Saturday, September 30th, 2017
Throughout the process of rehabilitation, the effects of a stroke or debilitating injuries on the body become clearer over time. Whether you’re a survivor yourself, a caregiver, or a family member attempting to help, it is import to be aware of the options out there. Decreased mobility can be especially trying for anyone already dealing with the effects of cerebral injuries, spinal damage, stroke, or other conditions.
Challenges such as gait change, a modification in the way one walks, stress on joints, and other physical impediments are common, and it takes time to maneuver the proper road to recovery. Luckily this guide can offer some helpful tips to anyone seeking more freedom and help on the road to recovery.
Foot drop, or what is occasionally referred to as drop foot, is a common issue following a stroke or other neurological injury. Foot drop is caused by interruptions in the common fibular and sciatic nerves and aggravated by the paralysis of the anterior (front) muscles of the lower leg. Those experiencing foot drop are often unable to fully lift their leg or foot while taking a step forward. Due to this weakness, the knee compensates, bending more deeply and lifting the leg higher off the ground to avoid dragging or “dropping.” This compensation creates what is referred to as a steppage gait, that can then cause exaggerated flexion at the hip and knee. While this prevents the foot from dropping (and tripping a survivor) it also creates an awkward ground reaction vector on the joints and subsequent slap of the foot as the pressure of impact is diffused by the body.
Struggles with mobility are, unfortunately, a common issue stemming from a variety of neurological impairments, but remember you can help yourself or a loved one, as long as you have the right tools.
This guide will cover a few key points to keep in mind as you’re approaching foot drop recovery:
While the root causes of foot drop are complex, the effects can often be quite clear. Men and women with foot drop complications are often unable to perform complete dorsiflexion—the flexing of the foot toward the body. Overall, there are several common symptoms indicative of peroneal nerve damage that can help diagnose foot drop. These include:
Due to the ever-expanding support tools and exercises available for lower extremity care, every caregiver and stroke survivor have options they can explore. Treatments include both surgical and non-surgical solutions, depending on the severity of the injury. Pharmacological treatments often aid in the healing process, providing support and decreasing inflammation and pain during rehabilitation.
Doctors may also recommend using treatments in tandem with one another. With dedication and a rehabilitation support system, the effects of foot drop can be mitigated.
Purpose built orthotics, foot splints, and shoe orthotic systems offer an easy to implement aid for foot drop. At a basic level, orthotics for foot drop are designed to keep feet from tipping forward so that users can have a more natural stride and experience better and safer mobility. The effects can be profound but they only offer a mechanical and simple approach for dealing with a complex problem.
Choosing the Right Foot Drop Solution
There are so many foot drop aids on the market that we recommend consulting directly with a physician and any additional clinicians you may be working with to make the best decision for your individual needs. Recovering from foot drop is complex, but it’s important to keep all the options in mind.
Qualities to Consider in an AFO Brace for Foot Drop:
The SaeboStep: One Possible Solution for Foot Drop
The SaeboStep uses unique foot splint technology that supports those suffering from foot drop or decreased foot sensation, provides an affordable and concealed option for ankle and leg care. Most importantly, those who choose SaeboStep wear their own shoes, making this a low-profile, comfort-based solution. Part of the appeal of a product like this is its high comfort, durability, and usability. Since the system integrates nicely onto any pair of shoes, someone recovering from foot drop can receive aid, without relying on bulkier and costlier solutions.
This at-home solution is particularly beneficial for those easing into the healing process with the assistance of a loved one or caretaker. SaeboStep is easy to order and has a minimal adjustment period compared to other orthotic devices that often alter the gait and balance habits of each user. It’s important to remember, if someone doesn’t want to use an orthotic, they may not enjoy improved mobility.
Individuals with the diagnoses below (but not limited to them) may benefit from using fixed and dynamic foot splints like the SaeboStep:
Orthotics are far from the only options out there. Read more below about some of the key opportunities out there for improvement.
As a foundation for rehabilitation, doctors and specialists may recommend a variety of outpatient gait training or physical therapy regimens. Gait training is a commonly used therapy that addresses the re-strengthening of muscles used in walking, balancing, and maintaining strong posture. Guided foot drop exercises may include simple repetitive movements of the ankle muscles, lower leg muscles, and feet—all with a focus on increasing dorsiflexion and re-activation of the damaged nerves and muscles in the lower part of the leg.
Frequently used to treat foot drop in those who have either suffered a stroke or are struggling with MS complications, Functional Electrical Stimulation (FES) involves sending small electrical impulses into the weakened muscles to create a contraction. Reactivation of these muscles through the low impulses encourages dorsiflexion in the correct angle, decreasing the dragging of the foot common in foot drop.
This technology is ideal for those who seek ongoing treatment outside of physical therapy. A small rectangular box is worn around the waist throughout the day. This box assists the body by sending signals into the ankle muscles and neurological pathway between the brain and muscles.
In partnership with an appropriate physical therapy regimen, certain categories of medication can aid the healing process, both by strengthening the neurological networks and by adding comfort during rehabilitation. For example, sympathetic blockers may be suggested for the common pain associated with recuperation, or in more intense situations, a strain of prescriptions that often assist those suffering from long-term pain, such as amitriptyline, duloxetine, or gabapentin are prescribed.
As with all ongoing treatments, pain-related medications should only be prescribed when it is necessary to further the recovery process.
Additional remedies are often administered to aid in the healthy progression of the damaged nerves themselves—for instance, Erythropoietin, a hormone naturally produced by the body which can lend a variety of benefits to the damaged area. With anti-inflammatory properties, and the ability to regulate stimulation and growth of the nerves (known as neurotrophic properties) this hormone is often suggested soon after the injury or stroke has occurred.
Depending on the severity of the nerve damage causing foot drop, doctors may recommend nerve or tendon-related surgeries to support the rehabilitation process. These may include nerve transfer, grafting, or nerve sutures—a procedure which connects the end of a divided nerve. Tendon transfer, for example, surgically relocates the posterior tibial tendon in an effort to aid in lifting the foot.
Ankle Arthrodesis—or the fusing of the ankle bones—is another successful procedure that often brings relief to those suffering from similar complications, more specifically arthritis of the ankle. Grafting two of the ankle bones together often relieves pain and swelling. By utilizing medical-grade plates, screws or nails, the doctor enters through the front of the ankle and compresses the bones together. Bone grafting may also be used to assist in the surgery.
Less-invasive, camera-led ankle arthrodesis is also an option for less severe cases. All surgery options should be discussed with your doctor to understand if long-term recovery would be strengthened by this additional process. Eligibility for surgery is based on age, health, and factors such as bone density. Physical therapy and support equipment is often prescribed during surgery recovery.
Gentle yet repetitive foot drop exercises aid in the at-home process of recovery as well. Progress can be made utilizing simple and common items throughout the house for maximum comfort.
Select a small round object, such as a tennis ball or orange, and place it on the ground. Next, find a comfortable chair, and sit just behind the chosen object. Lightly grip the ball between your feet and slowly lift it upward. Hold the item up for five seconds, and then gently lower it to the ground. Repeat the exercise in sets of 10.
To strengthen and stretch both sides of the legs and ankles, find a sturdy location to lean on, such as a table, wall, or strong chair. Rock forward and backward, up to the toes first—lifting the heels off the ground for five seconds—and then back to the heels, raising the toes for the same length of time. Complete this exercise in sets of six.
Choose a long portion of flexible material, such as an exercise band, towel, or scarf. In a comfortable place on the floor, extend your legs straight out in front of you. Loop the material around your two flexed feet, and gently pull the ends of the fabric toward your body. Hold this position for three sets of 30 seconds each.
Similar to the towel stretch, ankle dorsiflexion exercises are particularly helpful for those experiencing foot drop. Sit with both legs straight ahead of you on a comfortable, flat area of the floor. This time, anchor the exercise band to a stable chair and wrap the material around the top of the foot instead. Flex the ankle gently toward the body in soft repetitions of 10.
With the same resistance material or band, sit with your legs out straight once more, and wrap the material around the bottom of your foot. Hold the material firmly in your hands, and slowly point the toes. Repeat 10 times.
Lay out 20 marbles or small round objects near a container or bowl in front of you on the floor. Sit in a chair close to the marbles, and slowly move one marble into the bowl at a time using the affected foot.
The gentle recovery process should move at the body’s natural pace, and so it’s best to avoid certain exercises or habits during this time. Yoga poses that place a good deal of weight on the ankle and tendon should be avoided, as should any similar weight bearing on the ankle during exercise or rest.
While arranging a home for rehabilitation it’s important to remove any tripping or slipping hazards. Move loose rugs out of the way, and be mindful of small objects on the ground that may go unnoticed. Consider additional lighting throughout the home or fluorescent tape for stairs and hard-to-see areas on walkways.
Understanding foot drop rehabilitation is an ongoing process for caretakers, loved ones, and those experiencing post-stroke therapy. But remember, there are many useful tools and resources for foot drop recovery available. It all comes down to finding what’s best for you or a loved one. With the right combination of therapies and support, each person can find the ideal combination of treatment options.
All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.