Foot drop is a walking condition that can occur due to stroke, multiple sclerosis (MS), and other neurological disorders.
Foot drop causes weakness or paralysis of the muscles that pull the foot towards the shin. It can cause walking difficulties and an uneven walking posture.
While the condition does not constitute a medical emergency, it usually indicates an underlying neurological disorder or nerve issue.
Foot drop occurs when the peripheral nerves that control the feet become damaged or compressed. The National Institute of Neurological Disorders and Stroke state that it is a symptom of numerous underlying neurological conditions, including:
- cerebral palsy
- spinal muscular atrophy
- amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease
- spinal stenosis
- Charcot-Marie-Tooth disease
- peripheral neuropathy
- muscular dystrophy
- peripheral nerve injury
Foot drop typically affects the following
- L5 nerve root: This nerve exits the spine between the fifth lumbar vertebra and the first sacral vertebra. It
controls the shinmuscles that lift the foot upwards toward the shin.
- Sciatic nerve: Starts in the lower back and runs through the hips, buttocks, legs, and feet.
- Common peroneal nerve: Branches off the sciatic nerve, providing sensations and movement to the lower leg and foot.
- Deep peroneal nerve: This nerve extends from the common peroneal nerve and runs through the front of the leg to the foot.
- Superficial peroneal nerve: A nerve that supplies the front and outer side of the leg and the top of the foot.
Some risk factors for foot drop include:
- diabetes mellitus
- a herniated disk in the lower back
- intervertebral disc calcification, where calcium deposits accumulate on a spinal disc
- narrowing of the spinal canal
Some postures increase the risk of nerves in the legs and feet becoming compressed, such as sitting cross-legged or kneeling for extended periods.
Injuries and surgical procedures involving the knee, hip, or lower back could also potentially damage nerves in the feet.
The symptoms of foot drop may occur gradually or suddenly, and they vary depending on its cause.
Someone may experience early signs and symptoms before the condition fully develops.
For example, a shoe might feel looser than the other, making lifting the foot difficult or uncomfortable. A person may also walk with a higher step than usual, or one foot might feel numb or weaker than the other.
Foot drop affects the nerves controlling the muscles that flex the foot towards the shin. Therefore, people with the condition might experience weakness or paralysis in the muscles on top of the foot.
According to the American Stroke Association, foot drop can make the ankles and knees unsteady while standing. It might also cause the foot to drag and lead to an uneven step while walking.
There are several possible treatment options for foot drop.
Braces and other supportive devices are the
There are different types of these braces.
Hard braces fully stabilize the foot and ankle. However, these models can be cumbersome and heavy. Articulated braces have a flexible joint at the ankle, which provides a broader range of motion while walking.
Other supportive devices that can improve foot drop include:
- shoe inserts
- canes or crutches
Physical therapy may also improve foot drop. This treatment focuses on stretching and strengthening the muscles in the legs and feet.
Nerve stimulation involves applying electrical currents to the peripheral nerves that control the muscles in the legs and feet. The electrical currents stimulate the nerves and trigger muscles that lift the foot.
A doctor may recommend surgery if other treatments are not effective in improving foot drop. Examples of surgical treatment for the condition include:
- Tendon or nerve transfer: This procedure moves a working tendon or nerve from the leg or another part of the foot and attaches it to the muscles on top of the foot.
- Ankle fusion: This procedure fuses the ankle and foot bones.
- Nerve decompression: This technique relieves pressure on compressed nerves.
Home exercises can improve the foot’s flexibility and range of motion:
- Stand up straight while holding on to a chair or wall for support.
- Slowly rock on to the ball of the foot.
- Rock backward on to the heel, so the toes lift off the floor.
- Sit on the floor with the legs straight in front of the body.
- Place a resistance band over the top of the foot and anchor the other side to a chair leg.
- Pull the toes towards the body — this should create tension in the resistance band.
Assisted toe raises
- Sit in a chair with both feet on the ground.
- Place the affected foot on top of the non-affected foot.
- Use the non-affected foot to lift up the top foot.
Speak with a doctor if there are any symptoms of foot drop, such as:
- a weakness in one foot
- trouble lifting the foot
- difficulty walking
A healthcare professional can help with a diagnosis and suggest treatment options.
To diagnose foot drop, a doctor will perform a physical exam. They will look for signs of injury, such as dislocations or fractures. They will also check a person’s medical history for neurological diseases or other risk factors.
If a healthcare professional suspects foot drop, they will carry out a procedure called electromyography, which examines electrical activity in the muscles. They may also order blood tests to rule out infections, arthritis, and other possible causes.
Foot drop can make walking difficult and uncomfortable. It can affect a person’s mobility, independence, and quality of life.
However, treating the underlying cause can relieve foot drop. Braces and other orthopedic devices may also provide structural support, making walking more comfortable.
In addition, physical therapy and home remedies, such as stretching, can help improve flexibility and strengthen the muscles in the legs and feet. Doctors may recommend surgery if these treatments fail to improve symptoms.