foot drop

New diagnosis and before diagnosis
1

I’ve now been told twice - once by a physio and once by my GP - that I have foot drop. I’m unconvinced by this as from the very little I have seen I don’t look as if I have. However, the reason the GP said this is because when I sit with my legs out in front of me I can’t move my right foot/toes towards me but my foot doesn’t seem to drop down - when relaxed it naturally sits in the same position as my left foot, as I say I just can’t make it move towards me though if someone moves it it does move. In addition I find it very difficult to point the toes in my right foot but can eventually do this with lots of concentration though not as well as on the left. I’m not sure why the physio said it was foot drop as it was only mentioned in a letter to my GP that I only actually saw sometime after the physio appointment so I haven’t been able to ask why she said this. Can anyone advise please? Many thanks

2

Hi Sara

Foot-drop can be observed by someone else, or you can find out for yourself. Catch it in time and perhaps something can be done about it (eg by a good Orthotics person). Check these points for yourself:

  • It seems that it is your right foot, so, with your weight on the left foot, can you raise your right knee up toward your chin (not all the way, obviously, but so that the foot comes several inches off the ground). How many times can you repeat this? If you find it hard to do, or if it gets harder each time and you only manage five or six lifts, that is a sign of the problem.

  • You have started to try this already. Legs out when sitting, heels on the ground, point the toes forward, and then bring them back. If your right toes don’t move as far as the left, then that is the next sign.

  • In bare feet, does your right big toe touch the ground with the rest of the toes, or does it stick up a bit (that’s another sign).

In the end, there are only two treatments - mechanical or electronic.

  • Mechanical means that an Orthotics expert (NHS or Private) comes up with something to permanently lift your toes up a bit. This could be a splint round your foot and ankle (and there are some good ones out there), or something that goes under your shoe-laces (or velcro straps) and hooks to a wide strap round your ankle, or a cord that goes round your toes and hooks to your belt. Google “Foot-up” and “Mus-mate” to see what I am on about.
  • Electronic means something like FES (Google that as well), whick is a switch under your heel, two electrodes stuck to your lower leg, a control box hooked on your belt, and when you start to walk, the nerve feeding the muscle that is not lifting your toes up gets stimulated and the foot comes up.

Either way, this could mean that you are wearing jeans or trousers for the rest of your life.

Start asking about FES right away - some PCTs do not like to fund it unless pressed very hard, many Oc. Therapists and all Orthotic people do not like it, because it is outside of their competence, but some OTs will refer you.

Whatever you do, keep walking. If dropped foot gets bad, the foot drags on the ground, this plays havoc with your balance, this means you do not walk so much, the leg muscles weaken, and in the end you have trouble moving more than a few steps without help. Since FES just works on the muscle (which pulls at both ends, it can actually put a little flex into the knee as well. Even with a mechanical aid, keep walking and you will retain a lot of the muscle tone in your legs, and that does help the problem.

Geoff

3

Hi Elaine

Apart from what I wrote to Sara (especially the first bit) I think that you should get yourself referred to a Physio as soon as possible. The foot dragging on the ground is classic “dropped foot”, and even if all you can get is a splint or a “Foot-Up”, it sets up a marker for when this first became a problem. A GP, Neuro, or MS Nurse can all do the referral (whichever is easier for you) but just make sure that it goes on your MS records. If you can get yourself referred for FES, so much the better.

The progression of “dropped foot” can happen at any speed - from very slow, to quite quick - and you really do not want to be thinking that you should have done something about it last year. You have already seen how quickly your activity can diminish.

Geoff

4

I’ve been tripping over my own foot recently where I either trip over my toe or scuff my foot along the floor, is this footdrop?

5

Thanks to you all for you advice and comments. I am aware that I have trouble on stairs etc. as my foot keeps hitting the riser rather than landing on the step itself but the neuro never mentioned anything about this when I told him. the first person who mentioned it was the physiotherapist at a balance clinic and even she only put it in a letter to my GP and never said anything specific to me. If there is something that can be done to help I’m annoyed neither the physio nor my GP so far have done anything more than mention it in passing. I think I need to go and knock some heads together on this one!!! All the best ot you all.

6

Sounds a lot like it. Sorry.

On a more practical note, get it seen to before you start having falls. Next, start thinking about whether you need to apply for a blue badge. If it gives you a problem walking more than a very few yards - then it’s Blue Badge time. Given the way in which the BBs can be abused, I think that those of us who really need on should all apply.

Geoff