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DROP FOOT

Drop foot is a weakness of ankle and toe dorsiflexion (lifting the foot upwards so it clears the ground when walking). The gait of a person with drop foot is characterized by an exaggerated flexion (lifting up and setting down) of the hip and knee to prevent the toes from catching on the ground during swing phase.  A common description is that the person has a “high stepping” walk and the foot “slaps” the ground on the affected leg.  In some conditions, such as Multiple Sclerosis (MS) or Gullain Barre Syndrome, drop foot affects both feet.

Drop foot is not a disease but is a symptom of an underlying problem. All age groups are affected equally, but it is more common in males at about a 3 to 1 ratio.  Depending on the cause, it may be temporary or permanent. Often drop foot is caused by injury within the lumbar and sacral spine but can also be caused by direct injury to the tibialis anterior, extensor hallucis longus, and extensor digitorum longus muscles.  Systemic causes include peripheral nerve damage, stroke, neurological conditions, drug toxicities, or diabetes. 

Other names or similar foot conditions:

• Foot drop
• Steppage gait
• Foot slap

Symptoms:

• Dorsiflexion deficiency
• “High stepping” walk

Signs to look for:

• Can be observed
• Diagnosis already made
• Foot and gait abnormalities

Possible Causes:

• Direct injury
• Side effect of neurological conditions, such as stroke, MS, etc.
• Damage from medical treatment, such as radiation
• Lower back injury or pathology
• Peripheral neuropathy, such as found in diabetics

Goals:

• Medical treatment
• Provide toe dorsiflexion during the swing phase

• Restore balance
• Control motion of the feet and improve gait

• Footwear to make exercising more comfortable

Solutions:

Arch Supports:

• Bio-Orthotics Winstep or Sundance exercising support with metatarsal lift

• Lower and thinner arch support with longitudinal and metatarsal support, such as the Bio-Orthotics Journey or Silhouette, for use when shoes cannot accommodate the Winstep or Sundance exercising support

• Extra depth shoes with firm heel counter, full steel shanks and rocker soles

• For exercise, wear shoes with titanium springs

• Don’t wear pumps and high heels

• Go barefoot on a minimal basis only

Other: 

• Where the above shoes and arch supports do not provide enough stability, wedging and flares may be necessary

• AFO support if above support doesn’t lift the foot enough

Activities:

• Medical treatment

• Regular exercise program that promotes increased strength and circulation in lower extremities

• Regular stretching program for entire body

• Rotation of weight bearing and non-weight bearing exercising, such as walking (weight bearing) and swimming or bicycling (non-weight bearing)

This information does not constitute a diagnosis of your condition and does not take the place of a doctor’s care.  The information has been compiled from sources available to the general public and referenced below.  Copyright 2005 Carole Romig

Sources  Image: Doereport.com  Text:  Emedicine.com, Spineuniverse.com, Medicinenet.com