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What is Drop Foot?

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Key Takeaways

  • Foot drop, or drop foot, is a condition where individuals have difficulty lifting the front part of the foot up towards their shin. This lifting happens naturally when you walk, but for those with foot drop, their foot might drag on the ground and could cause them to fall.
  • Foot drop may be the sign of an underlying muscular, or neurological condition such as neuropathy.
  • Individuals who have had a stroke or have been diagnosed with muscular dystrophy, multiple sclerosis (MS), Charcot-Marie-Tooth disease, or other neuromuscular diseases may be at high risk for foot drop.
  • Treatment for foot drop varies, and may involve wearing an Ankle Foot Orthosis (AFO) to hold your foot in a normal position while walking.
  • Foot drop may be temporary or permanent based on the causes of foot drop.

What is Foot Drop?

Foot drop, or drop foot, is a condition where individuals have difficulty lifting the front part of the foot up towards their shin. This lifting happens naturally when you walk, but for those with foot drop, their foot might drag on the ground and could cause them to fall.

Causes & Symptoms

On a neurological level, foot drop is caused by damage or injury to the peroneal nerve.  Neuropathy is damage or dysfunction of one or more nerves that typically results in numbness, tingling, muscle weakness and pain in the affected area and can lead to foot drop due to damage to the peroneal nerve. The peroneal nerve is located on the outer (lateral) side of your lower leg below the knee. It is a branch of the sciatic nerve that controls the muscles that lift your foot upwards in a motion called dorsiflexion. Damage to the peroneal nerve may cause temporary or permanent foot drop and other neuromuscular issues.

The peroneal nerve can become damaged due to injury or underlying disorders including, but not limited to:

Muscle or nerve disorders

  • Charcot-Marie-Tooth disease
  • Polio or post-polio syndrome
  • Muscular dystrophy
  • Cerebral palsy
  • Parkinson’s disease
  • Loss of muscle tissue

Brain and spinal cord disorders

  • Stroke (CVA)
  • Multiple sclerosis (MS)
  • Amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease)

Nerve injury

  • Pinched nerve (most often the peroneal nerve)
  • Peroneal nerve injury after hip or knee replacement surgery
  • Injuries to the lower leg
  • Damage to nerve root or spinal cord

The most common symptom is a steppage gait, which is a modified way of walking that individuals develop in order to ensure their toes do not drag when walking.

Most often, partners or other individuals might notice foot drop before you do. Steppage gait is most easily identified by a raising of the thigh as though you are climbing stairs when you walk.

Another indication of foot drop might be frequent falling, due to toes dragging on carpet or other uneven surfaces.

When to See a Doctor

It’s important to see a doctor if you start to experience any of the following first signs of drop foot:

  • Steppage gait
  • Muscle weakness, especially in the front part of your foot
  • Numbness
  • Tingling feelings in the leg
  • Muscle spasms
  • Tripping

Diagnosis & Testing

Both imaging tests and nerve tests can be done to more specifically diagnose foot drop. Imaging tests assess nerve damage to the lower back, overgrowth of bone in the spinal canal, or tumors or cysts pressing on the spinal nerve that can cause foot drop. Nerve tests use nerve conduction to test the functionality of your nerves.

Imaging Tests

  • X-Rays
  • Ultrasound
  • CT Scan
  • Magnetic Resonance Imaging (MRI)

Nerve Tests

  • Electromyography (EMG)
  • Nerve conduction studies

Treatment & Risk Factors

Foot drop can be treated depending on the cause. If the cause is successfully treated, then your foot drop may improve or even go away. However, if the cause cannot be treated, you might have permanent foot drop.

Millions of people live with foot drop everyday and overcome its effects through some of the following treatments:

Braces or splints: An ankle foot orthosis (AFO) is a type of orthotic device that may be prescribed to you. It fits into your shoe and holds your foot up into a normal position to reduce potential for falls and enhance a normal walking pattern.

Physical therapy: You can perform exercises that strengthen the leg muscles in your lower leg. It is also important to include stretching to prevent tightness.

Nerve stimulation: A device might be prescribed that actually stimulates the common peroneal nerve for you and thus lifts the foot when you walk. This is often called functional electrical stimulation.

Surgery: If you have just recently developed drop foot, and depending on the cause, you can look into surgical options. Your doctor might suggest surgery that fuses ankle or foot bones or a procedure that transfers a working tendon and attached muscle to a different part of the foot.

Some risk factors are activities that compress the peroneal nerve can put you at higher risk for developing foot drop.

  • Crossing your legs
  • Prolonged kneeling
  • Wearing a leg cast for a prolonged period of time

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