Foot drop refers to an inability to lift the forefoot due to the weakness of the dorsiflexor muscles of the foot. This condition may be associated with muscular, skeletal, or nervous system problems. Foot drop can have many causes; thus, before starting any treatment, it is essential to evaluate the cause of the condition correctly.
Etiologies – Causes of the Condition
1) Compressive Disorders
The most common causes of nerve compression involve the peroneal nerve (a branch of the sciatic nerve which innervates the lower leg, foot, and toes). Compression and dysfunction can occur at the level of the fibular head, yet this condition can also present at the hip or ankle. Also, foot drop can occur in individuals with lumbar herniation and lumbar degenerative disease.
Trauma is the second most common cause of foot drop due to nerve impairment. Such conditions are associated with orthopedic injuries, such as fractures, dislocations, ankle injuries, trauma, and other injuries that involve musculoskeletal injuries and nerve damage. Acute ACL (anterior cruciate ligament) injuries can also lead to nerve damage and may result in the foot drop condition. Injuries in the hip area are considered high risk to peroneal nerve damage, which can result in foot drop. In addition, severe ankle sprains can also lead to nerve impairment.
3) Iatrogenic (surgical and medical interventions)
Surgical procedures can cause iatrogenic foot drop. Also, prolonged bed rest can lead to nerve dysfunction.
4) Neurologic Disorders
These disorders can include stroke, multiple sclerosis (MS), cerebral palsy, and Charcot-Marie-Tooth disease. Also, people with diabetes are at risk for nerve dysfunction.
Treatment – Nonsurgical
Surgical and nonsurgical medical treatment procedures are available for the management of foot drop. The selection of a treatment approach is dependent on patients’ etiology of foot drop. Proper evaluation, testing, and diagnosis are required to develop a personalized treatment plan.
Physical Therapy (PT)
At the beginning of the treatment, the plan is focused on gait and stabilization of the foot to reduce foot slapping conditions. In addition, PT centers on stretching and strengthening of the affected muscles and contralateral muscle groups. Electrical stimulation of the dorsiflexors and evertors can also be therapeutic.
Splinting and Braces
Physicians and physiotherapists can also provide a recommendation on various splints and braces to optimize movement, alignment, and overall treatment results. Depending on the location of the nerve damage, the correct splint can be used. In cases of inability to use the dorsiflexor muscles (in the front of the foot), an ankle-foot orthosis (AFO) is needed. Brace use can be applied to the treatment routine to reduce the load on the foot.
Chronic Conditions – Foot Drop
Living with chronic conditions of foot drop can be managed by the right treatment plan. In this way, patients’ mobility and independence can be preserved and controlled. Also, appropriate rehabilitative equipment promotes correct foot alignment and assists in developing adequate muscle strength to optimize treatment. Foot drop can be managed and expected to be improved in patients who are ready to take action.
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