Back to Health: Drop Foot
What is it?
Drop Foot is a condition in which an individual has weakness or paralysis of the primary muscle (Anterior Tibialis) that pulls the forefoot up off the floor. It is the result of damage to the nerve that innervates the anterior tibialis muscle. A person may not even know they have the weakness but they frequently trip over their foot while walking. In addition, they may note a double tap of the affected foot while walking. The first tap is the heel hitting and the second tap is the foot slapping the floor due to the muscle weakness not supporting the forefoot. To accommodate for the drop foot, the individual may lift the thigh higher while walking which is known as steppage gait.
What is the cause?
Drop Foot is caused by nerve damage to the Common Peroneal nerve. The Common Peroneal nerve is a branch of the sciatic nerve and runs into the lower leg on the outside of the knee. You can assimilate a nerve within the body like a tree. The roots of the tree are like the brain, the spinal cord is like the trunk and branches of the tree and the leaves of the tree are like the nerve endings within the muscles/skin. Damage can occur along the entire pathway and normal function downstream of the injury will be affected. A nerve can be damaged by direct crushing or stretching, diabetic complications, and/or neurologic disease like MS and ALS.
The most common cause of drop foot is a compressed nerve root in the spinal column at L4. The nerve is usually compressed by a herniated disc or advanced arthritis.
What is the best treatment for Drop Foot?
Proper diagnosis of this condition is crucial. An x-ray and MRI are warranted to identify the cause of the drop foot. If it is isolated to the spine, the patient should engage in aggressive strengthening of the ankle and consider an epidural injection to reduce inflammation to the nerve root. If the drop foot is still present after 6 weeks with little improvement in strength, a surgical consultation is likely the next step.
If the condition is chronic, lasted longer than 6 months to a year, surgery may have little effect on the nerve and weakness may persist. A drop foot orthosis may help keep the foot from affecting your balance and walking ability.
Dr. Custer is the owner/operator of Better Care Chiropractic and Physical Therapy. He combines chiropractic manipulation with active rehabilitative techniques to restore pain-free living. If you have questions/comments/suggestions, please feel free to contact Dr. Custer at [email protected].