex the forefoot on the rearfoot and see if the motion is limited.

If she skate boarded involved the foot hanging over the edge of the board so that the board edge was at the cuboid then it could be possible that skateboarding caused the osteophyte. If having a foot hanging over the edge of the board hurts, then any rigid orthotic could help eliminate the point pain.

I usually try and cast the foot with the midtarsal joint in a position where it is dorsiflexed to resistance. I'm having a hard time seeing a reason to add lateral arch height by plantar flexing the forefoot on the rearfoot when casting. An intrinsic forefoot valgus post is a different issue. It will add arch height but the contour of the orthotic at the cc joint should still be the same. The intrinsic post should be done distally. This is just my opinion, and I haven't tested it rigorously. The logic is that you want to support the lateral forefoot in a position where the ligaments are loaded when the foot moves into propulsion.

Eric

 

Thanks Eric, he's 300km away but we can do this, i've got him in heel raises (and off the skateboard) to reduce the load in the achilles tendon as he c/o posterior heel pain also, mark