Foot Drop

Foot drop, also known as drop foot, is a condition in which there is difficulty in moving the front part of the foot.

People with drop foot tend to drag the front of the foot on the the ground when walking. Foot drop usually indicates that a person has an underlying neurological, muscular or anatomical problem.

In some cases foot drop can be a temporary condition while in other cases it can be permanent.

People with drop foot are required to wear a brace on the ankle and foot is to hold the foot in a normal position.

Foot drop mostly affects one foot, although it can affect both feet. This mostly depends on the underlying cause.

The signs and symptoms of foot drop include:

• Difficulty lifting the front part of the foot, which may cause a person to drag the foot when walking.
• Steppage gait - raising the thigh when walking, like when climbing stairs.
• Slapping the foot down onto the floor with each step.
• Numbness around the skin of the foot and toes.

It may be caused by the following underlying conditions:

• Nerve injury, such as compression of a nerve that controls movement of the front part of the foot. Nerve injury can also occur during hip or knee replacement surgery, pinching of a nerve root in the spine and as a complication of diabetes.
• Various forms of muscular dystrophy - an inherited disease that causes progressive muscle weakness. Other disorders in which muscles are affected include polio or Charcot-Marie-Tooth disease.

• Brain and spinal cord disorders, such as amyotropic lateral sclerosis (ALS), multiple sclerosis or stroke.

Food drop can be diagnosed during a physical examination. Doctors may ask the patinet to walk to check for signs of muscle weakness and may also check for numbness on the shin or top of the foot and toes.

Imaging tests can also be used. Imaging tests used include,

• X-rays,
• Ultrasound,
• computerized tomography (CT) scan
• magnetic resonance imaging (MRI).  

Electromyography and nerve conduction studies may also be carried out. These two studies are used to measure the electrical activity of muscles and nerves respectively.

Although they may be uncomfortable, these two tests are very useful in determining the location of the damage along the afected nerve.

The underlying cause of foot drop determines the treatment which would be given to a patient. Treating the underlying cause can improve symptoms of foot drop or may even lead to foot drop disappearing.

In cases where the underlying cause cannot be treated, foot drop may become a permanent condition.

Treatements for foot drop include the following:

• Ankle and foot brace or splint that can fit into a shoe to help hold the foot in a normal position.

• Physical therapy which includes exercises that strengthen the leg muscles and help to maintain a range of motion in the knee and ankle. Physical therapy may improve gait problems associated with foot drop. Stretching exercises are helpful in preventing the development of stiffness in the heal.

• Nerve stimulation.

• Nerve surgery is mostly performed if foot drop is relatively new. Surgery may also be performed in long standing cases of foot drop to fuse the ankle or foot bones or a procedure that transfers a functioning tendon to a different position.

Lifestyle modifications are necessary in order to cope with foot drop.

Foot drop can increase the risk of tripping and falling.

This can be prevented by:

• Keeping all floors clear of clutter.
• Avoiding the use of throw rugs.
• Relocating electrical cords away from walkways.
• Making sure rooms and stairways are well lit.
• Placing fluorescent tape on the top and bottom steps of stairways.

There are several risks associated with foot drop.

The peroneal nerve controls the muscles that lift the foot. It runs near the surface of the skin on the lateral side of the knee.

Therefore, injury to this nerve can lead to foot drop.

Activities that can compress this nerve include:

• Crossing the legs frequently
• Prolonged kneeling or squatting
• Wearing a plaster cast that encloses the ankle and ends just below the knee