Foot drop

Foot drop, sometimes called drop foot, is a general term for difficulty lifting the front part of the foot. If you have foot drop, the front of your foot might drag on the ground when you walk.

Foot drop isn’t a disease. Rather, foot drop is a sign of an underlying neurological, muscular or anatomical problem.

Sometimes foot drop is temporary, but it can be permanent. If you have foot drop, you might need to wear a brace on your ankle and foot to hold your foot in a normal position.

Symptoms

Foot drop makes it difficult to lift the front part of your foot, so it might drag on the floor when you walk. This can cause you to raise your thigh when you walk, as though climbing stairs (steppage gait), to help your foot clear the floor. This unusual gait might cause you to slap your foot down onto the floor with each step. In some cases, the skin on the top of your foot and toes feels numb.

Depending on the cause, foot drop can affect one or both feet.

Causes

Foot drop is caused by weakness or paralysis of the muscles involved in lifting the front part of the foot. Causes of foot drop might include:

  • Nerve injury.The most common cause of foot drop is compression of a nerve in your leg that controls the muscles involved in lifting the foot (peroneal nerve). This nerve can also be injured during hip or knee replacement surgery, which may cause foot drop.

A nerve root injury — “pinched nerve” — in the spine can also cause foot drop. People who have diabetes are more susceptible to nerve disorders, which are associated with foot drop.

  • Muscle or nerve disorders.Various forms of muscular dystrophy, an inherited disease that causes progressive muscle weakness, can contribute to foot drop. So can other disorders, such as polio or Charcot-Marie-Tooth disease.
  • Brain and spinal cord disorders.Disorders that affect the spinal cord or brain — such as amyotrophic lateral sclerosis (ALS), multiple sclerosis or stroke — may cause foot drop.

Risk factors

The peroneal nerve controls the muscles that lift your foot. This nerve runs near the surface of your skin on the side of your knee closest to your hand. Activities that compress this nerve can increase your risk of foot drop. Examples include:

  • Crossing your legs.People who habitually cross their legs can compress the peroneal nerve on their uppermost leg.
  • Prolonged kneeling.Occupations that involve prolonged squatting or kneeling — such as picking strawberries or laying floor tile — can result in foot drop.
  • Wearing a leg cast.Plaster casts that enclose the ankle and end just below the knee can exert pressure on the peroneal nerve.

Treatment

Treatment for foot drop depends on the cause. If the cause is successfully treated, foot drop might improve or even disappear. If the cause can’t be treated, foot drop can be permanent.

Treatment for foot drop might include:

  • Braces or splints.A brace on your ankle and foot or splint that fits into your shoe can help hold your foot in a normal position.
  • Physical therapy.Exercises that strengthen your leg muscles and help you maintain the range of motion in your knee and ankle might improve gait problems associated with foot drop. Stretching exercises are particularly important to prevent the stiffness in the heel.
  • Nerve stimulation.Sometimes stimulating the nerve that lifts the foot improves foot drop.
  • Depending upon the cause, and if your foot drop is relatively new, nerve surgery might be helpful. If foot drop is long-standing, your doctor might suggest surgery that fuses ankle or foot bones or a procedure that transfers a working tendon and attached muscle to a different part of the foot.
Alimran Medical center