Overview

Foot drop also known as 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 can be unilateral (affecting one foot) or bilateral (affecting both feet)at the same time. It can strike at any age. In general, foot drop stems from weakness or paralysis of the muscles that lift the foot. Sometimes foot drop is temporary, but it can be permanent. If you have foot drop, Fortunately, there are several treatment options, which may include a combination of orthotics, physical therapy, and surgical procedures. However, it’s important to seek early treatment to improve the chances of recovery.

• multiple sclerosis
• amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig’s disease
• muscular dystrophy
• spinal muscular atrophy
• stroke
• Charcot-Marie-Tooth disease (CMT), a neurological disorder
• Parkinson’s disease
• poliomyelitis, also known as polio

Foot drop can also be caused by injuries to the nerves that control the muscles that lift the foot. The affected nerves may be in the knee or in the lower spine.

Other causes include hip or knee replacement surgery and diabetes. Nerve damage in the eye, which can result in pain when moving the eye or even vision loss, can also cause difficulties with walking.

Other causes of foot drop include nerve compression or a herniated disc.

Symptoms

• decreased muscle mass
• frequent trips or falls
• limpness of the foot
• loss of sensation in the leg or foot
• changes in gait, such as raising your leg higher or swinging your leg to the side when walking

Risk factors

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

• Leg crossing. 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 depends on the specific cause of foot drop. The most common treatment is to support the foot with lightweight leg braces and shoe inserts, called ankle-foot orthotics. Exercise therapy to strengthen the muscles and maintain joint motion also helps to improve gait. Devices that electrically stimulate the peroneal nerve during footfall are appropriate for a small number of individuals with foot drop. In cases with permanent loss of movement, surgery that fuses the foot and ankle joint or that transfers tendons from stronger leg muscles is occasionally performed.

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