Foot drop makes it hard to lift the front of the foot off the ground. It can result from neurological syndromes like multiple sclerosis or damage, including peroneal nerve injury.
Foot drop, also known as drop foot, can make physical activities like walking difficult. It usually affects one foot but can sometimes affect both.
Depending on the cause, foot drop may improve over time. But other times, the symptom can be permanent.
Keep reading to learn more about foot drop, including possible causes, how it’s treated, and exercises that may help.
Foot drop involves difficulty lifting the front part of the foot, which can make walking challenging. It’s a common symptom of multiple sclerosis (MS) but can also result from other neurological syndromes or physical damage to a nerve.
People with this symptom tend to walk by lifting their knees, as though they were walking up stairs. Having Drop foot, in addition to other muscle- and nerve-related symptoms of MS, can make walking even more challenging.
Treatment options range from braces to physical therapy to surgery.
While treatment may not completely restore your typical gait, it can significantly reduce symptoms and make walking easier.
Foot drop is typically caused by weakness in the muscles used to lift the front of the foot. It can occur with several different conditions, including:
- multiple sclerosis (MS)
- amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig’s disease
- muscular dystrophy
- spinal muscular atrophy
- stroke
- Charcot-Marie-Tooth disease (CMT), a neurological disorder
- Parkinson’s disease
- poliomyelitis, also known as polio
Foot drop can also be caused by injury to the nerves that control the muscles that lift the foot. The affected nerves may be in the knee or the lower spine. This can include:
Because MS affects communication between the brain and the body, nerve-related problems are common. Feelings of numbness or tingling in the extremities are often the earliest signs of MS.
Nervous system problems can develop into more serious complications. Foot drop results from weakness in the tibialis anterior muscle, which is controlled by the deep peroneal nerve.
Other symptoms of MS can also worsen foot drop-related walking problems.
Numbness in the feet can become so severe that someone with MS may have difficulty feeling the floor or knowing where their feet are in relation to it. This condition is called sensory ataxia. Ataxia is a muscle control problem that prevents the coordination of movement.
Many symptoms of MS can cause difficulties with walking. The general sense of fatigue that accompanies MS causes leg muscles to become tired, and tightness or spasms in the leg muscles can add to walking problems. Even without foot drop, walking can be challenging for MS people.
Several early symptoms, including trips, falls, and changes in gait, may be associated with drop foot.
A few common early indicators of drop foot
- decreased muscle mass
- frequent trips or falls
- limpness of the foot
- loss of sensation in the leg or foot
- changes in gait, such as raising your leg higher or swinging your leg to the side when walking
Foot drop treatment depends primarily on the cause of the condition and the extent of the disability. Treating a herniated disc, for example, may eliminate foot drop. However, spinal surgery may not solve the problem for people with MS.
Orthotics
A variety of orthotics, such as braces and splints, are available. Some are worn in the shoes, while others are worn around the ankle or near the knee.
One widely used device is the ankle foot orthosis (AFO). It helps keep the foot at a 90-degree angle to the lower leg to support it. While it can help improve your gait, it may require a larger shoe to accommodate the brace. An AFO may also become uncomfortable if worn for long periods.
Electrical stimulation (E-stim) while walking can also help reduce the symptoms of foot drop. This treatment is also known as functional electrical stimulation (FES). Small devices worn near the knee respond to the movement of the leg and send mild electrical stimuli to the muscle to help it move properly.
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Physical therapy
Physical therapy may also help. A variety of exercises can strengthen the leg muscles and improve flexibility.
If you have MS or another neurological syndrome, working with a physical therapist knowledgeable about the syndrome and foot drop can be especially helpful.
Surgery
If orthotics or physical therapy don’t sufficiently manage the condition, there are several surgical solutions that may help, including:
- Tendor transfer: This involves transferring a tendon that usually goes to a different part of the foot and directing it instead to the top of the foot to replace the tibialis anterior.
- Ankle fusion: This surgery
fuses the foot and ankle to remove the burden from the surrounding muscles. However, this procedure reduces ankle flexibility. - Nerve graft or transfer: This procedure repairs damaged nerves by replacing them with healthy nerves.
- Peroneal nerve decompression: This surgery treats peroneal nerve entrapment, a common cause of drop foot, by reducing pressure on the nerve.
- Lumbar decompression: This type of procedure relieves pressure on the nerves of the lower back. It usually involves removing small sections of bones from the vertebrae or discs in the spine.
All surgeries carry risks, so it’s important to contact your doctor about all your treatment options. If you’re going to have surgery, be sure to understand the risks, benefits, and long-term results of your choice.
Exercises for drop foot can help ease symptoms and regain mobility.
Assisted toe raises
- Place your affected foot on top of the non-affected foot.
- Use your non-affected foot to lift the other foot and then slowly lower it down.
- Repeat 10-15 times.
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 it to slowly move the foot up and down, keeping your ankle perpendicular to the floor as you move.
- Repeat 10 times.
Single leg stands
- Hold onto the back of a chair and try standing on your affected leg for 10-15 seconds at a time.
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.
Assisted ankle dorsiflexion
- In a seated position, cross your affected leg over your non-affected leg.
- Use your hand to slowly dorsiflex your foot by moving the toes back toward the shin.
- Repeat 10-15 times.
The amount of time it takes to recover from drop foot can vary depending on the specific cause and the severity of injury to the associated nerves.
Nerve injury may only take around
Potential indicators of healing may include:
- improvements in balance
- increased strength or muscle mass
- reduced numbness
- decreased stiffness
What causes drop foot in both feet?
Though drop foot usually only affects one foot, it can sometimes affect both feet.
This may be caused by damage or injury to the common peroneal nerves in both legs, which can occur during certain surgical procedures. Drop foot in both feet can also result from spinal cord injuries and systemic diseases.
How common is drop foot?
Drop foot is a symptom associated with many different conditions.
It affects an estimated
It may affect as many as
Can you walk with foot drop?
Drop foot causes issues with walking, including changes in gait or frequent falls and trips. Walking aids and devices like braces, splints, and shoe inserts can help improve mobility.
How long before foot drop is permanent?
Foot drop can be temporary and many people recover within a few months. However, it can be permanent for some people, especially when
Is drop foot serious?
Drop foot can be a sign of other issues, some of which may be serious.
For this reason, it’s important to talk with your doctor if you experience drop foot to determine the cause and best course of treatment.
Drop foot is a symptom characterized by difficulty lifting the front part of the foot, which can lead to issues with mobility.
Treatment options may include a combination of orthotics, physical therapy, and surgical procedures.
However, it’s important to seek early treatment to improve the chances of recovery.