Drop Foot

Definition / Symptoms

Drop foot (also known as dropped foot, foot drop or floppy foot) refers to a weakening of those muscles that allow the ankle and toes to flex, causing difficulty in moving the ankle and toes upwards (dorsiflexion). This causes the individual to drag their toes while walking and to compensate by bending the knee and hip to lift the foot higher than usual, to prevent it from catching on the ground during the swing phase.

Symptoms/causes

While drop foot is a neuromuscular disorder that affects the nerves and muscles, it is not actually a disease in itself, but rather a symptom of some other medical problem.

If drop foot is caused by an injury or nerve damage, recovery is often possible. However, if it's caused by permanent nerve damage or a progressive neurological condition, such as multiple sclerosis, it will be a lifelong symptom to manage.

 

Risk Factors

The immediate risk factors involve tripping and falling. Clearly, this is to be avoided particularly in the older population that has a higher risk of further injuries, such as fractures.

Medium- to long-term risks of leaving drop foot untreated are problems related to the skeletal system. They involve pain in the forefoot, the collapse of the midfoot, hip and knee alignment problems and postural problems, which can cause back pain.

Complications and related diseases

Drop foot can lead to many other orthopaedic problems if left untreated. These can include metatarsalgia; flat foot; tightness in the calf and Achilles tendon; and hyperextension of the knee.

It will also make walking more difficult. Often patients complain of having to constantly look at the floor while walking, which is tiring. This can lead to postural problems such as a Kyphotic Posture.

 

Tests and Diagnosis

Assessment for drop foot requires a full biomechanical assessment. This includes: assessing joint ranges of movement; joint stability; muscle strength; standing posture and alignment; and a gait/walking assessment.

Orthotic Treatments

There are many different types of orthoses that can be used to treat drop foot. Some are very simple and purely deal with the drop foot. These can include some elasticated supports and the 'foot-up' device. 

Some are more advanced and will require a bespoke or made-to-measure device. These tend to involve an ankle foot orthoses (AFO), of which there are many different types depending on the exact biomechanical requirement. Different materials, such as plastic and carbon fibre offer different solutions. The basic aim of each design will be to control the foot drop during the swing phase part of the gait cycle and ensure that any initial contact with the ground occurs with heel contact. The bespoke options will also be designed to control the medial/lateral stability of the ankle, and ensure that the lower leg is prepositioned during the stance phase to allow as normal a gait pattern as possible.

Also, in some cases where the cause of the rrop foot is an upper motor neurone problem, Functional Electronic Stimulation (FES) may be recommended.

Choosing the correct orthosis is essential. Although some devices appear to resolve the short-term risk factors, such as tripping, they do not prevent the longer-term risks of orthopaedic damage.

At LOC, we will make sure you understand what your orthosis will and won’t do, and ensure that you receive the most appropriate orthosis for your particular condition. 

Further information / Reading / Links

NHS website

Wikipedia

 

FAQs:

We have the following facilities and amenities at our Kingston Upon Thames location:

  • Free parking
  • Wheelchair ramp
  • Disabled toilet
  • Baby changing facilities

We also have the Gait Laboratory for orthotics patients and Onsite Manufacturing for speedy turnarounds and adjustments whilst you wait.

We have the following facilities and amenities at our Cambridge location:

  • Free parking directly outside the clinic
  • Large Waiting Room
  • No Toys (Due to Health & Safety Requirements of the clinic)
  • Baby changing space (In clinic room)

For more information about The Beechwood Complementary Medical Practice, please visit The Beechwood Practice.

We have the following facilities and amenities at our Bristol location:

  • Free parking directly outside the clinic
  • Large Waiting Room
  • Free tea, coffee and water
  • No Toys (Due to Health & Safety Requirements of the clinic)
  • Baby changing space (In clinic room)
  • Fully wheelchair accessible
  • Short walk to Clifton Village centre for shops, restaurants & cafes

For more information, visit Litfield House Medical Centre.

LOC’s clinic is based in the University of Salford’s Podiatry Department and provides treatments for orthotics, scoliosis, pectus deformities, positional plagiocephaly and club foot.

It is also the base for LOC’s northern OSKAR clinic which is run by Sam Walmsley, clinical director of LOC, in conjunction with Elaine Owen MBE MSc SRP MCSP.

Due to COVID-19, we have had to temporarily close the Salford clinic and are operating out of another clinic in Bolton. 

508 Blackburn Rd,

Astley Bridge,

Bolton

BL1 8NW

 

For more information, please visit The Good Health Centre 

An insole is a contoured orthotic device which alters the characteristics and biomechanics of the foot and ankle area. Biomechanics are concerned with mechanical laws and how they affect the living body, especially the musculoskeletal system.

They are removable devices, often made from plastic, that are designed to fit inside a shoe to provide additional support for your feet. As well as offering shock absorption, an insole can help distribute the weight of your body more effectively across the foot and can be made bespoke to cover a range of biomechanical conditions.

If you have symptoms in your feet, ankles, hips or your lower back that are intermittent or were not there to start with in early life, and have started to cause you pain over a period of time, bespoke orthotic insoles could be an excellent option.

If you have already tried rest, icing, compression and elevation and your feet have not recovered, we recommend a biomechanical assessment to consider the possibility of insoles. They are a non-invasive approach to treatment and in many cases, are a great option for symptoms that are not severe enough to warrant surgical intervention. Alternatively, they can be considered as an option prior to surgery.

We will send patients away when an insole is not appropriate, if a patient is suffering with iliotibial band syndrome for example, the problem can be helped with physiotherapy and a stretching programme. That’s what our biomechanical assessment is all about; determining whether there would be any benefit from altering the alignment of your feet.

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