Multiple Sclerosis and Foot Drop

Foot Drop is a common symptom of Multiple Sclerosis (MS).  It is caused by the disruption in the nerve pathway between the brain and the legs as a result of peroneal nerve injury or muscle weakness. A person with Foot Drop experiences difficulty in lifting the front part of the foot.  In a normal walking cycle, your toes pull up from the floor.  However, in a person with foot drop, the toes point down and strike the floor first.  Foot drop is not a disease but a sign of a neurological, anatomical or muscular problem.

People with Foot drop may develop a high steppage gait where they raise their knees high up while walking in order to avoid striking the front of the foot against the ground.   Some other foot drop symptoms are an exaggerated swinging hip motion, limp foot, tingling or numbness in the foot and muscle atrophy in the leg.

The following treatment options can reduce symptoms of Foot Drop significantly and make walking easier:

1.Physical Therapy:   Physiotherapist specialized in MS work on strengthening key muscles and improve flexibility to aid with walking.  They will also include gait training, which teaches the person how to walk properly.  Watch below some exercises that are recommended to do at home.

2. Ankle Foot Orthosis: A variety of splints, orthotics and braces are used to alleviate the issues caused by foot drop.  A widely used device is an Ankle Foot Orthosis (AFO) which is worn on the lower part of the leg to control the ankle and the foot by holding it in a straightened position.

3. Functional Electrical Stimulation (FES): FES uses electrical stimulation of the peroneal muscles to improve mobility.  A small device is worn near the knee and sends small electrical stimuli to the muscles to help it move.  A physiotherapist trained in the use of FES is required to perform an assessment to check suitability of the device for the individual.

4. Surgery: Several surgical solutions can treat foot drop and performed when physiotherapy and orthotics do not sufficiently work or the condition is severe.  Procedures such as transferring a tendon from a stronger leg muscle, Nerve reconstruction or fusing the foot or ankle bones are the types of surgeries that could be performed.  Be sure to understand the risks associated with the surgical procedure with a doctor.

A person with Foot Drop is at a risk for trips and falls, which is why it is important to take steps to be safe.  Wear suitable and well-fitting footwear to lessen the dragging along the floor.  Be aware of surroundings and look for routes that offers the least obstacles.  Remove clutter around the house and keep wires and cables covered in order to avoid tripping over.

Although the above treatments are effective for foot drop, MS patients go through many other reasons to why they have difficulty in walking such as leg spasticity, balancing issues, numbness and fatigue. It is important to speak to a neurologist or physiotherapist to know which options to treat foot drop would be most suitable.

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Sources

Multiple Sclerosis Net

Healthline

MS Unites

MS Trust UK

MS workouts – YouTube Video

Image – Thuasne