♪ Bob and Brad ♪
♪ the most famous ♪
♪ physical therapist ♪
♪ on the internet ♪
- Hi there folks, I am Bob Schrupp, Physical Therapist.
- Brad Heineck, Physical Therapist.
- Together we have the most famous physical therapists
on the internet.
- In our opinion, of course Bob.
- I have a foot to stand on, Brad.
(Bob laughing)
Today, we're going to talk about
pain on the outside of my foot
an easy self-treatment to try.
- That's what I like to hear.
Something easy, Bob.
- Now, the reason I head down this path, Brad
is my wife was having pain on outside of her foot.
It turned out it was something else.
It was not this.
- Right.
- But I thought, well, I studied up on it.
- Oh, you did?
- Yeah.
- You just didn't pull it out of your back pocket.
- No, I didn't.
- Your wife must be,
she's probably gonna give you a back rub, or something.
- She's my inspiration.
- That's right.
- By the way, if you're new to our channel,
please take a second to subscribe to us.
- Oh.
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We don't know giving away, do we?
Yeah.
- Well, but they can just look.
- Go to the giveaway section, go to Bob and Brad.
It's a Saturday video which means tomorrow
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- Right, so you can figure that out tomorrow.
- Yeah.
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but, we got some outstanding experts we're interviewing.
- That's right.
- So, don't miss a one.
- So there's a lot of things that could be causing pain
on the outside of your foot.
This is just tell one of them.
- Maybe you should tell them
what that is you've got in your hand.
- This is a foot.
(Bob chuckling)
- Yeah. So we've got the bone structure,
the skeleton of a foot.
- And there's 28 bones in the foot, did you know?
- Well, I'd have to count.
- You want to count them?
- No, I believe you, Bob.
- All right, and there's lots of ligaments and tendons.
And so a lot of things can get hurt,
but what we're going to talk about today
is cuboid syndrome.
- The cuboid is a -
- A specific bone.
- Okay.
- Kind of a square shape cuboid.
- And we're going to show you exactly
where it is on Bob's foot.
- Yep, and we're going to show it to you on this too.
- Yep.
- But signs you might have cuboid syndrome.
You have a sharp pain on the outside of your foot,
maybe the underside of your foot a little bit.
- So when you, with weightbearing, I'm assuming.
- Yup, with weight bearing.
- It's be right over her, that'd be the outside.
- Yep.
And you also may try to walk with your foot turned out
because it's more comfortable.
- Oh so, you're putting more pressure on the medial
or the inside of a sole.
- On the inside, yeah.
It occurs with people with flat feet
and after ankle sprains, it's very common.
- Sure, sure.
- Did you know that, Bred?
- No, I did not know that.
- We are talking about, you can walk on uneven ground.
- That makes a lot of sense.
- But the ankle sprain makes sense to me too,
'cause that could throw the cuboid off.
- Sure, anytime you twist
or mobilize that ankle.
- Brad, I'm gonna you grab the pen,
'cause I'm going to have you point out
the different bones here.
So, we got the bones.
This is the outside of the foot.
Now this right here is the fifth metatarsal.
- [Brad] So that's a long narrow bone
and it goes right up to the pinky toe,
the smallest toe, the fifth one.
- [Bob] I've seen people develop stress fractures
in that by the way.
- [Brad] Right, yep, there's one that
where the peroneal tendon connects up there.
- [Bob] Oh yeah.
- [Brad] And there's a name for that, but I can't think
of it right now, but that's another story.
- [Bob] Peroneal tendonitis, isn't is?
- [Brad] Well, for the fracture there.
- [Bob] Oh, for the fracture.
- [Brad] Yeah, don't worry about it.
(Bob mumbling)
- [Bob] All right, then the cuboid bone.
can you see that?
- [Brad] Yeah, so it's actually,
it's an odd shaped bone.
You really can't see -
- [Bob] Well, cuboid means square, doesn't it?
- [Brad] Yeah, but, you gotta use your imagination -
- [Bob] It's not completely square.
- [Brad] But it is, it attaches to actually the fifth
and the fourth metatarsal and also to the -
- [Both] calcaneus.
- [Bob] And that's what we want to show too
is the calcaneus, which moves,
especially in this rotational fashion.
- [Brad] Right.
- [Bob] And it can also abduct and adduct.
- [Brad] Probably not that much, but a little bit.
- [Bob] Not that much, right.
Now this bone, this cuboid, can get pushed up.
I don't know if we can do that at all here.
There we go.
- [Brad] It's not necessarily a large distance.
- [Bob] No, no.
- [Brad] You may see it, but probably not.
- [Bob] I'm exaggerating this,
or it could get pushed down kind of -
- [Brad] Sure.
- [Bob] Subluxed down or subluxed up.
So, we're gonna work on is actually,
we're going to wiggle it back and forth.
- [Brad] And just try to get,
cause it wants to go back into place.
- [Bob] Yeah, it wants to go back into place,
very good way of saying it.
- [Brad] And if you get the right pressure
in the right direction,
it'll probably just kind of pop and you'll know it.
It's going to feel good.
- [Bob] Yeah.
So you can also wiggle the fifth metatarsal
because it attaches into there.
So, we're going to show you how to find these on your foot.
- [Brad] We're going to try to mobilize this
joint bone, this one and this one.
- [Bob] This bone, and the calcaneus.
Since that plays such a large role too,
so we're going to get that moving.
- [Brad] Right, so there's three ways to approach this
and that's what we're going to show.
- [Bob] Yep, and we want to make sure these are
all moving the way they should,
because if you mobilize the cuboid,
but this one still isn't moving, like it should,
or this one, you're still going to have pain.
- [Brad] Yep, mobilization.
- So the first thing we want to do,
is you want to make sure you test it first.
So, before you do any of this,
walk a little bit,
and just say,
oh, it what is my pain at?
Zero, ten, maybe it's a three.
- So, typically when you put weight,
and you walk through it,
that's where you're going to feel
that little spike in the pain.
Let's say it goes up to a seven over ten,
ten being the worst.
Then we're going to do a treatment, right?
- Yep. And some people can actually do this Brad,
turn their foot out, and that brings it on too.
- Sure. Yep.
- So, all right, so we've,
Brad colored my foot.
And so you can see here, the fifth metatarsal -
- Right here.
- [Bob] And you can see the cuboid.
- [Brad] Right there.
- [Bob] And the calcaneus.
So if you want to find the fifth metatarsal,
you start by the little toe and you go all the way down,
you feel a bump here.
- [Brad] Right.
- [Bob] That's the end of it.
So you can just grab onto that
with your fingers, thumb and finger.
And just wiggle it back, up and down.
Now you've got to relax the foot.
- [Brad] Yeah.
- [Bob] I'm counterbalancing little bit here too, Brad.
- [Brad] Yeah, so you're stabilizing the rest
of the fore-foot with this hand.
So you're actually gripping pretty tight here
with both hands.
- [Bob] Yep, pretty good. And -
- [Brad] You can see now,
you can't see cause the skin is there but,
there's some motion going on there
and any healthy foot there should be a little motion there
- [Bob] Yep, and you're right.
If you compare the involved side to the non-involved side
if you're good at it,
you'll be able to tell the difference.
- [Brad] Right, right.
- [Bob] As a therapist, you should develop those skills.
Now the cuboid, the same thing.
You're gonna grab onto that with the thumb.
- Can you see that?
So he's getting his thumb right over that bone.
- [Bob] And I'm going to wiggle that up and down.
- [ Brad] Yep. So, and his middle finger on the bottom side
he's trying to -
- [Bob] Push, push that bone.
- [Brad] Pinch that bone.
- [Bob] So you can do these as many as 30 times.
- [Brad] Sure.
- [Bob] That's how often you can do it.
- [Brad] Your fingers will probably get a little tired.
- [Bob] Yep, and if you want to,
you can even do both at the same time, a little bit.
- [Brad] So grab the cuboid -
- [Both] and that fifth metatarsal
- [Brad] and get some motion between them.
- [Bob] With all these,
if you have started having increased pain, stop.
I don't want,
this is not a painful maneuver.
We want to feel better.
- Right.
- [Bob] So, all right.
The last, one's a little more difficult to do.
- [Brad] The calcaneus.
- [Bob] The calcaneus.
- [Brad] Yes
- I think the easiest way to do this
is to cross your feet over.
- Yep.
- Get your ankle on your knee here.
And I'm going to pull on the calcaneus that way.
- Downward if you were standing.
- Yeah, and then I'm going to rotate it,
while I'm doing that.
- Yeah.
So yeah, if we look at that -
- Yeah, sure.
- We're trying to get that motion.
- Yeah, but we're distracted a little bit before.
- So, pulling it down.
- Yeah.
- Like you said,
this one to do to yourself is a little challenging.
- Yeah, cause you can actually do it by
putting your leg off the edge of a chair,
and you can actually pull like this
and then turn it also.
- And if you could,
if your left arm was three feet longer,
you could reach behind and -
(Bob chuckling)
but obviously that's not going to work.
- It is a difficult one to do,
but it can pay off.
- Sure. Is helpful to get that cuboid moving.
- But one of the first two,
would hopefully do it.
But then after you get done it's important to -
- You stand up again-
- Post test.
- Yep, and say, oh, it is a little bit better,
or it's not.
- Right.
- That's not what you have then maybe
it's not cuboid syndrome.
- So I'd walk the same pattern,
you walked on the pre-test, walk again.
And then, you were at a seven before,
if it dropped down to a two or a three,
you've probably mobilized it very successfully.
If nothing happened or the pain got worse,
it wasn't successful.
- Right.
And generally the cuboid is going to be tender.
I mean, you're gonna feel tenderness
when you push it up and down.
- Sure, sure.
- And it should start to feel better though.
- Right, right.
- Again, not get worse and worse and worse.
Now it didn't prevent this Brad,
you can do a calf stretches.
- Oh sure.
- Calf stretches, and you can also use
more of a rigid shoe or an orthotic.
Cause that prevents that, that bone from, you know,
it's holding that bone in place.
- Right, right.
- Let's say, for example, on your ligaments,
you have loose ligaments here
and your bone wants to move up and down
and all around, a stiff orthotic,
can you see how that would support it?
- Yep.
- And stop it from moving.
- So that's the insert.
You can buy those at online, any shoe store.
- Yep.
- Get one that's a little more rigid.
Sometimes I like to a store so you can actually feel it.
If it's rigid, semi-rigid, some are plastic.
- Yeah.
- Some are soft and mushy.
Bob, we got a little time here,
do we want to show 'em
that it could be Morton's neuroma?
- Oh, sure, sure.
- And we've got a couple of videos on that too.
- So, Morton's neuroma can be between the,
am I right?
the second and third?
- Right.
- And the third and fourth, right?
- Right.
Third and fourth, I believe but -
- It can be between either one.
- Yeah. So it's a nerve bundle.
- Right
- It's on the bottom of the foot.
- And one of the telling signs of that, Brad,
it feels like your sock is rolled up under your foot.
- Yeah.
And it can be very painful when you walk.
- Yes.
But if you follow,
you have to kind of figure out
where the the metatarsals are.
- Well, show 'em on your foot, Bob.
It's as it's barefoot anyways.
Yeah. So the metatarsals run down to here.
- Yeah.
You know, on here, and you actually
gonna to squeeze between the two.
- Yeah.
- So here's the second one,
and the third one, you go right down there,
you find it.
- Right below the pad of the foot, typically.
- Yeah, you'll find it.
I mean, if it's sore, you'll know it.
- Yeah. you hit the spot and it makes your eyes open up,
and you might even see a bad word.
- So on my wife, it was between third and fourth
and we pushed on that,
and wooh! Doggy.
(Bob chuckles)
- You know, but that's not real hard to fix either,
if you -
- We're going to do a video on that
cause I'm fixing my wife's now,
we figured out what it is and that's what we're going to do.
Brad's been guiding us on this one,
cause he's got Morton's neuroma.
- Right, but it's successfully treated.
- You managed it.
- Yeah. So yeah.
Bob and Brad and Morton's neuroma,
and we'll give you some hints in new -
- Yeah, we got some old videos if you can't wait.
- Right.
- Check out a new one within the next couple of weeks.
- There you go.
- Thanks for watching.
- Be careful.
(electronic bop)