Foot Drop

What is foot drop?

Foot drop describes difficulty lifting the front of the foot and toes upwards.

It is usually caused by weakness of the muscles that lift the foot. This can result from problems affecting the nerves, spine, muscles or tendons.

What symptoms and signs might I experience?

• Difficulty lifting the foot.
• Toes catching on the ground.
• Tripping.
• A high-stepping walking pattern.
• The foot slapping onto the ground.
• Weakness around the ankle.
• Numbness or altered sensation in some cases.

How is it diagnosed?

A detailed examination is important to identify which muscles and nerves are affected.

Depending on the suspected cause, investigations may include:

• MRI of the spine.
• MRI or ultrasound around the nerve.
• Nerve conduction studies.
• Electromyography.
• Other neurological investigations.

How is it treated without surgery?

Treatment depends on the underlying cause and may include:

• Physiotherapy.
• Gait retraining.
• Strengthening where appropriate.
• An ankle-foot orthosis.
• Functional electrical stimulation in selected patients.
• Falls prevention.
• Treatment of the underlying nerve or spinal problem.

When might surgery be considered?

Surgery depends on the underlying cause.

Possible procedures include:

• Nerve decompression.
• Nerve repair.
• Tendon transfer.
• Tendon balancing.
• Ankle fusion for severe fixed deformity in selected patients.

What is recovery like?

Recovery depends heavily on the cause.

Nerve recovery can take many months and is sometimes incomplete. Tendon transfer procedures also require a structured period of protection and rehabilitation.

New or rapidly developing foot drop should be assessed promptly.