Foot Drop is a clinical condition when the person is not able to lift his foot upward. This is not a disease rather presentation of different neurological and muscular disorder which affects the upward movement of foot. Injury to Common Peroneal nerve can cause weakness of these muscle.

• Injury around knee; knee dislocation, fibular neck/head fracture
• Iatrogenic injury during surgery around knee, hip and spine
• Leprosy, poliomyelitis
• Compression of nerve root due to prolapsed disc, tumour or trauma
• Cerebrovascular injury; stroke
• Spinal cord injury or disease affecting spinal cord; amyotrophic lateral sclerosis, multiple sclerosis.
• Muscular dystrophy

Peroneal nerve which is responsible for upward movement of foot, wraps around fibular neck before entering leg. It is very superficial and there is no protective tissue between the nerve and bone . Few postures and situations can compressed the nerve against fibula and cause nerve injury, like;

• Prolong cross-legged sitting
• Tight plaster cast
• Inadequate padding around knee in lateral decubitus position during surgical procedure or in ICU patient
• Externally rotated limb in traction for lower limb fracture

Foot drop can be reversible or irreversible depending on the nature of nerve injury and causative factor affecting the nerve.

Walking becomes difficult due to inability to lift foot and get adequate ground clearance. One has to lift the leg higher than usual for ground clearance producing high step gait and also slapping sound while grounding foot. Inadequate ground clearance predispose to fall also. Long standing foot drop may cause the heel cord stiff and it becomes difficult to get the upward movement of the ankle passively as well producing equines deformity.

You should visit a doctor if you have difficulties in lifting your foot or toes get stuck with surface while walking due to inadequate clearance.

Your doctor will ask for history of your problem. He may enquire for other health related issues. He would examining your foot as well as your leg for any neurological deficit such as lack of sensitivity at foot and leg and power loss of leg muscles as well as foot muscles. He will do a generalised examination to find the possible cause of foot drop. Neurologist opinion may require to diagnose the underlying neurological condition responsible for foot drop. Your may have to undergo different tests like, MRI of spine or brain, NCV (Nerve Conduction velocity test) x-ray and CT scan.

Treatment depends on reversibility of injury. In case of a reversible nerve injury surgical decompression and following rehabilitation can improve the condition. In case of irreversible foot drop both conservative and surgical option can work depending on the ankle joint mobility and number of muscle affected.

• Active ankle movements
• Support such as Ankle foot orthoses
• Strengthening of Foot muscles
• Muscle stimulator on motor points
• Gait training

• Ankle fusion
• Tendon transfer procedure