Physical Therapy Exercises for Drop Foot

How therapists treat anterior tibialis weakness

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With drop foot, or difficulty lifting the front of your foot, physical therapy exercises can focus on different muscle groups in the lower leg and back. Balance exercises are also used to treat the 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.

Drop foot occurs when an injury or illness impairs functioning of the muscle in the front of your shin, the anterior tibialis. Also known as foot drop or dropsy foot, its telltale sign is catching your toes on the ground as you walk.

This article discusses the causes of foot drop and how it's diagnosed. It also details how exercises for foot drop can help to improve your gait and other treatment modalities that can help.

Possible Causes of Foot Drop
Verywell / Gary Ferster

What Causes Foot Drop?

Foot drop is caused by weakness or paralysis on one side of the body, usually from some kind of brain or nerve condition. Other times, injury to the nerves in your leg may cause foot drop.

Common causes of foot drop that may prompt your need for related exercises include, but are not limited to:

Physical Therapy Assessment for Foot Drop

During your initial physical therapy session, your therapist will ask you questions about the nature of your injury, how your foot drop affects your life, and how long it has been present.

Various tests and measures may be taken during your initial appointment, such as:

Foot Drop Exercise Examples

There are many different exercises for foot drop. Depending on your unique case, a therapist could prescribe the following:

Some approaches that can help even though they're not aimed at your lower leg inlcude:

  • Lower-back exercises: If your foot drop is caused by compression of your sciatic nerve, lower-back strengthening may help relieve it and restore normal function to your anterior tibialis.
  • Calf stretches: If your anterior tibialis muscle is not functioning to flex your ankle, your calf muscles may tighten.
  • Balance exercises: Your balance may be affected by foot drop, and these moves may help improve it. A BAPS board may also be used to help improve your balance and proprioception.

Complementary Modalities

During your physical therapy sessions, your therapist may use simple devices to help improve your ability to lift your foot while walking.

These may include:

  • An elastic band around your leg and foot that stretches when you walk and pulls your foot up as you step forward: This is a temporary solution for foot drop, but it may help normalize your gait pattern during the initial phases of your rehabilitation.
  • An ankle-foot orthosis (AFO), a stiff lower leg/foot brace that can protect the foot, stabilize the ankle, and normalize gait; This is a common recommendation for cases of permanent foot drop. Several types of AFO exist, which are usually made of molded plastic or carbon fiber.

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.

Your physical therapist can assess you during rehabilitation and evaluate your progress. Sometimes, improvement with foot drop is slow, so stick with it.

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By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.