What is Foot Drop?

Foot Drop – also known as drop foot – is a problem where a person has difficulty in lifting the front part of the foot. With Foot Drop, a patient is unable to lift the toes upwards, or towards the shin.

Foot Drop by itself is not a disease, but rather a symptom of another underlying problem or medical condition. Those conditions can include, but are not limited to: muscle or tendon injury, nerve injuries, a stroke, diabetes, reaction to a drug, multiple sclerosis, a spinal cord injury or herniated disc, and a number of other things. It can even be hereditary. Foot Drop can be a permanent problem or a temporary condition.

What are the Symptoms of Foot Drop?

Often, the only symptom a person may experience with Foot Drop is the inability to lift the front part of the foot. In some cases a person may have numbness in the foot or ankle that is affected. They may even experience some discomfort or pain. All of this may depend on the underlying reason that the Foot Drop is occurring.

In typical cases – Foot Drop only affects one foot, though it is possible for both feet to be affected depending on the condition that is causing it to occur.

The main signs that a person may be experiencing Foot Drop are a change in gait. Because you are unable to lift the toes, the toes may drag along the ground when walking. To compensate for this problem of dragging the toes, a person will often lift the affected leg as though they are walking up stairs. This is known as steppage gait.

A steppage gait is not only noticeable by the exaggerated motion of the leg in use, but by the sound the foot makes during the gait. When a person lifts the leg higher to prevent the toe drag, the heel strikes the ground with more force than the normal body weight, causing the front half of the foot to slap to the ground as though the foot is simply being dropped to the ground.

There are other ways that people try to compensate for Foot Drop. Swinging the leg outward and around is common as well as a simple toe drag. An easy first step in telling if a person is experiencing Foot Drop is to see if they can walk on their heels only. With Foot Drop, a person will be unable to walk only on the heels of their feet.

What are the Causes of Foot Drop?

• Drug Complications - Many times, Foot Drop can be brought on by an adverse reaction to drugs, or even alcohol. Some drugs used during chemotherapy in cancer patients have been known to cause temporary Foot Drop. Even some drugs used in treatment of Multiple Sclerosis (itself another cause) can have a toxic effect on the system leading to Foot Drop.
  
• Nerve or Muscle Damage -
• Injuries to the muscles, nerves, or tendons which control the front of the foot can lead to Foot Drop. These injuries can come from any number of sources. The peroneal nerve which branches off of the sciatic nerve and runs just below the knee is a key component in controlling the tendons and muscles that the foot uses. Damage to this nerve from an injury, medical condition, or even hip or knee surgery, generally has a direct effect in causing Foot Drop. Muscle damage through inherited diseases can also cause Foot Drop. Many forms of muscular dystrophy can bring the condition about. Sometimes foot drop can be caused by continuous athletic activity which places a strain on the muscle and nervous system. Often this takes many years to develop and is generally a temporary condition brought on by physical activity and then subsides with rest. In many cases, the condition will continue to worsen if left untreated.
  
• Central Nervous System Disorders - A number of disorders such as multiple sclerosis or a stroke can lead to Foot Drop. Because the tendons and muscles that control the front of the foot are directly controlled by the peroneal nerve, any type of damage to that nerve through a central nervous system disorder can also lead to Foot Drop which in some cases can be corrected, and in others it cannot.

Treatment Options for Foot Drop

Because Foot Drop is many times a symptom for another medical condition – treatment may involve a number of different things. There are a number of options available to directly go about treating Foot Drop which includes surgery, physical therapy, and corrective devices.

• Surgery - Many times surgery is an option because it may correct the underlying problem causing Foot Drop. If Foot Drop is caused by a pinched nerve or a herniated disc – surgical options are often the best bet in relieving a patient's discomfort. Also, if Foot Drop has been caused by direct injury to the muscles or tendons, surgical repair of those tendons is sometimes an option that can lead to elimination of the condition. Surgery options can also include nerve grafting or tendon replacement. In some cases where a patient has experienced permanent loss of movement that is unable to be repaired – a surgeon may fuse the foot and ankle joint in an effort to improve that patient's condition and gait.
  
• AFO Treatment - An AFO – Ankle Foot Orthosis – is a common solution to treating Foot Drop. An AFO is a device that is inserted into the patient's shoe and is designed to help the patient's ankle and foot achieve stability during movement. This helps to correct the awkward gaits that generally accompany Foot Drop. Similar to a brace or a splint, an AFO is fitted to a patient's foot to achieve the best results.
  
• Nerve Stimulation - If the cause of Foot Drop is determined to be directly related to a damaged peroneal nerve, another option in place of surgery is nerve stimulation. A small device is worn just below the knee (or surgically implanted) which creates a small electrical pulse while walking that simulates the normal function of the nerve. This causes the muscles and tendons to contract in a normal way and provide support to the foot where it was lacking previously. This is a popular non-surgical option and can have great results in helping patients overcome Foot Drop.
  
• Physical Therapy - Physical therapy is often prescribed to a patient suffering from Foot Drop in addition to one of the other options. Proper physical therapy and exercise can help to strengthen the muscles and tendons that are not functioning properly on their own.

Accessories and Devices that can help with Foot Drop

There are a number of devices that can be used to help with easing the discomfort of Foot Drop. These devices can also help to stop any aggravating conditions that might make Foot Drop worse. Preventing Foot Drop by limiting the loss of muscle mass and tendon flexibility in cases where a patient is immobile for a period of time can also be done with the aid of these devices.

• Blanket Lifters – A blanket lifter is designed to keep a blanket off of the toes and feet while a patient is sleeping. This can help to relieve unnecessary pressure on the foot and ankle joint. This is important for a patient following surgery for Foot Drop, or someone experiencing Foot Drop who wants to keep muscle and tendon deterioration from being accelerated. Blanket lifters come designed for regular beds and hospital beds, and are sometimes referred to as a bed cradle. Some blanket lifters are also designed to act as foot supports because the feet rest up against them in a way that prevents them from drooping in a damaging way.
  
• AFO (Ankle Foot Orthotics) – An AFO is a brace or a splint that is designed to be worn by somebody experiencing Foot Drop. The AFO can be inserted directly into the shoe and is secured by Velcro straps. Designed to help a person correct their gait – an AFO is a non-surgical solution for Foot Drop. Properly designed, an AFO will provide support laterally – side to side – as well as help with dorsi-flexion (controlling the front of the foot up and down).
  
• Splints and Braces – A splint or a brace may be used to help stabilize the foot and ankle joint. Generally a splint or a brace will provide more support and less flexibility. This can help to improve a person's gait if they are experiencing Foot Drop. Most splints and braces are designed to immobilize the ankle joint while stationary and provide enough support to walk with. They may look like a boot, because they're designed to be worn continuously and most are breathable in a way to prevent a patient from developing foot or heel ulcers.
  
• Foot Positioners, Stabilizers, and Elevators – A foot positioner is designed to support a patient's foot while bed ridden. This prevents further damage to tendons and muscles in the case of immobility and Foot Drop. Also known as stabilizers or heel guards, some of these devices are also designed as foot elevators in order to provide proper support to a patient who is immobile.
  
• Foot Lifters – A foot lifter is a device that is designed to provide help with moving a foot or leg that is somewhat immobile due to conditions like Foot Drop or something else. They are helpful in showers as well as situations like getting in and out of your automobile. They save the patient from having to strain and bend over in order to lift the foot or leg in various situations.

Foot Drop Tips

Although Foot Drop can be a temporary condition, even brought on by sitting with your legs crossed in a way that pinches the peroneal nerve, it is often the indicator or symptom of a more severe condition.

• If you think you are experiencing Foot Drop – try to walk on the heels of your feet for a short distance. If you are experiencing a case of Foot Drop, you'll be unable to walk on the heel of the foot with the problem.
• If you do indeed have Foot Drop, it's very important that you seek the advice of a physician in order to determine the exact cause of the problem. They'll be able to advise you on the proper course of treatment or surgery options for Foot Drop and the medical condition that might be causing it.
• Investigate splints and braces to help with correcting or minimizing Foot Drop. If treatment is going to be non-surgical, a splint or a brace can help along with proper physical therapy.
• Consider a foot stabilizer or positioner. Because Foot Drop reduces the ability to lift the toes towards your shin, while you are sleeping or sitting your foot will droop. This can cause additional stress on the ankle joint and tendons which may lead to additional problems. A stabilizer or positioner can help to keep this in check.
• And because it's the most important tip we'll say it twice – seek proper medical advice from a qualified physician.

Additional Web Sites about Foot Drop

• MayoClinic.com 
  The Mayo Clinic's web site is easy to navigate and presents medical conditions and explanations in easy to understand terms. Their section about Foot Drop clearly articulates the condition and factors surrounding it as well as options for treatment. As Foot Drop tends to be a symptom of another, sometimes hidden condition – the Mayo Clinic's web site is also a great resource in researching possible causes – though of course it shouldn't replace the consultation of a physician. But it does help with being prepared when you are ready to speak to a doctor.
  
• National Institute for Neurological Disorders and Stroke
  The National Institutes of Health have a division that deals directly with neurological disorders and stroke. The web site for the National Institute for Neurological Disorders and Stroke has detailed information on Foot Drop and the neurological causes that may be aggravating the condition. One very important feature of this web site is that they also list medical research being done on Foot Drop as well as any clinical trials that may be open to test subjects with the condition. These clinical trials are conducted throughout the United States as well as worldwide. For a listing of these trials and any related information – be sure to visit the web site.
  
• MedScape
  MedScape's web site is a peer reviewed medical research database that has a lot of information on various conditions and diseases. Their information on Foot Drop is comprehensive and complete. The articles are written by physicians performing research and treatments on various conditions – so the articles tend to be written with a lot of medical terminology that can sometimes be a little more difficult to digest for somebody looking for a simple explanation. That being said, the information contains a lot of statistics and studies that are currently being undertaken, and is very up to date. Reading through MedScape's articles can be a little like listening to one doctor talk to another doctor – you definitely get all of the information.
  
• Texas Nerve and Paralysis Institute
  The Texas Nerve and Paralysis Institute run a clinic that specializes in helping patients with Foot Drop because of a medical condition. They perform surgery and other corrective treatments for a large number of patients. Their web site is completely dedicated to Foot Drop, its causes and its treatment options. It's a very comprehensive web site that is designed to discuss Foot Drop in terms that everybody can understand – as well as provide complete information on treatment options and how to go about scheduling a consultation. This web site is a great resource and a fantastic place to start if you are looking for more information on Foot Drop, its causes, and what you can do about it. They also have a number of videos available to view that demonstrate what Foot Drop is as well as videos that demonstrate patients after surgery or treatments to correct Foot Drop.