What Is Foot Drop (and What Causes This Peroneal Nerve Injury)?

Foot drop, drop foot, slap foot… many terms are used to refer to the struggle to lift the front of the foot (AKA, forefoot). Likewise, there is an abundance of things that can cause drop foot syndrome, with treatment varying depending upon just what that is. In this article, we’ll lay out some of the basics about foot drop—its definition, causes, symptoms, etc.—as well as what you can do to prevent foot drop from tripping you up.

What Is Drop Foot?

Foot drop is a general term used to describe difficulty lifting the forefoot due either to weakness or paralysis of the muscles needed to lift that part of the foot. In other words, it’s a symptom of some underlying problem rather than a condition itself. To compensate for their drop foot condition, those affected with more severe cases will walk with a “steppage” gait, where they lift their knee high so that the front of the foot doesn’t drag against the floor or cause them to trip. This way of walking can create imbalances elsewhere in the body that could lead to hip, knee or low-back pain, for example.

Other Drop Foot Symptoms

Depending on the cause, foot drop may affect one or both feet (bilateral). And it can affect people of all ages, whether you’re a middle-aged adult, a child or an elderly individual. Besides the inability to hold the toes in dorsiflexion (pulled back toward the leg) and a steppage gait, other symptoms might include numbness of the skin at the top of the foot, shin and toes, especially if peroneal nerve damage is to blame.  This condition can also cause foot pain and throw off your balance. Unsure whether you have foot drop? Check out this Foot Drop Test to find out!

What Causes Drop Foot?

Foot drop causes include problems that are neurological, anatomical and muscular in nature, with the most common cause of foot drop being peroneal nerve damage or compression.

Peroneal Nerve: The Foot Drop Nerve
Taking a look at foot nerve anatomy, the peroneal nerve is a branch of the sciatic nerve that extends from the low back and controls the muscles responsible for lifting the foot. It wraps around the leg from the back of the knee to the front of the shin and lies pretty close to the surface of the skin. This makes it vulnerable to being pinched in quite a few scenarios, including:

• Trauma to the knee or shin
• A dislocated knee or fractured fibula
• Knee or hip replacement surgery
• Long hours kneeling or in a squatted position
• Habitual leg crossing
• Wearing a leg cast
• Childbirth

Diabetes (specifically, diabetic neuropathy) also increases the risk of sciatic or peroneal nerve damage affecting your foot. The same is true for anorexia and exposure to certain toxins.

Other Causes of Foot Drop

Many other disorders that impact the spinal cord, brain or muscles can compromise the function of the nerves or muscles involved in lifting the forefoot, leaving you with a floppy foot. Some examples include:

• Amyotrophic lateral sclerosis (ALS)
• Multiple sclerosis (MS)
• Cerebral palsy
• Stroke
• Charcot-Marie-Tooth disease
• Muscular dystrophy (in its various forms)
• Polio
• Parkinson’s disease

Is Peroneal Nerve Damage Permanent?

The answer to this question is, it depends. In some cases, decompressing the peroneal nerve can take care of nerve problems in the foot. But in other cases, the cause of drop foot is some other, irreversible problem (see the previous section) or the damage to the nerve may be permanent.

Generally speaking, the sooner you seek treatment, the greater your odds your recovery from drop foot nerve damage will be successful or at least help. So if you’re experiencing intermittent bouts where contracture of the forefoot is a problem, don’t delay! Seeking treatment could stop it from becoming a chronic problem.

How long the recovery period is for temporary foot drop also varies widely. While a woman who experiences foot drop after childbirth may regain normal function of the foot by the time she leaves the hospital, others who sustained peroneal nerve damage during surgery or due to trauma may not see foot function return for months.

In either case, there are things you can do to stop your foot from flopping against the floor and causing more complications and discomfort.

Foot Drop Prevention

One of the easiest, cheapest and effective ways of stopping your foot from slapping against the floor is to wear a brace or shoe insert to support the foot. Such products can stop you from walking in a goofy way that can cause imbalances and pain elsewhere in your body.

This drop foot brace has an innovative design that enables it to be worn whether you are barefoot or wearing shoes. A soft band of material wraps around the ankle and the forefoot with an adjustable buckle strap in between that holds your foot at a 90-degree angle to prevent your foot from dragging.

It also comes with an optional insert for laced shoes. You can find some other braces for treating acute or chronic cases of drop foot here.

Taking things a bit further, some turn to a small device that can be worn or implanted into your body for nerve stimulation for foot drop treatment.

Or you might try an epidural steroid injection to the spine to relieve inflammation that may be pinching your nerve root.  This can deliver a temporary or in some cases permanent fix for foot drop.

And for some, surgery to repair or decompress the peroneal nerve is an option. If nerve damage cannot be repaired or some other factor is to blame, some may opt to fuse the foot and ankle joints or transfer tendons from stronger muscles to address the problem.

Physical therapy to strengthen the ankle, foot, and lower leg muscles will be needed following surgery to treat drop foot.

Such exercises and stretches for weak muscles can also be effective in and of themselves for treating some cases of drop foot. Working the affected foot can help prevent stiffness from developing in the heel. A physical therapist may also employ electrical stimulation to help the peroneal nerve.

Sometimes if diabetes is involved, better control of blood sugar levels via a combination of medication, diet, and exercise can take care of the problem.

And to prevent a recurrence of foot flop or stop it from happening in the first place, you should avoid crossing your legs when sitting and try not to squat or kneel for extended periods. If that can’t be avoided, be sure to take regular breaks and use some sort of pad to cushion your knees.