Foot drop and leg muscle spasms often occur after a stroke or other brain injury or for people with cerebral palsy, muscular sclerosis or Parkinson's disease. Because of the weakness of your foot and ankle muscles or because of spasms, you will experience difficulty with standing, ambulating and completing your daily self care. Your physical therapist will work closely with you to facilitate your functional independence in the presence of foot drop.
Description
Foot drop is the condition wherein you are unable to keep your toes or your entire foot upright while lifting your leg to take a step. This causes you to trip on your foot and, thus, you are unable to safely walk and have a very high risk of falling even when walking with assistance or with a walker or cane. The most common cause is weakness of the foot muscles that bend your ankles or a spasm of the muscles that extend your ankle.
AFO Usage
One of the most effective tools your therapist will use to counteract your foot drop is a foot and ankle splint called an AFO, or ankle foot orthosis. Although there are many different designs and models, your therapist will use her judgement to determine which AFO is best for you. In many cases, a custom AFO must be designed to meet your needs, which can be provided by an orthotist. The AFO will provide support along your calf and foot to keep your ankle in the neutral position while walking, which will decrease the effort you expend and increase your safety. However, an AFO is merely used to treat the symptoms and will not improve your foot drop without the brace in place.
Spasms
Spasms in your muscles can further complicate foot drop by holding your foot in plantar flexion, or the position of foot drop, which can be very difficult to overcome. Because the spasm causes your muscles to contract tightly, the spasm can lead to severe loss of balance and pain when bearing weight on your foot. Your therapist can perform functional electrical stimulation, muscle stretches and massage to help control and reduce your spasms.
Physical Therapy
Physical therapy is vital to your recovery and functional restoration with the presence of foot drop and spasm. Along with the modalities provided to control your spasm and increase proper muscle tone, your therapist will strengthen your muscles with exercises. Performing sitting ankle pumps and standing ankle raises can strengthen the muscles that are weak. Additionally your therapist will teach you how to walk safely with your foot drop by using your AFO or ambulation device and proper step sequencing.
References
- American Orthotic and Prosthetic Association; Evidence Note - The Use of Ankle Foot Orthoses in the Management of Stroke; November 2008
- The Foot and Ankle Online Journal; Functional Electrical Stimulation for Treatment of Chronic Foot Drop Due to an Incomplete Sacral Nerve Root Lesion: A Case Study; August 2010
- MayoClinic.com; Foot Drop Treatments and Drugs; Mayo Clinic staff; Nov. 2009
