Understanding Foot Drop and what can be done to help with Mobility
Introduction
If you are unable to lift up your foot and toes, you may have a condition known as ‘Foot Drop’. Foot drop is typically a symptom of a bigger issue or underlying condition and is always much more than just a foot issue as it can affect the entire lower limb.
What is Foot Drop
Foot drop is the inability to lift up the foot to clear the ground while walking due to weakness to the muscles at the front of the lower leg. People experiencing foot drop often have to use their legs differently while walking so their foot can clear the ground without tripping.
What are the effects of Foot Drop?
To be able to clear the foot from the ground while walking, people experiencing foot drop often have to use the muscles around their knee and hip excessively to compensate for the weakness at the foot and ankle. This often looks like flexing the hip and knee much more than normal so the foot doesn’t scrape along the ground. This is often referred to as a ‘steppage gait’. Sometimes foot drop may also cause the foot to slap on the ground as the foot lands during walking. This is a concern as the muscles around the knees and hips are now working harder and may sustain injuries themselves from the extra work (load) they are needing to do. Injuries to the foot such as stress fractures can also occur as the foot may now be hitting the ground much harder than normal and/or landing on a different angle.
How is Foot Drop diagnosed?
Foot drop can be diagnosed during a physical assessment with your medical or allied health health practitioner with knowledge and experience in helping people with foot drop. Your practitioner will utilise a range of clinical assessments such as muscle testing and a walking (gait) assessment. As foot drop is often caused by an underlying condition, having a team care approach is important for helping an individual reach their health goals.
What causes Foot drop?
There are many different causes of foot drop, however, the common characteristic amongst the many causes of foot drop is injury to a nerve called the peroneal nerve. This nerve starts at the back of your knee and runs along the front of the shin. This nerve is responsible for the movement of the muscles that lift up your foot. If your foot has ever gotten pins and needles/numbness, this is often a result of compression to your peroneal nerve! Below is a list of conditions that can increase the risk of developing foot drop. (If you have any of the following conditions doesn’t mean you will develop foot drop, they only increase the risk)
- Neurodegenerative conditions such as Multiple Sclerosis (MS), Stroke, and Cerebral Palsy (CP)
- Peripheral nerve conditions such as Charcot-Marie-Tooth disorder (CMT) and peripheral neuropathy
- Motor neuron conditions such as polio and amyotrophic sclerosis (ALS)
- Peroneal nerve compression injuries
- Injury to the spinal cord
- Disorders of the muscles at the front of the leg like muscle dystrophy or myositis
- Diabetes
- Post-surgical complications
What are the treatment options for Foot Drop?
As foot drop has many different causes, treatment for foot drop can vary greatly as we always want to focus on the cause of the problem. If you are experiencing foot drop, it is very important to have the proper assessments so you and your practitioner can understand the cause and develop a plan together to help solve the cause, if possible.
As there can be underlying conditions that cause foot drop, a team care approach is often required. This may look like a GP and specialists helping the person with the underlying cause (such as Multiple Sclerosis). It is then often recommended a person will see a podiatrist or physiotherapist to help with foot drop. Sometimes people are told that their foot drop will never go away, however there can be many things we can do to improve the strength, balance and function of the lower limb to help!
Treatment options may include:
- Exercises / strength and conditioning program to improve the strength, balance and function of the entire lower limb. This will also include the muscles around the hips and knees
- Foot and ankle brace to help hold the foot up
- Orthotic therapy to reduce impact forces to the feet
- Footwear advice
It’s important to remember, a thorough assessment will lead to an individualised treatment program for foot drop. This is important because no two people experiencing foot drop are the same and treatment options will vary greatly depending on each individual.
Foot drop is something that deserves the care, attention and the opportunity to improve if possible as foot drop can impact so many activities and how someone feels day to day.
If you are interested in learning more about orthotics and how they can help, have a look at the following resource: https://www.proactivehm.com.au/how-do-orthotics-work/
You can book an appointment with a member of our practitioner team HERE LINK: https://www.proactivehm.com.au/book-online/
Written By:
Josh McGill
