Equinus Foot or Foot Drop

Everyday living
1

Hi folks,

I have a lesion on my spinal cord which has caused right foot issues. I may or may not have MS - jury is still out!

Anyway the problems started a few years back after a long walk I found that me right calf became tighter and tighter. I then found it harder to flex my foot when my calf was like this. When I went to my GP he got me to flex my foot and tried to pull it down. As I was able to resist him pulling it down he said I did not have dropped foot.

Anyway this calf tightness has got worse over the years making it difficult to lift my foot when walking. I can however lift my foot quite well when I am sitting.

I often wonder if it is Equinus foot I have rather than traditional drop foot. Equinus foot is tightness/contracture in calf muscles and sometimes surgery can help relieve the tension.

I have an appointment for FES next week but I often wonder if it will work of the calf is resisting the foot flexion.

Does anyone else think that they have this problem.

Thanks

Moyna x

2

Hi Moyna,

I don’t get calf discomfort when I get my footdrop, I sometimes get a tight feeling in both my hamstrings. Now I wear a Boxia AFO I get bad pain and spasm in my footdrop foot after standing for long periods or walking. Have you asked your Neurologist about it or do you have a Physio you can ask for their opinion?

Snowqueen x

3

I’m not sure I entirely trust your GP’s consclusions.

I have been diagnosed with foot drop by a neuro physio. However, I am confident I could resist someone trying to pull my foot down, so I don’t think it’s quite as clearcut as if you can do this, you can’t have foot drop. I can raise my foot/resist downward pull, by a conscious act of will - however, if I’m not consciously thinking about it (which you usually don’t, in everyday life), it will tend to drop of its own accord, and I will tend to walk by swivelling at the hip, instead of swinging my leg through.

It doesn’t hurt in itself, and I didn’t even know I had it, until the physio identified it. It’s not bad enough to make me trip, because I have been compensating with the hip rotation, without even realising - which, of course, is not OK, as it’s not the correct way to walk, and leads to other problems - but probably still beats falling over!

I do, however, have very tight calves - these are more painful than the foot drop itself, and were one of my earliest symptoms. In my 40s, I began to have unexpected muscle gain in my calves, which is most unusual for someone of that age, who has not done anything to promote it. I now know the muscle gain was due to spasticity, which meant I was getting a workout even when I was asleep, because my calves were getting continuous “contract” signals, but the “relax” signals were not getting through (this was due to one or more spinal cord lesions).

At the time, though, I was unaware of any disease that caused more pronounced musculature, and when I tried to explain to people (specifically family) that I was concerned, because it seemed odd, they thought I was mad, because they couldn’t understand anyone being worried about seeming muscular.

I tried to show Dad, but he said, exasperatedly: “But that’s just your muscle, Dear, isn’t it?”

I said: “Yes, but they never used to look like this!” My calves now look as if I play basketball or something. Aesthetically pleasing, but painful and useless. At least I now know I wasn’t mad to say: “This muscle tone is odd, and I’ve not been doing anything to encourage it!” Excessive muscle tone is the hallmark of spasticity.

Tina

x

4

Thanks Snowqueen and Tina,r

I have tried several AFOs and they all cause more pain in calf because they are trying to resist the calf pull.

Tina I think my problem is similar to yours and my right calf is larger and more toned than the left. The problem is spastisity. Although it still is tight even on large doses of baclofen so I wonder if there is a permanent contracture. When I google footdrop it mentions that the peroneal nerve is weak and not sending message properly to dorsiflex the foot. FES stimulates the peroneal nerve which makes the foot pick up. I have been told FES will help my footdrop but what if the calf is just too strong for that little impulse sent to the peroneal nerve.

There is a procedure called the Strayer Procedure which helps release contracture of the calf muscles. I feel if these were released a bit then maybe the FES would work better or I might not need it at all.

Thanks for your help

Moyna x

5

Moyna,

At last l got an appointment for assessment for a new FES. Took 3 yrs - yes 3yrs. l was surprised that the physio found the FES was really helping my dropped foot - because it has been like that for 33yrs. But it did respond. And this week l go back to see them and hopefully will be coming away with a new FES. l was hoping for a wireless one - which just fits as a cuff below the knee. But l think this too expensive for funding. lts a postcode lottery. Someone l met on the facebook group Biotin for Progressive MS. Asked his GP about a FES for his dropped foot. The next week he was seen by a physio who referred him to Salisbury OdStock and he was fitted with the new cuff type - and all in 3 weeks. And this chap has only had MS for 5yrs.

l shall still try to get a wireless one - once l have got used to this basic one.

Moyna, l have heard about people with MS - having Botox injections in their calves to stop the tight muscles. Have a google and see what can be done.

l have muscle wastage in my left leg/foot - from my MS.

Don’t get a AFO - l think - in the long run - they cause more damage to your leg muscles. Whereas a FES will keep the muscles working and hopefully relax them. Also, it re-trains the brain to use these muscles.

6

Thanks Spacejacket. They gave me botox in one calf muscle and it made no difference. To be honest I think it can be hit or miss getting the right spot to put it. Yes when I did wear my AFO my foot felt even weaker after it.

Thanks

Moyna

7

Hi Moyna, best thing is to try FES…I was never told about this when I was having foot drop and my mobiity probems esclated rapidly.

Good luck hun.

luv Pollx