What EXACTLY is foot drop?

Symptoms and treatments
1

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 itā€™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 wasnā€™t.

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

2

Well mine just feels that I have a bag of flour attached to that ankle so that lifting up the foot to walk is possible but damned hard work and I keep tripping over things because the amount of effort required to lift that foot is so much more than on the other side and I keep forgetting that. Then the weak leg runs out of steam so I have to stop and rest. With me it is a matter of weakness in knee and hip on that side too, as well as ankle and calf.

I think that, for people with MS, temporary, episodic weakness that is very localized (i.e. only that bit), comes on typically with exertion and is short-acting and relieved quite quickly by rest is called ā€˜neurological fatigueā€™ and arises from MS nerve damage.

Alison

3

Rosey,

Yes it does sound like the start of foot-drop- to me. lt was one of the first symptoms l got 33yrs ago. My MS is PPMS. l could not move my toes or lift my foot. lt makes getting a shoe on difficult. l have to wear shoes with a strap across - mary janes - to keep them on.

l have been following the Biotin for Progressive MS facebook group for about 6 weeks. And one of the first signs of improvement has been that l can now get a slight wriggle in my toes and also lift my foot - just a bit - but it is still an improvement. Several others on the Biotin - have also noticed the same. And those with purple swollen feet have had good results.

l am sorry you had some ā€˜not niceā€™ replies when you posted previously. lt does happen - sadly. Got really bad about 3 yrs ago -

but thankfully those people have since left [or were pushed].

lf you canā€™t say something nice - say nothing at all.

4

Yup, me too. Constantly kicking the doorstep. (Left side) Donā€™t wear shoes/socks at home so painful. By the end of the day my calves feel like leadā€¦

5

Hello, although I donā€™t have MS, I feel my experiences may be of use. I was wrongly diagnosed with PPMS for several years and do have a similar condition, called spastic paraplegia. In MS messages from the brain do not always reach their destination, in order for the body to carry out a movement.

This is what happens, through demylination. The nerve channels lose their coating, think of a conduit enclosing an electrical wire, when the sheath is broken down, message signals seep out and get lost.

So this is what occurs with foot drop. Your brain tells your foot to lift, in order to walk. We donā€™t even have to think about it usually. But when the message is lost, the foot wonā€™t lift. Hence drag or a trip or a fall.

This was my first symptom, along with a very heavy left leg.

There are boots, straps and something called FES, which can help the problem.

There, hope this is clear for you. Oh, and I am really sorry you received unhelpful replies to your earlier posts. No need for that Iā€™m sure!

Love Poll.x

6

Poll, yesterday my son went to high school for a passport day. (He goes in September). They put him in Boudicca house !!! You got room for him .??? Anon - yes, sorry you didnā€™t get better answers the first time. Normally theyā€™re very helpful on here, or if on my thread, very silly. But laughing helps. Honest. And maybe balloons.

7

Hi Caraboyā€¦yeh, your lad can join meā€¦loads a room in Boudiccaā€™s heart!

Pollx

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8

:smiley:

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9

I have foot drop. Basically I cannot pick up my right toes at all, which means I canā€™t pick up my foot. If I shut my eyes and try to flex my feet upwards, I think Iā€™ve flexed both feet but only the left has moved. This means that walking is difficult/impossible. Some people with foot drop manage to sort of push their foot out to the side and then park it in front of them, a kind of sliding motion. Iā€™d do this if I could and bu**er the consequences to the rest of my body but I canā€™t. My right leg and hip is also useless so walking does damage to my right hip and hurts like crazy. Foot drop is caused by damage to the nerve which controls the lift of the foot; for some reason this is pretty common with MS and once youā€™ve got it, it tends to be permanent unfortunately.

There are various aids to help with foot drop. Iā€™ve tried lots of them, the best is FES (functional electrical stimulation) but itā€™s a bit of a postcode lottery as your local NHS service may not fund it.

If you have got foot drop, you should try to get some proper help with it asap because itā€™s better for the rest of your musculature to walk properly. There are various other devices that can help you a physiotherapist should be able to help.

Sue

10

Hi, foot drop is when it is hard to pick up your foot. Mine started with a foot drop that came after a long walk was ok when I rested. There is a flaccid foot drop when the problem is the nerve to pick up the foot is not getting a signal. This foot drop is easy to treat with AFOs and FES. Then there is equinus foot drop which occurs when the calf muscles are so tight that they resist the muscles that are trying in vain to lift the foot up. Sometimes people have a combination of both. I have the latter and ny calf muscles fight against AFOs. I have just bought my own FES (was in Salisbury yesterday and it will lift my foot but the calf muscles are still resisting a bit.

I have no clear Dx yet although I have a lesion on my cervical spinal cord.

What tests and results have you had ?

Moyna xxx

11

I got fitted with a Velcro splint not long ago for my footdrop and it is doing diddly squit. My foot feels fused and they are saying there is a problem from the knee.

Its nearly impossible to walk without tripping over something and the other leg is painful because of having to compensate.

I would love to try a FES but you have to fund it yourself here. I am currently fighting with PIP just now so if I donā€™t win my case I donā€™t think I will be getting it.

Mags xx

12

And by now, you should have figured out that there is more than one bit to this **** foot drop.

When we walk, as we bend a knee to start to move a foot forward, the body acts to lift the toes on that foot up so that the foot does not drag.
Then comes an inability to bend that knee.
OR: THE OTHER WAY ROUND

In my case, the knee refused to lift first, then the foot refused to turn the toes up.

The ā€œnormalā€ FES is usually set up to work on the foot, bypassing the non-functioning nerves to flick the foot out and up so that it does not drag. It can be set up to bend the knee rather than make the foot movement. The trouble with this is that it can be hard to see where to stick the electrodes (that is not a joke so stop sniggering).

If you can still bend the knee, a SAFO (Google it) will stop the foot from dropping by fixing the foot/leg relationship.

What you may need depends on which is right for you - some people here use one, some the other (me, Iā€™m a FES user).
You should ask the Physio about the pros and cons of each. A physio can refer you, but your CCG will have the financial say.

What you do not want to do is to trip up and have a serious fall.

Geoff

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13

Hi.

I have had foot drop now for some years. As Dr Geoff and others describe it - foot doesnā€™t raise.

I use an AFO - it helped me so much and despite the way it looks it really is comfortable. Puts literal spring in my step as it gives me a bit of bounce. My leg muscles are wasting though all be it very slowly and I am now on the strongest AFO.

The physio was the person who sorted this out for me and referred me to Orthotics. So grateful to her. She also gave me excellent exercises and I followed these up at home and also do some stuff at he gym - just a few minutes on some pieces of equipment to help strengthen the muscles. I find it really useful as I can concentrate on the weak leg and let the other one just be quite relaxed on something like an exercise bike.

Have used FES to help stimulate the foot to raise but just as an exercise - and when I tried recently I couldnā€™t get a reaction. -

Used to fall so much before I had the AFO. Life is much better with it (for me)

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14

Iā€™ve developed foot drop, itā€™s not all the time, itā€™s mostly when Iā€™m tired, I feel so low, and that the future is bleak, Iā€™ve sold my house and Iā€™m looking for a ground floor flat, trying to future proof, itā€™s all so bloody depressing,

15

My foot drop comes on if Iā€™ve tried to push myself too hard or not taken enough rests.

Basically either my left or right foot, sometimes bloody both, sort of turns in and theres no lift when trying to walk so I end up dragging & catching the outside of my foot on the ground.

Iā€™ve always felt that when my mobility problems start to kick in itā€™s due to not having enough lift from my hip flexors, this then gets worse as I try harder to walk, which then starts the foot drop, which then ends up with me basically dragging my foot/feet.

16

I use an AFO itā€™s the only way that I can walk outside.

17

Hello Sheilar

There are a lot of solutions for foot-drop, these are a selection:

Simple (cheap) nylon / elastic devices like the Foot-up made by Ossur - see https://www.ossurwebshop.co.uk/foot-up-for-drop-foot.html or the Boxia made by Orliman - see http://www.orliman.com/en/product/calf-support-for-the-boxia-drop-foot-aā€¦ Both of these devices cost about Ā£50, but you can get them from your NHS physiotherapist too.

Traditional Ankle Foot Orthosis (AFO). They come in a whole range of designs and fabrics, from steel to nylon. You can get a referral to your NHS hospitals Orthotics Department from your neurologist.

The Silicon Ankle Foot Orthosis (SAFO) is a custom made AFO. The company make a plaster cast of your foot and ankle and construct a perfectly formed silicon ā€˜bootā€™. The company who make them is Dorset Orthopaedics - see https://www.dorset-ortho.com/en/ These are not cheap, in the region of about Ā£800, but they last a long time.

Then thereā€™s Functional Electrical Stimulation (FES). There are several companies who make different varieties. Your local NHS service may pay for FES, but it depends on the Community Commissioning Group. Mine for example, Coastal West Sussex does not pay for FES for most people with MS, it has to be an exceptional case, and since we are all different, everyone is exceptional, therefore no one is. The most common FES (and the one most people have funded by the NHS) is Odstock in Salisbury - see https://www.odstockmedical.com/ The cost of the Odstock version is a strange arrangement whereby you pay Ā£330 per appointment. Odstock provide all equipment and consumables for this, the set up is expensive as you have to have several appointments, but thereafter just one appointment per year.

Obviously, there are other FES systems available.

If youā€™re experiencing foot drop just now and then, you could either ask your physiotherapist or buy yourself a Boxia or Foot-up. They work well enough, and if your feet arenā€™t too bad, theyā€™d probably just give you a bit of help when tired.

Best of luck with your flat hunt Sheilar, future proofing is sensible even though it makes you feel rubbish at the time. Once youā€™ve found the right place and got settled, Iā€™m sure youā€™ll feel better for having made the move.

Sue

18

Jactac BOTH feet, for fog sake that is bloominā€™ inconsiderate, I will now try to whinge less about only one foot dropping.

i was lucky enough to get NHS funding for FES whilst in West Sussex once I had shown how much the NHS would save in the long term with far fewer trips to A&E and calls on paramedics to pick me up again.

good luck to one and all with foot drop

Mick

19

The definition of foot drop is when one is carrying two plates of full English breakfast and the left foot doesnā€™t quite make it from the hard floor up onto the carpet. This sends both plates of hot food flying across the hall, and I fall flat on my face breaking my spectacles and grazing my nose.

Oh, and the Memsahib has to cook two more breakfasts - when she has finished laughing, which takes about ten minutes.

I realise that this is a rather particular definition but I donā€™t know what other people have for breakfast. Or how far it can travel, given enough momentum.

20

They do say that full English (Scottish or Welsh) breakfasts are bad for you. Now you know why.

Sue