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Foot Drop


Foot Drop is a condition which occurs when a person has difficulty lifting their forefoot. This is caused by a weakness of certain muscles in the leg and is usually a symptom of a greater problem such as nerve damage or paralysis. If you have difficulty lifting your foot or feel that your foot does not respond the way you wish, you may be experiencing this issue.

 

Foot drop is classified by the weakness of the ankle and toe dorsiflexion. The foot and ankle are made of complex structures of tendons, ligaments and muscles. This includes the tibialis anterior, the extensor hallucis longus, and the extensor digitorum longus. These muscles are responsible in controlling the foot during walking specifically to dorsiflex (lift up) the foot, preventing it from dragging when the foot is raised, or “slapping down” on the heel strike phase.

3D4Medical muscles of the foot shot

Causes

Foot drop is defined by weakened muscles in the leg. This is usually caused by lower motor neuron disease but has also been reported in 52-67% in people with upper motor neuron pathology.1 Conditions that affect the L4 to L5 vertebrae of the spine, such as peripheral neuropathy, commonly cause foot drop as well.

 

This impairment or inability to lift the toes or foot up can either be permanent or temporary. Contributing factors include –

  • Damage to nerves caused by disease
  • Damage to nerves caused by muscle or spinal cord trauma.
  • Abnormal anatomy

Other disorders that may affect the motor and sensory nerve pathways and cause foot drop may include:

  • Stroke
  • Poliomyelitis
  • Multiple Sclerosis
  • Cerebral Palsy
  • Muscular dystrophy
  • Guillain-Barré syndrome
  • Some surgery to the hip or knee

Symptoms

  • Foot hangs with the toes pointing down, causing the toes to scrape the ground while walking
  • Lifting one leg higher than normal when walking to prevent scraping/dragging.
  • Tip-toeing on the opposite leg or lifting the thigh to compensate
  • Swinging the leg out wide to avoid lifting the thigh.

Treatment

Treatment will vary depending on the cause of the condition; while it is important to deal with the foot drop, healthcare professionals must also ensure that the underlying factors are addressed.

 

Ankle foot orthotic (AFO) devices are used to support the foot and ankle especially in the case of foot drop. These are lightweight devices that are customised for individual patients, providing comfort as it supports the foot contours and can be fitted into regular shoes.

 

AFOs come in different forms, and your podiatrist will determine the most suitable for you depending on your condition and your needs. Prior to the design and prescription of the AFO device, the podiatrist will carry out comprehensive assessment to determine your diagnosis, and design an AFO suitable for your lifestyle and condition.

 

 

 

1 Van der Salm A, Nene AV, Maxwell DJ, Veltink PH, Hermens HJ, IJzerman MJ. 2005. Gait impairments in a group of patients with incomplete spinal cord injury and their relevance regarding therapeutic approaches using functional electrical stimulation. Artif Organs 29:8–14.

Pod fitting AFO or other doing some other treatment