Foot Drop – Dragging Toes When Walking

In Multiple Sclerosis foot
drop (sometimes called “drop foot”) is exactly what the name
implies; The front of your foot drops as you take a step causing your
toes to drag across the floor which of course can cause you to trip. This is a very common MS symptom.
What
causes Foot Drop?
Basically what happens in MS particularly is a partial paralysis of the muscle that lifts the front of the foot (toes)
up (tibialis
anterior
) which inhibits your ability to keep your toes from dragging across the floor (this action is known as a dorsiflexion) as you are taking a step. This can be the result
of a damaged Peroneal nerve or of course any number of lesions in the brain causing an interruption in the
signals sent to the foot from the brain (as MS typically does). That detail doesn’t really matter though because it doesn’t change the symptom or the treatment for it.

Foot Drop Complications
Well for one, the obvious,
it can cause you to trip and even injure yourself upon falling. Over
time (depending on how long this issue lasts for you) foot drop can
impair your gait (the movement of how you walk) by causing you to
compensate for your foot drop by (for example) lifting your knee
higher to avoid dragging your toes across the floor or even causing
you to swing your leg outwards with each step rather than swinging it
straightforward to again, avoid dragging your toes across the floor. For a while, when I had foot drop, it started causing
joint paint in my hip because of how it impaired my gait; I was leaning into my hip as I took a step forward and swung my leg outward causing me to put more weight on one side.


How to Treat Foot Drop
A simple solution is an Ankle Foot Orthosis (AFO) [more simply known as a foot brace] which
can be worn to help keep the toes lifted up therefore preventing them from “dropping” and dragging on the floor. This simply goes under your foot and behind your leg (Imagine an “L” shape) and is placed inside your shoe and under your pant leg (if you really want to
hide it that is). This keeps your toes from being able to drop downward and is what I used to wear when I had foot drop. 
They also can put a rubber
fitting on the bottom of your shoe so that when it does drop
downward it will slide across the floor rather than gripping the floor causing you to trip… Before I had this added to my shoe we simply taped either a piece of paper or thin piece of flexible plastic to the tip of my shoe and it worked just the same, it was just a hassle to tape it on every time I needed it! Some people say physical therapy
can help strengthen your ability to take a proper step which I
totally agree with as I did much physical therapy and it definitely
helped! As they say, “If you don’t use it, you lose it”! For more permanent foot drop that persists there are small electronic
devices (such as the WalkAid) that straps to your leg an delivers a small electrical signal
(using AA batteries and two small electrodes) to your muscle to help
stimulate it (causing your muscle to contract) as you walk which helps you lift your toes as you take a step.

My Experience

Foot drop was one of my first symptoms that lead to my Multiple Sclerosis diagnosis and at the time I had no idea what it was or what to do about it so I tried to simply control it but surprisingly, I still tripped a lot. I remember the constant sound of my foot dragging across the floor and getting pretty frustrated at it. Luckily this was not so permanent for me, after the many rounds of steroids my neurologist pumped me up with, it went away. In February of 2012 when I had my major flare up that landed me in physical rehab, my foot drop was really bad, especially because I could not lift my entire leg all that well to even try to compensate! This is when I got my AFO, started using aids to help my foot slide across the floor, and started my physical rehab to try to try to fix my improper gait… Now I wear normal shoes again and no AFO. I can tell my gait is not beautiful but that is more a result of spasticity then anything else. When I get really fatigued however, I will hear the flat of my foot drag across the floor a bit but I think I subconsciously have modified my gait in such a way as to not let my toes drop downwards, that’s how it seems at least.

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