Footdrop occurs when the foot has little or no dorsiflexion (pulling the foot upward toward the shin). This causes the foot to drop down, making it harder to walk without scraping the toes along the floor and potentially causing a person to trip or fall. There are several strategies used to address footdrop.

Bracing

Bracing is the most common initial approach to improving footdrop. An ankle-foot orthotic (AFO) is usually used to keep the foot at a 90-degree angle relative to the ankle. The AFO can be made of hard plastic that is an L-shape. The upper portion of the brace has hook and loop tape that wraps around the shin and calf, whereas the lower portion has hook and loop tape that wraps around the foot. The bottom of the brace is trimmed to fit the foot length. It is usually recommended to place the brace inside the shoe, then place your foot inside the shoe and attach the brace. Bracing allows the person to walk normally without lifting the leg higher to clear the floor.

Physical Therapy

Physical therapy (PT) may also be prescribed to help strengthen muscles that become weak with long-standing footdrop. One type of exercise is a stretching exercise which involves wrapping a towel around the foot and pulling the foot toward you. Another form of PT can involve electrical nerve stimulation. The goal of stimulation is to help stimulate the surrounding muscles and minimize muscle atrophy. Some people with significant footdrop will experience severe gait abnormalities. Gait training can make it easier to walk and place less stress on the back, hips, and knees during walking. Assistive devices may also be necessary to help a person walk more normally and maintain their balance.

Surgery

Several types of surgery might be appropriate for footdrop, depending on the extent of the problem and the exact underlying cause. When footdrop is relatively new, surgery on the nerve might be appropriate. Some people with footdrop may be good candidates for surgery which involves a tendon transfer to help keep the foot perpendicular to the ankle. This is typically reserved for people that have no chance of recovery of nerve function. A tendon transfer may involve just a transplant of the tendon or the entire muscle with the tendon attached.

Footdrop can be caused by various injuries, such as compression of the spine or compression of the nerve at the knee. In some instances, it is spontaneous, without an obvious underlying cause. Management of footdrop involves tactics to help the foot become perpendicular to the ankle and reduce the instance of falls.

Contact an orthopedic injury rehab facility near you to learn more.