What EXACTLY is foot drop?

Rosey · 10 June 2014 19:34

Could anyone kindly please explain what foot drop is? My GP states its when the foot drags behind when walking.

My neuro says its when you cannot bring the foot upwards (e.g. you are sitting on a chair and your leg is stretched out and after you point downwards with your foot you then cannot draw it upwards towards your belly)

I have the neuro definition of this but it is so intermittent and just comes and goes - heat does not affect it and I have no clue as to what causes it. Is this actually foot drop as I can walk when it happens but just for a wee while, then I rest up and its all fine again?

I saw my GP - he thinks its musculoskeletal and has referred me for PT (appt next Tues) I saw a podiatrist some weeks back who undertook a 2 hour long assessment and emphatically stated that it was biomechanical. He said I had the tightest calf muscles he had ever seen (go me!) as I could not do a lunge against the wall at all. He gave me a bunch of calf stretching exercises. Over the last 6 weeks - my calves have loosened - no tightness at all and I can do lunges against the wall from 10cms back. Yet, intermittently, I still cannot draw my foot up with ease - its like its stuck in glue but just intermittently and this goes on to affect my walking for short periods.

I am hopeful the PT will work but I could really do with all you knowledable bods helping me with the definition of foot drop as I fear I (amongst many) may frequently use it erroneously.

I have posted anonymously as last time I posted about this I was pretty much told to face up to the fact that I have MS (not confirmed yet though) and it’s just a bit daunting as I just do not have the knowledge as although its been 2 years almost since my first episode, I do not have an MS nurse and have only seen a neuro twice (have had a couple of telephone conversations with them though) and whilst I thought this issue was my 2nd episode (thus confirming MS) the neuro stated that it wasn’t.

Anyway, I babble - any help on defining/describing foot drop would be gratefully received. Thank you.

annelda72 · 10 June 2014 19:54

I’ve not had this but I’m sure someone will be able to help you. Bump!

Inactive_User · 10 June 2014 21:12

A to Z of MS Foot drop Foot drop, or dropped foot, is a symptom experienced by some people with multiple sclerosis. It is caused by weakness in the ankle that means the foot drags along the ground or hangs down when walking. People with MS with foot drop are more vulnerable to tripping and falling. Walking also uses more energy and people may alter their gait to compensate, commonly lifting their leg higher. Foot drop can be treated using functional electrical stimulation (FES). This uses small electrical charges to force the foot into a more natural position for walking. An ankle splint (orthosis) can also be used to hold the foot in a rigid position. This is taken from MS Trust Website (didn’t know how to do a link as am not very bright!) M x

Alysea · 10 June 2014 21:27

I have this most of time not diagnosed yet and not due to my ankles it’s the stiffness that stops me being able to lift it properly mostly happens with left leg. I don’t do much walking at the moment due to poor balance but manage.

Rosey · 10 June 2014 21:35

Thanks Manoon - I had seen something like that but my foot doesnt hang and I dont trip, it just is hard to pull up and when I walk it just gets harder/stiffens and sometimes just slaps around but I guess this is somewhat similar.

Thank you though. x

Alysea - I’m sorry you are suffering at the moment. Have you seen your GP or neuro? x

Rosey · 10 June 2014 21:35

Thanks Manoon - I had seen something like that but my foot doesnt hang and I dont trip, it just is hard to pull up and when I walk it just gets harder/stiffens and sometimes just slaps around but I guess this is somewhat similar.

Thank you though. x

Alysea - I’m sorry you are suffering at the moment. Have you seen your GP or neuro? x

Alysea · 10 June 2014 21:40

Yeah had MRI 2weeks ago he’s sure I have ms as he specialises in it so I’m in good hands I get terrible back pain can cope with rest good thing I got family helping me with my daughter considering a scooter to get out lol only go out when I have hospital. Hope you feel better like you it’s hard to lift due to stiffness.

hoppity · 10 June 2014 23:00

From one who shuffles on a zimmer and spend vast majority of day in wheelchair it’s taken twenty years to come to this so don’t worry, if it bothers you and it must do try a stick I started with one then two then crutches etc They are aides to help you get the best out of life.maybe a fold up one to aide you when it occurs will be a benefit excersise never bought back what was lost for me . Hope you get it sorted. DON

Moyna · 11 June 2014 10:16

Hi

There are 2 types of foot drop.

One caused by the shin muscles not having the stength to lift the foot up.

The second type is when the calf muscles are too tight with spasticity that no matter how hard the shin muscles try to lift the foot the calf muscles resist.

Most doctors think there is only the first type.

I have the second type. A year after an MS-like attack (not dx yet) I had exactlt the same problems that you are having now. I went to GP and when I flexed my foot he tried to pull it down and couldt. So he said my shin muscles were fine and I couldnt have foot drop. I was sent to podiatrist as he said problems were mechanical not neurological. The podiatrist did the same tests and said the same as gp. I tried to explain that the problem only arose when I had been walking for a while. They still said it was mechanical.

When I eventually saw neuro he said the problem was with the calf and it was that type of foot drop. FES is not great for this footdrop type as it only addresses the shin muscle problem.

My spasticity has progressed in that the foot drop is always there now and not just after a long walk. Baclofen does help. My neuro has suggested a Baclofen pump because it targets the spasticity directly through the CNS and people with this type of foot drop can get 80% resolution.

People just tend to lump foot drop under the same umbrella - the most common type.

Hope this makes sence

Moyna xxx

Rosey · 11 June 2014 11:39

Hi May & Don - hoping exercise from PT will be of use - will keep you all posted (that’s me assuming that I will be given some exercises) but the lunge ones from the podiatrist made a huge difference to the calves but the ‘drop’ still occurs but no ‘drag’ thus far. But appreciate Don’s experience and guess I will have to wait and see.

Thank you both x

Rosey · 11 June 2014 11:40

Hi May & Don - hoping exercise from PT will be of use - will keep you all posted (that’s me assuming that I will be given some exercises) but the lunge ones from the podiatrist made a huge difference to the calves but the ‘drop’ still occurs but no ‘drag’ thus far. But appreciate Don’s experience and guess I will have to wait and see.

Thank you both x

Moyna · 11 June 2014 11:45

Hi, can you explain what the lunge exercises are. I would like them to help me.

Moyna xxx

Rosey · 11 June 2014 12:31

Moyna!

I have tried to send you a private message but for some reason, it just won’t let me

Wow! Reading your post is literally like reading my experience (the only difference being that I could move my foot downwards just struggled brining it up and it resisting after a certain point).

Like you - this has occurred well after my first presenting symptoms - almost 18 months later but still no dx??!! Interesting that both our podiatrists felt it was mechanical, my first neuro wanted to give me botox shots as he felt it was the tendon that needed relaxing (didn’t go for that, first time I ever have Botox will definitly be in the wrinkles on my face ), my neuro up where I am currently staying feels that I must have another 2 MRI’s before we can move forward and states that it is something to do with my CNS for sure. He states that its intermittent due to my body temperature and that as soon as my temperature rises, it hits me. I disagree with this as I have times where I know my body temp is pretty stable. I am minded to ignore him (for now) as everytime I have contact with him (mostly by telephone) he will not discuss anything until I have a new set of MRI’s. I have to pay for them myself as I am very claustraphobic (didn’t actually know that I was until my first one) and have to use the Upright Centre and at 1k a pop, I would be at around 7k by now.

It will be interesting to see what the PT assessment on Tuesday comes back with - will keep you updated. I feel very unheard by all neuro’s as this occured firstly in December after I had stupidly upped my running from a gentle 1k to 18k without stretching and really hurt my ankle and the second time after turning my foot on a cobbled street. Neuro’s just do not see this as related but I will post the link on here that I found that sets out extreme exercising (without warmup/stretching) can cause tendon issues which can lead to intermittent foot drop/slap. My neuro firmly stated that I turned my ankle due to the foot drop but I was there (!) and I know that I turned my ankle due to catching my heel inbetween the cobbles in a crowded market & I felf the pain of it!

Has your neuro given you any more details on the ‘problem with your calf’ is that it’s tight? Have you been given any exercises for it? Can you describe the spacisity? is it just in the luscle of your calf or also in your ankle/foot? I also had this but the exercises completley eliminated this and it doesn’t really re-ocurr unless I take a lengthy walk.

Were you pescribed the Balcofen after all other avenues were explored? I only ask as I have been made very aware by the podiatrist that neuro’s will often just lump everything under neurological conditions and he has dealt with 3 other non dx ms’y folk and manged to sort out their issues througk shoe inserts and exercises and identified that 2 of them had issues stemming from the knee. This is where I get scared from some of the forum members as I am sure I will get shouted down but I strongly feel its worth exploring when we are not dx as sometimes other things ocurr and not everything is a neuro/ms issue. Of course, it may well end up being so but if there’s a chance that it’s not then I for sure will examine this.

So, now that you have been given Balcofen, does your neuro feel that you have a confirmed dx? Do you mind explaining what a Balcofen pump is? if this different to the tablets?

Have you altered your footwear? I immediatley went to flat-ish shoes (no more than an inch block/flat heel) but honestly, I feel no difference with the flat shoe to the ones with a slight heel - I did when my calves were tight but now that they are no longer tight (I still do the stretch lunges 3 times a day - actually, when I don’t, I do feel the return of the slap) I feel the footwear does not seem to impact. I am sort of stuck in Scholl’s at the moment just to be on the safe side but had an evening out and work a 3 inch heel and felt no differnce during or the day after. I have bought a collapsable stick but haven’t had to use it as when I take what for me is a longish walk nowadays (usually Ikea as I’ve just moved), I just stop for a couple of moments when it happens then it disappears after that.

I cannot thank you enough as my experiences really fit your journey - I hope you continue to improve and the spacisity stops soon.

Hoping you have a great day and hope to hear back when you have time xx

Rosey · 11 June 2014 12:31