Foot Drop

Overview

Foot drop is difficulty lifting the front part of the foot. The muscles that normally raise the toes and foot are weak or not working, so the foot tends to drag along the ground when walking. To avoid tripping, people often lift the knee higher than usual (a high-stepping gait) or the foot may slap down with each step.

Foot drop is not a disease itself but a sign of an underlying problem with the nerves or muscles that control the foot. It can affect one or both feet and may be temporary or long-lasting, depending on the cause. Because it makes tripping and falling more likely, foot drop should be evaluated to find and treat the cause and to keep you safe while walking.

Common Causes

Foot drop most often results from a problem somewhere along the nerve pathway that controls the muscles lifting the foot:

• Compression of the peroneal nerve: This nerve runs near the surface at the outer knee and can be pinched by crossing the legs, prolonged kneeling or squatting, a tight cast, or prolonged bed rest.
• Pinched nerve in the lower back: A herniated disc or other pressure on the nerve roots (such as in sciatica) can weaken the foot.
• Nerve injury: From trauma, hip or knee surgery, or a fracture.
• Nerve and muscle diseases: Conditions such as peripheral neuropathy (often from diabetes), multiple sclerosis, and muscular dystrophy.
• Brain or spinal cord conditions: Stroke or spinal cord injury, which may affect more than just the foot.

Associated Symptoms

Foot drop may come with other symptoms that point to the cause:

• A slapping sound as the foot hits the ground
• Dragging the toes or tripping easily
• Numbness or tingling over the top of the foot or the shin
• Pain that shoots from the lower back down the leg
• Weakness elsewhere in the leg or the other leg
• Muscle wasting in the lower leg over time

If foot drop appears suddenly along with weakness on one side of the body or trouble speaking, it may be part of a stroke and needs emergency care.

Diagnosis & Evaluation

A clinician will watch you walk, test the strength of the muscles that lift the foot, and check sensation and reflexes. To find the cause, tests may include:

• Nerve studies (nerve conduction and electromyography) to locate where the nerve or muscle problem is
• Imaging of the lower back (such as an MRI) if a pinched nerve root is suspected
• Imaging of the knee or leg if local nerve compression or injury is likely
• Blood tests for conditions such as diabetes

Pinpointing the level of the problem, from the back to the nerve at the knee, guides treatment.

Treatment & Management

Treatment depends on the cause and how reversible it is. Many cases, especially from nerve compression, improve once the pressure is relieved:

• Treating the cause: Relieving a pinched nerve, managing diabetes or other nerve conditions, or addressing an injury.
• Ankle-foot orthosis (AFO): A brace worn in the shoe that holds the foot in a normal position, improving walking and preventing trips.
• Physical therapy: Exercises to strengthen and stretch the leg and to retrain walking.
• Nerve stimulation devices: Which help lift the foot during walking in some people.
• Surgery: Considered when a nerve is compressed or for certain lasting cases, such as a tendon transfer.

Recovery can take time, and some causes improve fully while others are managed long-term with a brace and therapy.

When to See a Doctor

See a doctor promptly if you notice new difficulty lifting your foot, frequent tripping, or a foot that drags when you walk. Early evaluation gives the best chance of recovery and helps prevent falls.

Call emergency services if foot drop comes on suddenly together with weakness on one side of the body, facial droop, slurred speech, or loss of bladder or bowel control, as these can indicate a stroke or serious spinal problem that needs urgent treatment.

Self-Care & Prevention

You cannot prevent every cause of foot drop, but some steps lower the risk and help you stay safe and mobile while it recovers:

• Avoid prolonged pressure on the nerve at the outer knee; do not sit cross-legged or kneel for long stretches, and ask about padding if you wear a cast
• Manage conditions that harm nerves, especially by keeping blood sugar controlled if you have diabetes
• Do the strengthening and stretching exercises your therapist recommends to maintain muscle and motion
• Wear your ankle-foot brace as advised to walk more safely and avoid trips
• Reduce fall hazards at home, such as loose rugs and clutter, and use good lighting and handrails
• Choose supportive, well-fitting footwear

Early treatment of the underlying cause gives the best chance of recovery, and these measures help prevent falls and injuries in the meantime.

Related Topics

Frequently Asked Questions

References

1. Mayo Clinic. Foot drop — Symptoms and causes.
2. National Institute of Neurological Disorders and Stroke (NINDS).
3. MedlinePlus, U.S. National Library of Medicine. Movement, uncontrolled or slow.
4. American Academy of Orthopaedic Surgeons (AAOS).