Having foot drop means that weakness in your foot, ankle or leg makes it difficult for you to move your foot up towards the sky at the ankle joint.
Having foot drop means that weakness in one or both of your feet or legs makes it difficult (or impossible) to point your toes up towards the sky because the right muscles aren’t working properly to help you do so. When this happens, your foot remains in a dropped position when you walk with your toes hanging downwards. This makes it difficult for your foot to safely clear the ground as you walk, putting you at risk of tripping and falling from your toes hitting the ground - or forcing your body to compensate for the foot drop by excessively lifting and bending your knee and hip - which can cause a different series of pains and problems.
Having foot drop feels like a noticeable weakness when moving your foot up and around on your ankle, with your foot having a heavy feeling. You may also experience some tingling or numbness in your foot, notice that your toes are curling, and find that your foot drags along the ground or catches the ground during regular walking if you don’t lift your knee higher than normal to stop it from touching the ground.
Foot drop is actually a symptom of an underlying problem with one of your nerves called the peroneal nerve, which is responsible for innervating the muscles that work to seamlessly lift your foot up relative to your ankle. The peroneal nerve is a branch of the sciatic nerve, starting at the back of the knee, and runs down the lower leg and into the foot where it branches out further.
While one of the most common causes of damage to the peroneal nerve we see is through trauma or an accident, like during a sudden knee dislocation during skiing or a car accident, direct impact to the nerve during a fall or during sports, or a fracture to the fibula, there are many other issues that can also affect the peroneal nerve. One of these is from neurological conditions including strokes, multiple sclerosis and spinal injuries, where damage to the peroneal nerve can be sustained. Specifically:
Other causes of foot drop can include:
Nerve irritation or damage can be a tricky problem to manage at home, and as such, home remedies typically are unable to cure the underlying cause of foot drop. In some cases, depending on the severity and cause of the nerve damage, there are a few things you can try that may help support your symptoms or mobility:
Here at Matt Raden Podiatry, our trusted and experienced podiatrists listen to the concerns, goals and needs of our patients with foot drop, and utilise a range of evidence-based treatment methods to help you get the best outcome.
Every appointment starts with a comprehensive assessment to understand the status and function of your peroneal nerve, and then look beyond the nerve for any other signs and symptoms that can indicate what may be causing the problem, including:
We may also use the ‘Tinel sign’ test to help pinpoint the area of nerve irritation or entrapment by tapping along the course of the nerve, particularly around the neck of the fibula bone. If tingling or numbness is felt along the area that is tapped, it i ok s a positive Tinel sign and will guide our course of treatment.
We’ll then create a tailored management plan based on your results. You should know that managing foot drop is very different from managing muscle, tendon or joint injuries because nerve damage can often be unpredictable and multifaceted. Some cases of foot drop may resolve in weeks or months, while others may be longstanding or permanent. It can vary greatly depending on the way the nerve was injured and the severity of the injury. Either way, there are several therapies we can use with the goals of helping you move comfortably without pain, reduce the risk of further injury, and support your balance and confidence on your feet. To achieve this, we may use:
As a note, surgery is not a first-line treatment for foot drop, with many cases of foot drop resolving long before surgery should be considered. However, it can be explored in cases such as the presence of a rapidly deteriorating lesion, no signs of improvement within three months (or signs of worsening foot function with no other explanation), and open injuries with a suspected nerve laceration.
If you’re experiencing foot drop or foot and ankle weakness, our team is here to help - and to ensure you have the best experience doing so. We’re proud to go above and beyond for our patients, focusing not only on managing your pain and symptoms, but helping you get the best long-term outcomes.