Foot drop

Overview

Foot drop is a condition that can occur due to the weakening or paralysis of certain foot muscles. It causes the patient to drag their toes while walking and raise their knee higher than usual to prevent tripping. This condition can affect one or both feet and is not a disease, but rather a symptom of a deeper anatomical, muscular, or neurological issue.

Although foot drop can be a permanent condition, it is sometimes temporary. Patients with this condition may require the use of ankle and foot braces to support and stabilize their affected foot, with the type of brace used depending on the severity of the condition.

It is crucial to identify the underlying cause of foot drop in order to determine the best treatment. Physical therapy may be recommended to strengthen the affected muscles and improve mobility. In some cases, surgery may be required to correct the underlying issue causing foot drop. Proper treatment and management can improve a patient’s ability to walk and reduce the risk of falls or other injuries.

Symptoms

Foot drop can lead to difficulties in walking due to the inability to lift the front of the foot. This requires the affected person to raise their leg higher than usual when taking a step to prevent dragging their toes or tripping. The foot may produce a slapping sound when it hits the ground, a condition referred to as a steppage gait. Furthermore, the condition may affect one or both feet, depending on the root cause. Seek medical attention if you notice any weakness in your foot, or if your toes drag on the ground while you walk.

Causes

Foot drop is a condition that occurs when the muscles responsible for lifting the front part of the foot are weakened or paralyzed. Some potential causes of foot drop include:

• Lumbar radiculopathy: Radiculopathy is caused by an inflamed or compressed nerve root where the nerves connect to the spinal column. When a nerve is pinched in the lower back, it’s called lumbar radiculopathy. The legs and feet are served by nerves that originate in the lumbar spine, which is made up of the L1 to L5 vertebrae. Foot drop can be caused by conditions that affect the spinal cord or brain, such as stroke, amyotrophic lateral sclerosis (ALS), or multiple sclerosis.
• Peroneal nerve injury: Foot drop is most commonly caused by compression of the nerve in the leg that controls the muscles involved in raising the foot. An extreme knee injury can lead to nerve compression and foot drop. Foot drop can also result from damage to the common peroneal nerve, which can be caused by various factors. These nerve injuries often occur due to severe damage to the knee, leg, or ankle. Additionally, foot drop can occur due to nerve damage sustained during hip or knee replacement surgery.
• Muscle or nerve disorders:  Foot drop can also be caused by various neurologic disorders, such as muscular dystrophy, an inherited disease that causes progressive muscle weakness. Other conditions that can contribute to foot drop include polio and Charcot-Marie-Tooth disease.

Risk factors

The muscles responsible for elevating the foot are controlled by the peroneal nerve, which is situated close to the skin’s surface on the side of the knee nearest to the hand. Activities that put pressure on the peroneal nerve can increase the possibility of foot drop, and there are certain factors that can elevate this risk.

Examples of these factors include:

• Leg crossing: Frequent leg crossing can lead to compression of the peroneal nerve in the leg that is on top, causing symptoms such as numbness, tingling, weakness, and foot drop. To prevent this, it’s recommended to avoid crossing the legs for long periods of time and to change positions often.
• Prolonged kneeling: Jobs that involve prolonged bending or kneeling, such as gardening, construction, or plumbing, can put pressure on the peroneal nerve and cause foot drop, a condition in which the foot cannot be lifted properly due to weakness or paralysis of the muscles. To reduce the risk of foot drop, it’s important to use proper kneeling techniques, take frequent breaks, and wear supportive footwear.
• Leg cast: Plaster casts that cover the ankle and extend to just below the knee can cause compression of the peroneal nerve, leading to symptoms such as pain, swelling, and numbness in the foot and ankle. To prevent this, the cast should be applied properly by a trained professional, and regular checks should be done to ensure that there is no excessive pressure or constriction.