Drop foot (aka foot drop), can be a scary occurrence. Both terms describe an inability to lift the front of your foot while walking. The results of drop foot include scuffing the forefoot along the ground, and tripping over simple obstacles, like the edge of a rug.
In order to compensate for foot dragging, people with drop foot tend to lift the affected foot unusually high, as if they were climbing stairs. Or they will elevate the dragging foot by swinging it out in a semi-circle. Either way, the affected foot will tend to slap when it again contacts the ground.
What is drop foot?
Drop foot, in and of itself, is not a discrete disease or condition. It’s merely a symptom. And that’s the primary problem. The symptom of drop foot can indicate a myriad of anatomical, muscular, or nerve problems, and several of these conditions are quite serious.
The biomechanics of walking
Normal walking requires the front of the foot to be elevated above the heel. This flexing action is called dorsiflexion. Dorsiflexion allows a normal gait, in which the heel re-contacts the ground before the forefoot does.
Dorsiflexion requires the coordination of four muscles in your leg. If those muscles become weak or paralyzed, or if they are not receiving adequately strong signals from your nervous system, dorsiflexion can’t happen, and your foot will drop.
Diagnosing drop foot
Diagnosing drop foot itself is simple. The patient’s distinctive gait quickly identifies the symptom of drop foot. But identifying the underlying cause can be much more complex, convoluted, and difficult. Your doctor is likely to use imaging techniques such as x-rays, ultrasound, CT scans, magnetic resonance imaging (MRI), and nerve tests such as electromyography (EMG).
What causes drop foot?
Drop foot is always a symptom of an underlying cause. It’s most common cause is compression of the peroneal nerve as it passes across the fibular bone just below the knee.
But drop foot can also indicate neurodegenerative disorders of the brain that cause muscular problems, such as multiple sclerosis, stroke, and cerebral palsy.
Drop foot can also signify motor neuron disorders like polio, muscular atrophy, and amyotrophic lateral sclerosis (commonly known as Lou Gehrig’s disease). Narrowing of the spinal channels through which nerves pass can also result in a foot that drops.
Muscle disorders, such as muscular dystrophy or myositis, can also be revealed by the symptom of drop foot. Diabetes typically causes nerve cells to degrade, so drop foot can also indicate this condition.
Sometimes posture, such as prolonged kneeling, and constantly crossed legs, can compress the peroneal nerve.
Drop foot treatment
Treatment of drop foot is divided into two classes: alleviation of the symptom itself, and treatment of the underlying condition. Treatment of the underlying condition often requires coordination between your podiatrist and a physician who specializes in the root cause.
Drop foot itself, is typically treated with a drop foot brace called an ankle-foot orthosis. It maintains the angle between the foot and the leg at no more than 90°. The drop foot brace most often utilized by UFAI is known as Dorsi-Assist, which effectively elevates the forefoot and prevents tripping. Drop foot treatment can also include:
- Orthotics that fit inside a shoe to help keep a foot in a normal position.
- Physical therapy to restore strength to the muscles involved in dorsiflexion.
- Devices that use electricity to enhance the strength of signals carried by nerves.
Drop foot surgery
Some cases of drop foot require surgery, such as when a trapped segment of the peroneal nerve must be extricated. In other cases, a surgical transfer of a tendon will restore normal dorsiflexion. In cases where drop foot has failed to respond to conservative treatment, bone fusion is used to permanently establish a 90° angle between the leg and the foot.
Why choose University Foot and Ankle Institute for your foot and ankle care
If you are experiencing problems with your feet or ankles, the staff of University Foot and Ankle is ready, willing, and able to help. Our nationally recognized foot and ankle specialists offer the most advanced podiatric care and the highest success rates in the nation. We are leaders in the research and treatment of all foot and ankle conditions.
For more information or to schedule a consultation, please call (877) 736-6001 or make an appointment online.
Dr. Briskin is a Diplomat of the American Board of Podiatric Surgery and a Fellow of the American College of Foot and Ankle Surgeons. He also serves as an assistant clinical professor at the UCLA School of Medicine.
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Do you have any doctor who specializes in Charcot-Marie-Tooth disease?
Yes, several of our doctors do including Dr. Baravarian.