Foot drop, sometimes called drop foot, refers to a weakening of the muscles that allow one to flex the ankle and toes, causing the individual to drag the front of the foot while walking, and to compensate for this scuffle by bending the knee to lift the foot higher than usual. It isn’t a disease, rather it’s a symptom of an underlying neurological, muscular or anatomical problem.
Sometimes foot drop is temporary. In other cases, foot drop is permanent. If you have foot drop, you may need to wear a brace on your ankle and foot to hold your foot in a normal position. The possibility that it may be caused by a condition in the low back may be overlooked, but it is important to evaluate in order to pursue appropriate foot drop treatment.
• nerve injury
• brain or spinal disorders
• muscle disorders
Nerve injury – Most commonly, foot drop is caused by an injury to the peroneal nerve. This nerve is a branch of the sciatic nerve that wraps from the back of knee to the front of the shin. Because it sits very close to the surface, it may be easily damaged.An injury to the peroneal nerve may also be associated with pain or numbness along the shin or the top of the foot.
Some common ways the peroneal nerve is damaged or compressed include:
• sports injuries
• hip or knee replacement surgery
• spending long hours sitting in a crossed-legged or squatting position
• large amount of weight loss.
Injury to the nerve roots in the spine may also cause foot drop.
Brain or spinal disorders – Neurological conditions that can contribute include:
• multiple sclerosis (MS)
• cerebral palsy
• Charcot-Marie-Tooth disease.
Muscle disorders – Conditions that cause the muscles to progressively weaken or deteriorate that may result in foot drop include:
• muscular dystrophy
• amyotrophic lateral sclerosis (Lou Gehrig’s disease)
Foot drop makes it difficult to lift the front part of your foot, so it might drag on the floor when you walk. To counter this, you might raise your thigh when you walk, as if you were climbing stairs, to help your foot clear the floor. This odd gait might cause you to slap your foot down onto the floor with each step you take. In some cases, the skin on the top of your foot and toes may feel numb. Foot drop typically affects only one foot. Depending on the underlying cause, however, it’s possible for both feet to be affected.
The peroneal nerve controls the muscles that lift your foot. This nerve runs near the surface of your skin on the side of your knee closest to your hand. Activities that compress this nerve can increase your risk of the ailment. Examples include:
• Crossing your legs – People who habitually cross their legs can compress the peroneal nerve on their uppermost leg.
• Prolonged kneeling – Occupations that involve prolonged squatting or kneeling such as laying floor tile can result in foot drop.
• Wearing a leg cast – Plaster casts that enclose the ankle and end just below the knee can exert pressure on the peroneal nerve.
Tests and Diagnosis
Foot drop is usually diagnosed during a physical exam. Your doctor/podiatrist will want to watch you walk and may check a number of your leg muscles for weakness and any numbness. In some cases, additional testing is recommended, such as:
• Computerized tomography (CT scan)
• Magnetic resonance imaging (MRI)
• Electromyography (EMG)
It depends on the underlying cause. If the cause is successfully treated, foot drop may improve or even disappear. If the cause can’t be treated, foot drop may be permanent.
Specific treatments may include:
• Ankle-foot orthosis (AFO) – An ankle-foot orthosis is a device worn on the lower part of the leg to provide direct control of the ankle and foot. It is designed to hold your foot and ankle in a straightened position, to improve your walking.
• Physical therapy – Exercises that strengthen your leg muscles and help you maintain the range of motion in your knee and ankle, may improve gait problems associated with foot drop. Stretching exercises are particularly important to prevent the development of stiffness in the heel.
• Electrical stimulation device – An electrical stimulation device can be used to improve walking ability in certain conditions, but not all cases of foot drop. It can help you to walk faster, with less effort and more confidence.
• Surgery – In cases where foot drop is relatively new, nerve surgery may be helpful. If foot drop is long-standing, your doctor may suggest surgery that fuses ankle or foot bones or a procedure that transfers a functioning tendon to a different position.
Because foot drop can increase your risk of tripping and falling, you might want to take these precautions around your house:
• Keep all floors clear of clutter.
• Avoid the use of throw rugs.
• Relocate electrical cords away from walkways.
• Make sure rooms and stairways are well lit.
• Place fluorescent tape on the top and bottom steps of stairways.
Your feet mirror your general health . . . cherish them!