Forum

If it's not foot drop, what is it?

For over a year now I’ve been suffering what I describe as foot slap. My right foot works normally, rolling from heel to toe as I walk. My left foot slaps down after the heel hits the ground. Sometimes the whole foot just thuds down, rather than trying to roll from heel to toe. I’d always assumed that the problem was related to foot drop, but my neuro says otherwise. He tested my ability to resist him pressing my foot down and found no evidence of ankle weakness. My GP says that the muscles in my left calf are significantly weaker than my right calf.

Since then I have studied the way I walk. It seems that the problem is stiffness rather than weakness. The foot is almost stuck in one position when I’m walking. I’ve tried doing calf stretches, but that doesn’t make any difference. Has anyone experienced anything like this? If so, what was the problem and is there a solution. I’m currently receiving FES treatment but I’m beginning to wonder if it’s appropriate.

In my case, the “foot slap” was a precursor to the “dropped foot”.

It was the drag from the dropped foot that got me a refwrral to Odstock for an FES,
If you can get am FES, take it - you will not regret it.

Geoff

What is an FES please Geoff ?

FES stands for Functional Electrical Stimulation. Mild electrical pulses through electrodes on your leg stimulate the muscles that control foot movement. It can be very effective. Last year I saw a programme about an alternative Olympics for the disabled. This one looked at aids and adaptations for disabled people. Paraplegic cyclists raced on recumbent bikes, leg movement being stimulated by FES. And all I want is normal foot motion! I guess I just don’t have any ambition.

I suppose that the answer to my question is that it’s not foot drop yet. This poses more questions​ How long did it take for foot slap to develop into foot drop? Did you have FES at the time? If so, did it make a difference to the progression? I’m not using walking FES at the moment. The neuro-physiotherapist wants to strengthen the muscles first.

Well C_D, it probably took about 18 months to two years for the foot slap to turn into drop foot.
No.I did not have FES at the time. Whether it made any difference to the progression is harder to quantify
I had a couple of years on Copaxone, and had a stair-lift put in (this cuts down on the exercise, but the trade is being confined to one floor).

All I can say is that with the FES and one stick/two sticks/3-wheeled rollator/4-wheeled rollator I am still sort of mobile.

Geoff

Thank you Cheerful Dragon and Geoff. I thought I had foot drop BUT now I am not so sure. All the toes on my right foot do not move at all. I looked at the way I walk and it is like you describe Cheerful Dragon, my left foot rolls from toes to heal fine but the right foot just slaps down. I am seeing my neurologist today and will ask him about this.

I had the foot slap to begin with. Initially I thought I was imagining things. I also had foot drag, in that I could lift my right foot properly. Quite a few years ago after walking in heavy snow, I remember looking back and my left footsteps were very clearly defined whilst the right was a bit of a mess.

After about 4 years or so, the slap turned into foot drop. I use a SAFO ( a lightweight, easy to apply, silicone brace) to help counter the effects of foot drop. I’ve tried the FES a couple of times but couldn’t get it to work for me.

Now I struggle to walk full stop, but without the SAFO, I wouldn’t be walking at all.

derek

I have an AFO that I use when I’m going to be on my feet for a long time. I haven’t been using recently - it’s much too hot to have my ankle strapped up.

I saw the neuro-physiotherapist today. I told her what the neuro had said. Her reaction was that there are degrees of weakness and it’s not​ all-or-nothing with foot drop. It’s not possible to rule out foot drop by one simple test that doesn’t compare the ease of movement of both feet. She’s hoping that using FES every day will help strengthen the ankle muscles and improve flexibility. She’s given me some simple exercises to do as well. She says that it’s possible that daily use of FES will prevent the problem worsening.

With the SAFO, you barely even know you’re wearing it.

Derek