Foot drop is a common word used in healthcare settings. But do you know what foot drop is?
Foot drop is a condition in which the foot is hanging downwards, and the person is unable to bring their foot up. It is not a disease itself but a consequence of an abnormality in the brain, spinal cord, nerves, or muscles.
Two major movements that occur at your ankle joint are Dorsiflexion (when you bring your dorsum (uppar facing part of foot) of the foot towards your shin) and Plantarflexion (when you move your plantar surface (sole) towards the ground).
In foot drop, the foot is constantly in plantarflexion and the person is unable to perform dorsiflexion movement
What Causes Foot Drop?
To understand the cause of foot drop, you must understand how movement occurs in your body. Muscles are responsible for moving our bodies. A network of wires (known as nerves) supplies messages to these muscles. These nerves originate from the spinal cord (in your spine). The major control center is your brain (in your skull).
So if you want to move the dorsum of your foot towards the shin, your brain generates a message that travels down to the nerve (common peroneal nerve) which is then supplied to the dorsiflexor muscles via the spinal cord.
When this nerve stimulates the dorsiflexor muscles present in your leg, your foot moves towards your shin (Dorsiflexion).
If you know how you are able to move your foot normally, you’ll also understand that any condition that affects your brain, spinal cord, nerve (common peroneal nerve), muscles (dorsiflexor) can cause foot drop.
Following are the major causes of foot drop.
- Trauma to the common peroneal nerve (fracture of fibula, knee or hip replacement surgeries)
- Conditions affecting brain and nerves (Stroke, Multiple Sclerosis)
- Conditions affecting muscles (dystrophies)
Foot Drop and Gait
Foot drop can result in alteration of gait pattern of individuals. A person may lift his foot high in the air by bending their hip and strike their foot on the ground with a high force (Stepagge gait pattern).
Another commonly seen strategy is that the person swings their leg from the side to avoid dragging the foot while walking. This gait is known as the circumduction gait pattern.
Treatment of drop foot depends upon the cause. If the major cause of foot drop is compression on the common peroneal nerve, it can resolve on its own when the compression is relieved. On the other hand, if this condition results from a complete tear of the common peroneal nerve or irreversible damage to the brain or spinal cord, foot drop persists and makes walking difficult.
Minor cases of foot drop (with the capability to resolve) can get better with physiotherapy, focusing on dorsiflexor muscles’ training and electrical muscle stimulation.
Surgical options include repair of the common peroneal nerve and tendon transfer of Tibialis posterior to substitute the action of Tibialis anterior.
The most commonly used option for managing foot drop is Orthosis or Bracing.
The orthosis or brace holds the foot in a neutral position. During walking, when a person’s foot touches the ground, the brace allows the foot to go down (in plantar flexion) and pulls it back into a neutral position when the person lifts his leg and swings it to take a step.
The suitable treatment option for each case of foot drop varies from person to person
Watch the foot drop recovery story of our patient MaryEllen Grage. Multiple Sclerosis has nearly immobilized MaryEllen with foot drop and balance/stability difficulties. She believes that with The NewGait, she can walk normally again.Continue reading