What is foot drop?
The medical term is impaired dorsiflexion, meaning the ability to lift the top of the foot towards the shin (NCBI, 2023). The condition is not an illness in itself, but a sign that something in the muscle, nerve or skeletal system is not working as it should (Physiopedia, 2023).
Many people experience foot drop after nerve injuries, surgery, a stroke, or as a consequence of neurological illness. In some cases it resolves. For many it becomes a lasting condition.
Everyday effects
When the foot does not lift as normal, people often compensate by raising the knee higher so the toes do not catch the ground. This is called steppage gait, and it produces a characteristic walk where the leg swings higher with every step (Wikipedia, 2024).
Over time this can lead to uneven loading, pain and more tiredness when walking. Many describe feeling less secure on stairs or uneven ground. Having to think about each step can affect both the sense of freedom and quality of life.
An ankle-foot orthosis is currently the most common way to support the foot while walking. These hold the foot in a raised position and reduce the risk of tripping.
What causes it
The most common cause is damage to the peroneal nerve, which controls the muscles that lift the foot (Mayo Clinic, 2024). The nerve can be injured by a blow to the knee, during surgery, after a fracture, or by sustained pressure on the nerve.
Other causes include conditions affecting the nervous system, such as multiple sclerosis or ALS, or the after-effects of a stroke. In some cases foot drop is due to muscle weakness or injury in the foot or calf itself.
Diagnosis and care
Treatment depends on the cause. If the nerve is only temporarily affected, function can return gradually. In more serious cases orthoses or electrical stimulation are used to help lift the foot while walking. Physiotherapy and targeted exercise are also important for maintaining movement and strength.
In some cases surgical options such as nerve transposition or tendon transfer may be considered to improve function (Kirurgen, 2023).