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 a sign of underlying neurological, muscular or anatomical disorder. Typically, when the leg is swinging forward, the foot is pulled up to obtain ground clearance. However, for people with foot drop, the foot droops downwards and the lack of ground clearance causes them to stumble or trip over.
We must first determine what is causing or has caused the foot drop condition. Once this is successfully identified, the condition may be managed directly. However, in some cases foot drop can be permanent if the underlying cause cannot be addressed. 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 higher risk of foot abrasions, wounds and ulcerations, especially if the patient is experiencing 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 specific appropriate orthotic devices to improve mobility and carry on with everyday activities.
Causes of foot drop:
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 and causes include:
- Muscular dystrophy (inherited diseases that cause 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
- Circumduction 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 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, book an appointment with our podiatrists today to find out how we can help.
