Foot drop is a condition in which a person has trouble lifting the front part of the foot while walking. This can cause the foot to drag or change the way a person walks, which can raise the risk of tripping and falling. Many conditions can cause foot drop, including multiple sclerosis (MS).

Although foot drop isn’t a disease itself, it’s caused by an underlying problem. The problem may involve the bones, muscles, or nerves. Finding and treating the cause is important for managing foot drop and helping you move more easily.

Foot drop can happen when the ankle extensor muscles that lift the foot are weak, as in MS. It can also happen when the peroneal nerve that controls those muscles is not working properly.

Fortunately, there are treatments for foot drop, including physical therapy, self-management strategies, assistive devices, and surgery.

What To Do With MS Foot Drop

David Wallis shares how he manages MS foot drop with a rollator and finds freedom and strength through swimming.

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Transcript

00:00:00:24 - 00:00:10:12
David Wallis
You get the foot drop and you lose your balance when you do things too quickly. And I just have to be very deliberate and not quick, so I’m slow.

00:00:10:14 - 00:00:33:19
David Wallis
Several of the times I have fallen, mainly because of the foot drop. If I’m not consciously telling myself up, down, up, down, my legs don’t always behave the way they did before I had MS. I might catch my foot on the curb or whatnot, and down I go. I’ve said “Slow and steady wins the race” many, many times to myself.

00:00:33:22 - 00:00:54:12
David Wallis
I’m not dependent strictly on my feet anymore. I’ve got something else that I’m grabbing onto to keep me from tripping and falling. Having the foot drop, my physical therapist recommended the rollator — gives me four points of contact. I haven’t had any falls since using the rollator.

00:00:54:14 - 00:01:15:09
David Wallis
The swimming pool is my happy place. I found swimming to be so helpful for me just because you can’t fall down in the pool, and I do have full range of motion, which I don’t on the land, but I do in the water. Swimming is not only good exercise. Swimming has kept my sleep pattern in such a good place. Because of MS,

00:01:15:09 - 00:01:33:21
David Wallis
I can’t walk well, but I can swim. I can say I did a mile swim four, five times a week. I am not disabled in the water at all. I have full range of motion, and I’ve never once fallen down in the pool. Learn more and connect at MyMSTeam.com.

Foot Drop in Multiple Sclerosis

Although research has not confirmed how often foot drop happens in MS, it is a well-known symptom. It may develop when MS disrupts the signals between the brain and the muscles that lift the foot.

What Does Foot Drop Look Like?

Foot drop can affect only one foot (unilateral) or both feet (bilateral). Because of this muscle weakness or nerve injury, people with foot drop may drag the affected foot, or feet, on the ground while walking. They may also scuff the foot on the ground, which can be uncomfortable and increase the risk of trips or falls. To avoid dragging, some people lift the knee higher than usual when walking. This is called a steppage gait.

How Can Foot Drop Affect Daily Life?

Walking up stairs and curbs and on other uneven surfaces can be hard for people with foot drop. To avoid obstacles that might make walking difficult, they may change their walking style, usually by lifting the affected leg higher as if climbing up.

Changing your way of walking is tiring, as it requires more effort and energy. This may cause you to feel wobbly. Over time, walking this way can lead to hip and lower back pain, muscle tightness, and issues with overall balance.

These difficulties in walking can also make you more prone to falling. This can sometimes be embarrassing or frustrating — especially if people don’t understand that it’s caused by MS — but also potentially dangerous with a risk of injury.

MyMSTeam members have shared how their experiences with foot drop affect their lives:

• “I’ve struggled with my left foot dropping to the point of needing something to grab onto most of the time I’m on my feet. I’ve fallen about five times over the last three years.”
• “My knees are so sore from all the trips caused by drop foot that I can no longer kneel. Not that I can get up again if I do!”
• “Speaking of embarrassing, I’ve caught my foot and fallen out of the car in the grocery store parking lot.”
• “I had a similar situation with my left foot. Went through falls, out of balance, humiliation, people laughing at me, thinking I’m on drugs or drink.”

Foot drop can also affect your ability to do your job. Difficulty moving around can affect your productivity and ability to perform physical tasks.

What Causes Foot Drop in Multiple Sclerosis?

Foot drop results from weakness in the ankle muscles or a lack of signaling between the brain and the leg muscles. In both cases, it becomes impossible to lift your foot to the correct angle when taking a step. This causes the toes to drag or scuff on the ground.

Foot drop may get worse depending on your other MS symptoms. Numbness and other abnormal foot sensations reduce sensitivity to the floor, which can cause changes in how well or how fast you can walk. MS spasms and muscle weakness can also make it harder to control the affected foot.

Certain occupations that require long periods of kneeling or squatting can put pressure on the peroneal nerve, which may raise the risk of foot drop.

How Is Foot Drop Diagnosed?

If you’re experiencing difficulties raising the front of your foot while walking, you may have foot drop. Contact your neurologist so you can figure out why this might be happening.

To diagnose foot drop, a doctor will perform a physical exam. They will watch how you walk and check how your leg muscles work. In some cases, imaging tests may also be ordered to diagnose foot drop. These can include X-rays, CT or MRI scans, or ultrasound scans.

Even if you have MS, other factors can cause nerve damage that leads to foot drop or makes it worse. In that case, your doctor may order nerve tests to find where the damage is. They may also perform electromyography, a test that checks electrical activity in the muscles.

Is MS-Related Foot Drop Permanent?

Foot drop in MS can be permanent or can get better with time. There are several treatment options for foot drop. Your doctor can help you come up with the best approach for your needs.

Several MyMSTeam members have reported that their foot drop improved with proper treatment. They often encourage each other on how to cope with this symptom. “Yes, it’s humiliating, but it’s not uncontrollable. Just be patient and don’t get down on yourself too much,” said a member.

Another member shared, “I go to the gym three times a week, which really has improved my walking and foot drop. Also, keeping my weight down really helps.”

Your needs may also change over time as MS progresses. “The brace I had was very helpful,” shared one member. “It prevented the front of the foot from dragging and causing me to fall. I was able to walk around for over 15 years. In the early years, I didn’t need a walking stick. Then I needed the walking stick to help with balance but still got around great.”

How Is Foot Drop Treated?

Foot drop treatment in MS involves physical therapy, assistive devices, and self-management strategies. In some cases, surgery may be necessary.

Several treatments are commonly used to manage foot drop. Members say different treatments work for different people, so it may take time to find what works best for you.

Physical Therapy

Physical therapy can help you strengthen your leg, ankle, and foot muscles. Physical therapy can also help manage other MS symptoms that tend to worsen foot drop, including spasticity and walking-related complications. Your physical therapist can also recommend devices to help keep your foot in a better position.

Assistive Devices

The two common types of devices used to treat foot drop are functional electrical stimulation (FES) and ankle-foot orthosis (AFO).

An FES device is typically placed on the leg or around the waist. These devices send small electrical signals to the nerves near the affected muscles to help move your leg as you walk. A physical therapist can help you decide whether this treatment is right for you.

AFO devices, which include braces and splints, are worn on the lower leg. These devices, typically made of plastic or carbon fiber, are used to place your foot and ankle in the right position as you walk. If your doctor determines an AFO device is right for you, they may refer you to an orthotist (someone specifically trained in fitting braces and orthotics).

Lifestyle Changes

You can also make lifestyle changes to help manage drop foot and support other treatments. These include:

• Wearing the right footwear — Wear shoes that fit well, provide ankle support, and are lightweight so as not to tire out your muscles.
• Avoiding certain positions — Avoid positioning your body in ways that increase the risk of foot drop. Crossing your legs regularly can gradually lead to compression of the peroneal nerve on the upper part of the leg, and squatting or kneeling for too long can also cause foot drop.
• Taking it slowly — Be careful when moving around. Watch for obstacles, and avoid them when you can.
• Keeping your walkways clear — Remove potential hazards in your home, especially in high-traffic areas. That includes wires or cables that can cause trips and falls.

Surgery

Severe or long-lasting foot drop can lead to muscle paralysis, which can result in permanent difficulty with movement. Surgery can help.

Often, surgery for foot drop involves transferring muscle tendons from stronger leg muscles to the affected muscle. Another available procedure fuses the foot or ankle bones to steady the ankle. Talk with your doctor to find out if you’re a candidate for either one.

Join the Conversation

On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.

Do you have MS and foot drop? What has helped you manage it? Let others know in the comments below.