Physical Therapy for Foot Drop

If you have an injury or illness that results in impaired function of the muscle in the front of your shin, then you may suffer from foot drop. Foot drop occurs when the anterior tibialis muscle that helps lift your foot up does not function properly. When that happens, you may catch your toes on the floor as you are walking.

When you have foot drop, your ability to walk and move around safely may become impaired. Whenever you attempt to swing your leg forward during the gait cycle, your anterior tibialis muscle should contract to lift your foot. If this does not happen, foot drop occurs, and this can alter the way you walk.

Foot drop often causes a specific gait pattern called a high steppage gait. This gait pattern is easily recognizable in people with foot drop. As you step forward, your foot and toes drop towards the ground. To clear your foot off the ground, you flex your hip and knee excessively, and this results in a high steppage gait.

If you have foot drop, you may benefit from the skilled services of a physical therapist to help treat your condition. Your physical therapist will assess your foot drop and use various techniques to help improve your condition. The main goal of physical therapy for foot drop is to improve functional mobility related to walking. This can ensure that you are able to get around safely and may lower your risk of falling.

There may be many different causes of foot drop. Occasionally, problems in the central nervous system may cause weakness or paralysis of your anterior tibialis muscle. Other times, injury to the nerves in your leg may cause foot drop. Some common causes of foot drop may include, but are not limited to:

• Stroke
• Sciatica
• Peroneal nerve injury
• Transverse myelitis
• Multiple sclerosis

During your initial physical therapy session, your physical therapist will ask you questions about your condition. He or she will ask questions about the nature of your injury, how your foot drop is affecting your life, and how long your foot drop has been present.

Various tests and measures may be taken during your initial appointment. These may include:

•  Foot and ankle range of motion (ROM)
• Lower extremity muscle strength
• Functional mobility
• Functional outcomes measures
• Balance and proprioception

After your physical therapist assesses your condition, he or she will be able to determine the best treatment for your foot drop. The main goal of physical therapy for foot drop is to improve your walking and functional mobility.

Your physical therapist may use various treatment modalities to help improve the function of your anterior tibialis muscle. Neuromuscular electrical stimulation (NMES) may be used to help improve the way your muscle contracts and lifts your foot. This type of electrical stimulation artificially contracts your muscle to help re-educate it to contract properly. Ankle exercises are typically performed during and after NMES treatments.

There are many different exercises for foot drop.  Exercises to improve ankle strength with a particular focus on your anterior tibialis are essential. If your foot drop is being caused by compression of your sciatic nerve from your back, low back exercises may be prescribed in an attempt to relieve that compression and restore normal function to your anterior tibialis.

If your anterior tibialis muscle is not functioning to flex your ankle, your calf muscle behind your leg may become tight.  Exercises to stretch your calf muscle may be prescribed to help keep it from getting too tight.

Your balance may become affected if you have foot drop. If this is the case, your physical therapist may prescribe balance exercises. A BAPS board may be used to help improve your balance and proprioception.

During your physical therapy sessions, your physical therapist will work with you to help improve your ability to lift your foot while walking. One technique to lift your foot while walking is by using an elastic band around your leg and foot. The band stretches when you walk and then pulls your foot up when you are stepping forward. Using an elastic band is a temporary solution for foot drop, but it may help to normalize your gait pattern during the initial phases of your rehabilitation. This can help avoid getting into bad habits of using a high steppage gait pattern.

Your physical therapist can assess you during rehabilitation and evaluate your progress. Sometimes, improvement with foot drop is slow, so stick with it. Occasionally, foot drop is a permanent condition, and an external brace called an ankle-foot orthosis (AFO) is necessary to help lift your foot while walking.  If this is the case, your PT can make recommendations for the best AFO for you.

A drop foot can be a scary experience, and it requires attention to fully return to normal activity. If you have foot drop, you may benefit from physical therapy to help strengthen your anterior tibialis muscle. Your PT can also work with you to improve balance, and he or she can ensure that you are walking properly. If your foot drop is a permanent condition, your PT can make recommendations for the best brace for you.

By working hard in physical therapy to treat your foot drop, you can maximize your chances of making a full recovery and you can quickly and safely return to your previous level of function.