Need to Know: What Is Foot Drop and What Can I Do About It?

Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the forum topic “Do you suffer from the MS symptom of ‘drop foot?’” from Sept. 20, 2018.

Maybe you’re at the grocery store, your kid’s baseball game, or walking the dog when it happens. Suddenly, you struggle to lift your foot high enough to take a full step. Your toes catch or drag on the ground, and then you’re stumbling or even falling without an obvious obstacle to blame.

This describes a common symptom among people with multiple sclerosis: foot drop.

What causes foot drop?

People can experience this risky symptom for any number of reasons, including but not limited to spinal injury, stroke, and MS.

For those with MS, foot drop is caused by weakness in ankle muscles (a product of muscle weakness or spasticity related to MS) or poor nerve conduction between the brain and the legs. The latter is an outcome of demyelination, when disease activity leads to the development of lesions on brain tissue.

Why is foot drop a problem?

A foot drop problem is actually a fall-risk problem.

Research shows that more than half of people with MS experience falls over a three-month period. These falls can result in injuries such as sprains, fractures, and head trauma. They also can lead to an unwillingness to participate in physical activities for fear of falling, as well as lost time from work or school.

Falls don’t only happen to people who are otherwise upright and walking. According to research in 2017 cited by the National Multiple Sclerosis Society (NMSS), as many as 75 percent of people who use wheelchairs or scooters have reported one or more falls within a six-month period. These people may be using an assistive device to avoid falling, yet fight with gravity as the result of foot drop when transferring, if they are able to walk.

Reducing your fall risks

The following solutions may help you avoid the unexpected and nasty turns that foot drop can cause — as well as other balance and coordination symptoms of MS that increase your fall risk.

• Free From Falls programs, via the NMSS. In-person, group-based programs that promote sustained improvements in mobility and balance have shown success in fall reduction in people with MS. A new online version of the program, called FFFO, may be an option in the future.
• Learn to “fall the right way.” If you’ve ever learned to ski, you’ve also learned there’s a right way to fall. Multiple Sclerosis News Today columnist Ed Tobias gives great tips, references, and resources on safer falling.
• Wearable devices to correct foot drop. A soft-ankle “exosuit” is currently in development to help correct problematic heel strike positioning. The device uses resistors and sensors in tandem with a servo motor and cable to control the way the foot moves while walking, standing, or taking on stairs.
• Braces or splints. A simple repositioning aid that fits inside your shoe might be all you need to keep your foot in the proper walking position.
• Physical therapy. Strengthening the muscles in the calves, ankles, and feet can help protect against foot drop. PT can also aid you in correcting MS-affected gait, which can result in joint misalignment and muscle pain from overcompensating for foot drop.
• Functional electrical stimulation. This involves applying “smart” electrical stimulation to the nerves serving the lower legs to improve mobility and walking speed while reducing fall risk and the overall effort spent on walking.
• Surgical procedures. The Mayo Clinic suggests that for enduring problems with foot drop, a bone-fusing or tendon transfer surgery might be effective. Neurological procedures might be useful in people with new but severe symptoms.
• Manage your foot drop. Just like managing MS itself, you can manage with proper footwear, practicing fall risk awareness, and removing obstacles that might cause you to trip, according to advice from the MS Trust website.

Do you experience foot drop? Was it an initial MS symptom or did you develop it post-diagnosis? Do you experience foot drop as something unrelated to MS? How do you deal with it? Post your replies in the comments below or at the original “Do you suffer from the MS symptom of ‘drop foot?’” forum entry.

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Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.