If you have foot drop, your toes drag on the ground when you walk. This causes tripping and falling, and can make a “slapping” sound as your feet hit the floor.
A healthcare professional can diagnose it by examining you and doing imaging tests, like X-rays, ultrasound or MRI scans. These can check for a mass pressing on a nerve in your legs, spine or brain.
What is Foot Drop?
Foot drop (also called dropped foot) happens when you can’t raise the front part of your foot due to weakness or paralysis in the muscles that lift it. This can cause your foot to drag on the floor when you walk and may make a slapping sound with each step. It can affect one or both feet (bilateral) and can be temporary or long-term, depending on the underlying condition.
Symptoms of foot drop may include a heavy feeling in your foot, curling toes, or difficulty with walking. You might find that your foot catches or drags on the ground when you take steps, especially if you have to lift your knee higher than usual to avoid tripping or falling. You may also notice that your foot slaps the floor when you climb stairs. Foot drop can be caused by a number of health conditions, typically due to problems with the muscles or nerves in your leg and foot. The most common cause is compression of the peroneal nerve, which controls the muscles that lift your foot. This can happen due to a serious injury to your leg or hip, such as a serious knee surgery or a fall that causes a broken hip. It can also be caused by spinal nerve injuries, such as lumbar radiculopathy — a pinched nerve in your lower back.
Diagnosis
Foot drop is diagnosed when a person cannot lift their foot from the ankle, which causes them to drag the front of their foot on the ground while walking. It is typically not considered a disease itself but rather a symptom of a hidden neurological, muscular or anatomical problem. It can also be a sign of certain metabolic conditions, such as diabetes or endocrinologic syndromes.
Often the condition is caused by compression of a nerve in the leg that controls the muscles that lift your foot and toes. This is called peroneal nerve palsy. Diabetes can cause this type of neuropathy, as can a knee injury or surgery and some muscle disorders, such as polio and muscular dystrophy. Prolonged squatting or kneeling, such as when working for long periods of time or wearing a cast that encloses your leg at the knee, can injure this nerve.
To confirm a diagnosis, the doctor will perform a physical exam and watch you walk to check your strength and movement of your feet and toes. The doctor may use a test called Tinel’s sign, which involves tapping the peroneal nerve near your knee and evaluating whether you feel a tingling sensation in the lower leg or foot. Other tests include magnetic resonance imaging (MRI), electrodiagnostic studies, such as nerve conduction study and electromyography and X-rays.
Treatment
Foot drop (or dropped foot) is the inability to raise or lift the front of your foot when you walk. You may find that the front of your foot drags on the ground or that you trip more often. You may have pain or numbness in your foot or toes, or you may hear a slapping sound as you walk.
Usually, this is a sign of an underlying problem that affects the nerves or muscles in your leg and foot. The most common cause is injury to a nerve in your lower leg that controls the muscles used to raise your foot, called the peroneal nerve. This can happen after serious knee injuries, or it can occur because of diabetes, herniated discs in your spine, or conditions like Charcot-Marie-Tooth disease.
Your doctor will do a physical exam and ask questions about your symptoms. Your doctor may order an X-ray, ultrasound or CT scan to see what is causing your foot drop. You may also need an electromyography, which measures the electrical activity in your muscles, or a nerve conduction study to test your peroneal nerve.
Treatment depends on what is causing the foot drop. Often, treating the underlying problem will fix your foot drop. Other treatments include physical and occupational therapy, which can help you learn to move your foot properly. You may use braces or orthotics to support your foot. Some people need surgery to relieve pressure on the peroneal nerve or repair a damaged ankle or foot.
Prevention
Typically, foot drop results from weakness in the muscles that control your ankle and foot. It can be caused by brain or spinal cord disorders — such as stroke, multiple sclerosis or amyotrophic lateral sclerosis (ALS) — or injuries to the nerves in your leg and foot. Conditions such as diabetes or arthritis may also cause foot drop. People who cross their legs frequently or spend much of their time on one knee can compress the peroneal nerve in the top of the upper leg and cause it to “drop.”
Exercises to improve ankle and foot mobility help strengthen the muscles that support your feet. These exercises can also re-establish the neurological pathways and connections that have been disrupted by nerve damage. They can also help supplement clinical treatment, such as physical therapy, bracing or surgery.