What is Foot Drop? How Do You Treat Foot Drop?

Some patients notice they have difficulty lifting up their ankle. This causes them to lift their knee higher when walking. In general, this is called ‘foot drop.’ 

What is foot drop? 

Foot drop is when the tendons that lift your ankle and toes stop working. This can occur slowly overtime or after an acute injury. 

What are the symptoms of foot drop?

The main symptom is weakness or the inability to lift the foot. The muscles that push the foot down still work. Foot drop causes patients to walk with an altered gait, as they have to lift their foot higher off the ground to prevent their toes from hitting the ground. This is called steppage gait. A patient’s foot can also slap the ground as they walk. 

Foot drop can also affect the muscles on the outside of the leg and ankle, so it is difficult to push your ankle to the side. 

Why do patients get foot drop? What causes foot drop?

There are a number of causes of foot drop. In general, the nerves that control the muscles that lift the ankle up and push the ankle out are damaged. Once these nerves are damaged, the muscles no longer function properly. 

Causes of nerve damage that may lead to foot drop:

• Lumbar spine injury
• Total hip replacement
• Knee fracture or dislocation
• Laceration or blunt trauma to the peroneal nerve
• Tearing of tendons at the ankle

How do you fix foot drop?

First, when foot drop develops, you work to evaluate the cause of the foot drop.

• Did you recently have an injury to your lower back?
• Did you have a complex hip surgery or hip trauma that may have injured a nerve in the hip?
• Have you recently had trauma or a fracture to your knee that damaged the nerve on the outside of your knee?
• Did you have a penetrating laceration about your leg that may have cut the nerve?
• Did you tear the tendon that lifts your ankle up?

Once the cause of the foot drop is identified, the root cause can be treated. If there is a nerve laceration or injury, it can be repaired or addressed. If a nerve is being pinched, it can be released. If a tendon is cut, it too can be repaired. 

Will foot drop ever get better? 

This is the most common question for foot drop, but the hardest to answer. If foot drop is from a nerve injury, it takes a long time (months) for the nerve to heal. Unfortunately, sometimes the nerve doesn’t heal. If the nerve doesn’t heal, there will be permanent weakness.

Is foot drop permanent?

Sometimes. Again, this is a difficult question to answer. Sometimes the foot drop is permanent, but sometimes patients regain some strength of their leg muscles. 

What is a foot drop splint?

An ankle foot orthosis (AFO) is a splint that can be fabricated specifically for each patient. These are molded from your leg and fit into a shoe. They are used to hold your ankle in a straight position to help with the symptoms of foot drop. This does not fix foot drop, but it can improve a patient’s ability to walk. 

There are other types of AFOs, including carbon fiber and Velcro straps. 

The orthopedic surgeons at Southwest Orthopedic group and Dr. Stautberg can find the best brace for your foot drop. 

What are nonoperative treatments for foot drop?

Once the cause of the foot drop is identified and treated, your orthopedic surgeon can focus on your foot drop treatment. First, the Achilles tendon often is still working, but it becomes very tight (contracted). Thus, the Achilles must be stretched out. Some patients attend physical therapy to help with this. Some patients can do it at home, but continuous stretching is needed. 

Various AFO braces can be used to help foot drop. 

What is the surgical treatment for foot drop?

If patients have permanent foot drop, and they are not tolerating bracing, they can consider surgical treatment. Surgery involves tendon transfers. See our post about tendon transfer surgery for foot drop. 

The American Orthopaedic Foot & Ankle Society (AOFAS) has more information about ankle fractures at FootCareMD.

For more questions or to set up an evaluation, contact Dr. Stautberg’s office at 281-977-4870. 

Author

Eugene Stautberg, MD