The National Institute of
Neurological Disorders and Stroke, National Institutes
of Health, defines foot drop as “the inability to raise
the front part of the foot due to weakness or paralysis
of the muscles that lift the foot.” Muscles in the leg
cannot raise the foot at the ankle, or the front part of
the foot, due to paralysis of muscles that lift the
Consequentially, people who have
foot drop scuff their toes along the ground; they may
also bend their knees to lift their foot higher than
usual to avoid the scuffing, which causes what is called
a “steppage” gait. When caused by pressure on the nerves
that control the muscles in the leg or by a knee injury,
foot drop can be temporary. However, damage to the
nerves — and other medical disorders — can cause this to
be a permanent condition affecting one or both feet.
Compression of the nerve that
controls the muscles involved in lifting the foot, which
can happen at the knee or in the lower spine during hip
or knee replacement surgery. Additionally, diabetic
neuropathy (long-term nerve damage associated with
diabetes) can also cause foot drop.
Muscle or nerve disorders
Forms of muscular dystrophy (an
inherited disease that causes progressive muscle
weakness), polio or Charcot-Marie-Tooth disease can
cause foot drop.
Brain and spinal cord disorders
These include amyotrophic
lateral sclerosis (ALS), multiple sclerosis (MS) or
One neighbor experienced foot
drop as the result of a stroke nearly one year ago. I
hadn’t seen him in many months; he didn’t want to
discuss it. I saw the stroke had affected his left side.
While physical therapy helped him lift his leg, it
looked like his foot and ankle muscles hadn’t fully
Toes that point away from the
body when the foot is relaxed indicated foot drop. Feet
and legs may feel weak; the person may have difficulty
walking, or scuffs his or her toes, and trips frequently
over the affected foot. To overcome or compensate, the
person may lift the knees higher (step gait) so there is
less chance of stumbling over the toes. The person may
also slap his or her foot down with each step. In some
cases, there may be tingling or numbness on the top of
the foot, toes and ankle, caused by the particular way
of walking, or it can be linked to an underlying cause
of foot drop.
Foot drop is diagnosed during a
physical exam. The doctor will ask you to walk and will
check leg muscles for weaknesses and may check your
shins and the tops of your feet and toes for numbness.
Specific causes of foot drop
determine its treatment. Supporting the foot with
light-weight leg braces and shoe inserts, called
ankle-foot orthotics, is a commonly-used treatment;
exercise therapy can strengthen muscles and maintain
joint motion, which helps improve gait.
The peroneal nerve controls the
muscles that lift the foot. Activities that compress
this nerve, such as crossing one’s legs, prolonged
kneeling or squatting, or wearing a leg cast, exert
pressure on this nerve and increase risk of foot drop.
stimulating the peroneal nerve during foot fall can be
appropriate for some people with foot drop. Surgery
fusing the foot and ankle joint, or that transfers
tendons from stronger leg muscles, is occasionally
performed when there is permanent loss of movement.
Foot drop caused by trauma or nerve
damage can show a partial or complete recovery; if a
symptom of progressive neurological disorders, foot drop
can continue as a lifelong occurrence and will not
shorten life expectancy. Treatment depends on the
underlying cause, which, if successfully treated, may
improve foot drop or cause it to disappear.
treatments include an ankle and foot brace or a splint,
physical therapy and exercises that strengthen the leg
muscles and help maintain knee and ankle range of
motion; heel stiffness can be prevented by stretching
Due to increased risk of falling
and tripping, caregivers are reminded to take
precautions at home: keep floors clear of clutter;
avoid using throw rugs which can slip; move all
electrical cords from walkways and halls; keep rooms and
stairways properly lighted; and place fluorescent tape
on the tops and bottoms of stairs.
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