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Foot Drop


Foot Drop (or drop foot) is a term describing a debilitating condition where a person is unable to lift the forefoot off the ground.  It is not a disease but instead is a sign of underlying neurological, muscular or anatomical disorder.  Foot drop typically affects the person when the leg is swinging forward and the foot is pulling up to obtain ground clearance.  Lack of ground clearance causes stumbling or tripping over.

 

Treatment for foot drop depends on the cause.  If the cause is successfully identified, then foot drop may be directly treated.  If the cause can’t be treated, foot drop can be permanent.  Foot drop can affect one or both feet.

 

Patients with foot drop must consciously focus on lifting their foot during gait, to reduce their risk of stumbling and falling.  They are at increased risk of foot abrasions, wounds and ulcerations if the foot also has associated numbness.  Traditionally patients would be fitted with a rigid ankle-foot orthotic device (AFO).  However, with advancements in device technology patients now have more functional options available for walking aids.  At East Coast Podiatry, most of our patients with foot drop can use the appropriate orthotic devices to live a normal life in terms of mobility and convenience.

 

Foot drop is normally identified by a neurologist or orthopaedic doctor.  Foot drop is caused by weakness or paralysis of the leg muscles involved in pulling up the forefoot and toes.  Causes of foot drop include:

  • Muscular dystrophy (inherited diseases that causes progressive muscle weakness) such as Charcot Marie Tooth, spina bifida, and cerebral palsy.
  • Brain and spinal cord disorders such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS) or stroke.
  • Peroneal nerve injuries in the leg.
  • Sciatic impingement at the hip.
  • Spinal nerve root impingement in the low back.
  • Spinal cord tumors.
  • Autoimmune conditions affecting the nerves such as demyelinating polyneuropathy.
  • Ankle arthritis.
  • Nerve injury following hip or knee replacement surgery.
  • Diabetic peripheral neuropathy.
  • Prolonged leg cast immobilization.

Symptoms of foot drop:

  • Sensation of foot heaviness.
  • Dragging the toes on the floor.
  • Raising up the knee and thigh excessively while walking (steppage gait), as though climbing stairs, in order to avoid tripping.
  • Involuntarily slapping the foot down on the floor with each step.
  • Numbness to the top of the foot, toes or lower leg.
  • Circumducting gait pattern.

What can podiatry do for my foot drop?

If foot drop is present, your podiatrist will assess the extent of weakness, spasticity and/or muscular compensation in the lower limb.  The podiatrist will work with you to help lift the front of your foot to ensure that you can clear the ground while walking.  Depending on the specific type of foot drop, the podiatrist may use:

  • Orthotic devices.
  • Footwear modifications.
  • Rigid vs dynamic braces and splints.
  • Physical therapy.
  • Nerve stimulation and muscle spasticity reduction with focused ESWT, radial ESWT and SIS modalities.
  • Referral for foot surgery (tendon transfer or joint fusion).

If you or your loved one is suffering from foot drop, then book with our podiatrists today to explore methods of proven, evidence-based treatment that may not have been offered to you before.