Exercises For Foot Drop

There are several different common causes of foot drop that could lead you to look to exercises to improve or alleviate symptoms. First is a neurological impairment such as brain injury,  spinal cord injury, or disorders such as stroke (CVA), cerebral palsy, ALS, or multiple sclerosis.

Additionally, another cause can be a general or diabetic nerve injury to cause compression of the peroneal nerve, a nerve in your leg that controls the muscles responsible for lifting the foot. Lastly, muscle or nerve disorders which include inherited diseases or disorders that lead to progressive muscle weakness or contractures, such as muscular dystrophy, polio and Charcot-Marie-Tooth disease can also lead to foot drop where these exercises are helpful during or after physical therapy to maintain progress.

All of these causes can result in varying degrees of foot drop.This muscle weakness of the lower limb, as well as ankle instability will affect the gait pattern in different ways for each person affected. Although there are many treatment options from wearing a brace like an AFO (Ankle Foot Orthosis) to surgery, a great way to treat foot drop symptoms can come from working with a physical therapist and continuing these exercises at home. In this article we will dive into the exercises that may help improve foot drop symptoms to make walking easier.

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 as well.

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 more normal function in your lower leg.

Like any exercise program, it is best to consult your healthcare professional before you begin. If any of the following foot drop exercises cause pain or harm to your body, you should stop immediately and contact your orthotist or general provider. It is always best to work with a trained professional for guidance and safety to make sure you are doing the best foot drop exercises for your particular impairment, but the following are great options to consider:

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Exercise 1

Toe to Heel Rocks: 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.

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Exercise 2

Marble pick-ups: 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.

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Exercise 3

Ankle Dorsiflexion: 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.

Hip and knee positioning also play a role in a patient’s ability to complete dorsiflexion.  With hip and knee flexion, it is easier to complete dorsiflexion.  Trying this in supine with knees flexed and attempting dorsiflexion may be beneficial and then gradual progression to legs straight. 

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Exercise 4

Plantar Flexion: 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.

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Exercise 5

Ball lift: 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.

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Exercise 6

Assisted Toe Raises: Place your affected foot on top of the non-affected foot. Use your non-affected foot to lift the other foot up and then lower it down slowly. Repeat 10-15 times.

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Exercise 7

Ankle abduction and adduction: In a seated position, start by crossing your affected leg over your non-affected leg. Place your hand on the toes and use your hand to slowly move the foot up and down, keeping your ankle perpendicular to the floor as you move. Repeat 10 times.

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Exercise 8

Single leg stands: Hold onto the back of a chair and try standing on your affected leg for 10-15 seconds at a time.

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Exercise 9

Ankle eversion and inversion: Place your affected foot on the ground, slowly lift the outer edge of the foot up, and then lower it down. Next, try lifting the inner edge of the foot and lowering it slowly. Repeat each exercise 10 times.

Stretching the posterior musculature of the lower leg may benefit and complement this exercise routine, decreasing muscle spasticity from gastroc/soleus/posterior tib.will also free up the ankle range for improved dorsiflexion. 

Seated in a chair, completing towel slides can help strengthen dorsiflexors, just in the reverse motion… instead of bringing toes up towards tibia, the tibia is moving towards foot/toes.  Try to keep the heel down when doing the towel slides.  Foot drop treatment primarily depends on the cause of an individual’s drop foot and the severity of their disability. In some cases foot drop exercises like these may improve the symptoms of drop foot, but in some cases there are more targeted and substantial treatments necessary. For example, a surgery or more targeted program with a physical therapist may be needed to improve drop foot symptoms.

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The time frame to see improvements in foot drop can also vary depending on the specific cause of foot drop and the severity of the disability. Some foot drop patients may see improvement in symptoms after  three months, while others may need 12 months or ongoing physical therapy support to see improvements. In terms of signs that foot drop symptoms may be healing or improving, patients may notice improved balance, increased strength or muscle mass in leg muscles, reduced numbness and decreased stiffness in the lower leg.

Aside from foot drop exercises, an alternative patients can explore is functional electrical stimulations. In the case the patient’s foot drop is being caused by damage to the peroneal nerve, electrical stimulation can offer an alternative to surgery. Electrical stimulation is when there is a small device worn or surgically implanted just below the knee. This device stimulates normal function of the peroneal nerve, causing muscles to contract and the foot to lift while walking.

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