Monday, June 11th, 2018
Foot drop (sometimes called drop foot or dropped foot) is the inability to raise the front of the foot due to weakness or paralysis of the muscles and nerves that lift the foot. Foot drop itself is not a disease, it is a symptom of a greater problem or medical condition.
You can recognize foot drop by how it affects your gait. Someone with foot drop may drag their toes along the ground when walking because they cannot lift the front of their foot with each step. In order to avoid dragging their toes or tripping they might lift their knee higher or swing their leg in a wide arc instead. This is called steppage gait, and is a coping mechanism for foot drop issues.
There are three main causes of the weakened nerves or muscles that lead to foot drop:
1: Nerve Injury. The peroneal nerve is the nerve that communicates to the muscles that lift the foot. Damage to the peroneal nerve is the most common cause of foot drop. The nerve wraps from the back of the knee to the front of the shin and sits closely to the surface, making it easy to damage. Damage to the peroneal nerve can be caused by sports injuries, hip or knee replacement surgery, a leg cast, childbirth or even crossing your legs.
2: Muscle Disorders. A condition that causes the muscles to slowly weaken or deteriorate can also cause foot drop. These disorders may include muscular dystrophy, amyotrophic lateral sclerosis (Lou Gehrig’s disease) and polio.
3: Brain or Spinal Disorders. Neurological conditions can also cause foot drop. Conditions may include stroke, multiple sclerosis (MS), cerebral palsy and Charcot-Marie-Tooth disease.
Treatment for foot drop requires treating the underlying medical condition that caused it. In some cases foot drop can be permanent, but many people are able to recover. There are a number of treatments that can help with foot drop:
If your foot drop is caused by a pinched nerve or herniated disc then you will likely have surgery to treat it. Surgery may also be necessary to repair muscles or tendons if they were directly damaged and are causing foot drop. In severe or long term cases, you might have surgery to fuse your ankle and foot bones and improve your gait.
If your foot drop is being caused by damage to the peroneal nerve than Functional Electrical Stimulation may be an alternative to surgery. A small device can be worn or surgically implanted just below the knee that will stimulate the normal function of the nerve, causing the muscle to contract and the foot to lift while walking.
Wearing a brace or AFO that supports the foot in a normal position is a common treatment for foot drop. The device will stabilize your foot and ankle and hold the front part of the foot up when walking. While traditionally doctors have prescribed bulky stiff splints that go inside the shoe, the SaeboStep is a lightweight and cost effective option that provides support outside the shoe.
Therapy to strengthen the foot, ankle, and lower leg muscles is the primary treatment for foot drop and will generally be prescribed in addition to the treatment options mentioned above. Stretching and range of motion exercises will also help prevent stiffness from developing in the heel.
Specific exercises that strengthen the muscles in the foot, ankle and lower leg can help improve the symptoms of foot drop in some cases. Exercises are important for improving range of motion, preventing injury, improving balance and gait, and preventing muscle stiffness.
When treating foot drop, you may work with a physical therapist who will help you get started strengthening your foot, leg and ankle muscles. Rehabilitation for foot drop can be a slow process, so your physical therapist will likely recommend that you continue to do strengthening exercises at home on your own.
By being consistent about your exercises at home, you can maximize your chances of making a successful recovery from foot drop. Strengthening the weakened muscles will allow you to restore normal function and hopefully start walking normally again.
Like any exercise program, please consult your healthcare professional before you begin. Please stop immediately if any of the following exercises cause pain or harm to your body. It’s best to work with a trained professional for guidance and safety.
Sit on the floor with both legs straight out in front of you. Loop a towel or exercise band around the affected foot and hold onto the ends with your hands. Pull the towel or band towards your body. Hold for 30 seconds. Then relax for 30 seconds. Repeat 3 times.
Stand in front of a table, chair, wall, or another sturdy object you can hold onto for support. Rock your weight forward and rise up onto your toes. Hold this position for 5 seconds. Next, rock your weight backwards onto your heels and lift your toes off the ground. Hold for 5 seconds. Repeat the sequence 6 times.
Sit in a chair with both feet flat on the floor. Place 20 marbles and a bowl on the floor in front of you. Using the toes of your affected foot, pick up each marble and place it in the bowl. Repeat until you have picked up all the marbles.
Sit on the floor with both legs straight out in front of you. Take a resistance band and anchor it to a stable chair or table leg. Wrap the loop of the band around the top of your affected foot. Slowly pull your toes towards you then return to your starting position. Repeat 10 times.
Sit on the floor with both legs straight out in front of you. Take a resistance band and wrap it around the bottom of your foot. Hold both ends in your hands. Slowly point your toes then return to your starting position. Repeat 10 times.
Sit in a chair with both feet flat on the floor. Place a small round object on the floor in front of you (about the size of a tennis ball). Hold the object between your feet and slowly lift it by extending your legs. Hold for 5 seconds then slowly lower. Repeat 10 times.
Don’t let foot drop affect your mobility, independence, and quality of life. With proper rehabilitation and assistive devices many people are able to overcome the underlying cause of their symptoms and get back to walking normally. If you are showing symptoms of foot drop, talk to a medical professional about your treatment options.
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