Foot Drop

Foot drop describes the inability to raise the front part of the foot due to weakness or paralysis of the muscles that lift the foot. Foot drop can be unilateral (affecting one foot) or bilateral (affecting both feet). It is a symptom of an underlying problem and is either temporary or permanent, depending on the cause.

Signs and Symptoms

Individuals with foot drop scuff their toes along the ground or bend their knees to lift their foot higher than usual to avoid the scuffing, which causes what is called a “steppage” gait.

Causes

Foot drop is a consequence of a variety of conditions:

• multiple sclerosis, stroke, cerebral palsy, and other neurodegenerative disorders that cause muscular problems
• polio, some forms of spinal muscular atrophy, amyotrophic lateral sclerosis (commonly known as Lou Gehrig’s disease), and other motor neuron disorders
• spinal stenosis or other injury to the nerve roots
• Charcot-Marie-Tooth disease, acquired peripheral neuropathy, or other peripheral nerve disorders
• local compression or damage to the peroneal nerve as it passes across the fibular bone below the knee
• muscular dystrophy, myositis, or other muscle disorders

Diagnosis

Foot drop is often diagnosed during a physical exam and is based on the presence of the characteristic symptom, which is steppage gait.

Treatment

Specific treatment for foot drop may include:

Braces or splints

A brace on your ankle and foot or splint that fits into your shoe, called ankle-foot orthotics,can help hold your foot in a normal position.

Physical therapy

Exercises to improve the gait and maintain joint motion.

Nerve stimulation

Sometimes stimulating the nerve that lifts the foot when you step (peroneal nerve) improves foot drop, especially in the case of foot drop caused by a stroke. In some cases, a small, battery-operated electrical stimulator is strapped to the leg just below the knee. In other cases, the stimulator is implanted in the leg.

Surgery

In some cases, surgery can be performed to fuse the foot and ankle joint, or to correct nerve or spinal problems.

Expected Outcome

The prognosis for foot drop depends on the cause. Foot drop caused by trauma or nerve damage usually shows partial or even complete recovery. For progressive neurological disorders, foot drop is a lifelong disability, but it does not shorten life expectancy.

Research

The National Institute of Neurological Disorders and Stroke (NINDS) conducts research related to the neurological conditions that cause foot drop in its laboratories at the National Institutes of Health (NIH), and also supports additional research through grants to major medical institutions across the country. Much of this research focuses on finding better ways to prevent, treat, and ultimately cure the kinds of neurological disorders that cause foot drop.