Dr. Timothy K. Durnin - 8/29/2007

Question
QUESTION: My son recently started football practice after 6 months of training at speed camp with no complaints.  After 3 days of practice in new cleats, started complaining of left foot popping and hurting on top a little ways down from ankle. Had X-rays and MRI, shows no breaks or tears.  Dr. believes it to be related to cuboid bone and bone next to cuboid rubbing together. They first had therapist pop it hoping that would put it in place if it was out of place and that didn't help.  They Put in walking cast for 2 weeks and Naproxen. After 5 days, went back because cast was loose and  foot hurt to walk, they took off and while cast was off foot still popped and hurt and they recasted and put on crutches. Have you ever heard of this before and what is the best treatment.  Son would love to get back to playing football before the end of the season.  I would appreciate any input or help for a speedy and safe recovery.

ANSWER: Hi Kerry,

These things are quite common in adolescence. Finding a Chiropractor that specializes in extremity manipulation would be your best option. Casting only worsens the problem due to atrophy (muscle weakening), this further destabilizes the articulation (joint) and begins a vicious cycle with no end. Getting it assessed by the proper professional (Chiropractor) is paramount for your sons recovery. I suggest you go to a teaching institution and get a clinic director to evaluate him since finding a DC that specializes only in foot manipulation would be difficult. Depending on where you live, this may only be a slight inconvenience. If you need further assistance, I will need the area you live in to direct you to the proper resource.

I hope this helps,

Dr. Timothy Durnin
drs.chiroweb.com

---------- FOLLOW-UP ----------

QUESTION: Returned to doctor and requested 2nd opinion.  Got 2nd opinion.  Both doctors concur it is a bone contusion on the cuboid bone.  Put in cast for 3 more weeks.  How long do these typicaly take to heal and are there any herbs or vitamens to help speed up the healing process?  Also, should you take naproxen with a bone contusion?

Thank You!

Kerri

Answer
Hi Kerry,

The medical name for this is periostitis. It takes a long time to heal, ice it if possible and continue the Naproxin. Expect at least 3 more weeks for it to subside.

I don't like the approach they are taking with regard to a cast, but I haven't examined him either. If the bruise is on a side that doesn't articulate with a neighboring bone, than casting it makes little sense. If the pain is on the top of the foot next to the ankle, why cast it? It isn't broke. Their logic may be to protect it from getting stepped on, but if he can positively avoid this, then having direct contact with it for icing would be a faster route for healing. The cast will only atrophy surrounding supportive tissues and prevent him from direct ice. See if he can avoid casting or at least ask why they want to in the first place.


Thanks for keeping me informed.

Dr. Tim