MS and Foot Drop

MS and Foot Drop

One of the more common issues that people associate with multiple sclerosis is trouble walking. When I talk to people who don’t know a lot about the disease, that’s one thing they often bring up. They know that many folks with MS can end up limping or using a cane or even a wheelchair. Few understand why though. Today I want to tackle one of the many reasons that those of us with MS can have trouble walking: foot drop.

Foot drop (some people refer to it as “drop foot”) is a symptom where those with MS have weakness in the muscles that flex the ankle. By now, you know that in MS, the lining around our nerves gets attacked by our own immune system, so the signals from our brain to other parts of our body don’t always get to where they are going in a timely manner or at all. This “weakness” we talk about with foot drop is actually when the signal from the brain that says “lift the front part of your foot” doesn’t make it. My brain says “take a step” but my body only gets part of the instructions.

It can have a significant impact on your day-to-day

As you might imagine, even though this is a small area to have trouble with, it’s pretty significant. Trying to walk with this condition can be incredibly hard. When someone with foot drop walks, their toes tend to catch the ground because they can’t move them out of the way. Foot drop is often one of the symptoms that leads to falls, so it can be extremely dangerous. One of the instinctive ways those of us with foot drop end up countering the problem is by trying to raise our knees higher to help our feet clear the ground. Not only does this look very awkward, but it can lead to muscle injuries and also contribute to fatigue. It may not seem it, but that’s a lot of extra and unnatural work to try to walk. That’s one reason I know that if I have to walk too much, I’m going to be extra worn out the next day.

Foot drop is one of those symptoms that, while not invisible like cog fog or mood swings, is still only visible if you are really looking for it. If someone isn’t staring at my foot when I walk or if I’m not raising my knee or using a cane then chances are people won’t notice it. That is, until I stumble or fall. And chances are, you’ll never see the toll it takes on me from a fatigue standpoint of trying to walk around with it. Foot drop is another example of why you should never question a person legally parked in a handicap space if they aren’t actually in a wheelchair. From a quick glance, they may appear fine, but every step for them may be a struggle. I know I’ve had several bad falls in parking lots because, even though I have a handicap placard, I worry about the backlash of using it because I don’t look handicapped. Thankfully, there are some ways to help overcome foot drop or at least mitigate some of dangers that come along with it.

Physical Therapy – Seeing a physical therapist who specializes in MS can be very helpful in combating foot drop. They will often work on strengthening key muscles in your leg to aid you in walking. Many can also work on your gait, teaching you a better and more effective way to walk.

Braces – There are a variety of orthotics, splints, and braces that can be used to alleviate the problems caused by foot drop. One that is particularly common is a brace that keeps your foot at a 90 degree angle to your leg so that you don’t drag it. I’ve tried using this, and it can be helpful but can also be a bit uncomfortable.

Functional Electrical Stimulation (FES) – This is a device that you wear on your leg that sends electrical signals to the nerve that lifts the foot. Like any MS treatment, some people have great success with this and others don’t. I’ve tried it out and it was pretty effective for me. These devices can be very expensive though, and many insurance companies (like mine when I was prescribed it) won’t pay for it.

Surgery – There are a few surgical treatments for foot drop that are often considered a bit extreme. Some involve trying to replace or repair the peroneal nerve. Surgery to replace the tendon near the ankle and foot can also been done. Also, in some cases, a surgery can be performed to fuse the foot to ankle. Surgery is the least common way of combating foot drop.

While there are effective ways to fight this symptom, it must be remembered that foot drop may be only part of the reason that a person with MS may have difficulty walking. Leg spasticity, problems with balance, numbness, and fatigue can all also reduce a person’s ability to walk. While these foot drop treatments can be very helpful, they don’t guarantee that an MS patient will be walking around with no issue. It’s important to talk with your neurologist and physical therapist to determine which, if any, of these options is a good fit for you.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The MultipleSclerosis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (20)
  • Antknee909
    4 months ago

    Food Drop has condemned me to life in a wheelchair

  • Lindsay
    4 months ago

    After fighting it as long as I could, I have had to say good-bye to walking. Prior to doing so, I was dragging my left foot without realizing it. I did not realize I was walking like this until someone mentioned it to me. I think I had lost a lot of feeling, particularly in my left leg so I did not realize I was dragging my left foot. I was interested in knowing if anyone else was walking like this without realizing it until someone pointed it out to them?

  • Devin Garlit moderator author
    4 months ago

    Hi Lindsay, I’d say it’s not uncommon. I have had many issues through the years, where I haven’t noticed until someone else has told me, or, in the case of leg and foot related issues, I’ve ended up on the ground. I know some people will think, how can you not notice? But it does happen. Our brain is still sending that signal to walk, it just isn’t making it there, so part of our body still thinks it’s doing it’s job and everything is fine.

  • Redd
    3 years ago

    oh man was out walking last week and noticed my foot wasn’t lifting up high enough so started picking my knees up kind of march/walking. I thought i was clever till I read your article. Oh crap i have the dreaded foot drop. I also fell that day, thought due to a wide space between the sidewalk and grass but now I am rethinking the cause of the fall. Till I read your article I thought about looking into walking sticks. Think physical therapy is calling me first. Thank you so much for writing this article. It really helps having someone spell things out.

  • Lindsay
    4 months ago

    In my case, and we are all different, my doctor, who is a well-known MS specialist, advised me against PT. He advises some patients to proceed with PT and he advises others to avoid PT. I don’t know how he knows, but he does. He knows who will be helped by PT and who will be hurt by PT. Because he is a long way from home I temporarily saw another neurologist who doesn’t specialize in MS. He prescribed PT. I then saw why my first physician advised me against it. This was my first and last PT visit as the therapist did not understand why I was unable to exercise at her pace and expected me to lay down and lift my legs, something I have not been able to do for a long time. She didn’t understand why I was not able to do the “MS exercises” as she called them. I almost ended up in the hospital but instead called my husband to come pick me up. I had to spend the rest of the day lying down because of the pain and fatigue that the PT session caused me to have. My advice to MS patients is to either see an MS specialist or at the least to have a neurologist who is experienced in treating MS.

  • Devin Garlit moderator author
    3 years ago

    I’m glad you came across the article then! Be careful, it’s one of those things that can really get you when you least expect it! Thanks for reading!

  • tfs
    3 years ago

    This was very timely. I was diagnosed with PProgress MS in May 2014. I took a great tumble today just missing that step leading from a patio into the garage. Only my ego bruised, but it makes you wonder what is next. I will keep up with the physio and try to keep active.

  • Devin Garlit moderator author
    3 years ago

    Those falls can certainly hurt our egos (among other things)! Thanks for reading and sharing!

  • JULIE SAVENE
    3 years ago

    As for using/not using your handicap placard–I read it here on this site(sorry, I do not remember who to give the credit to), but just say”my Nurologist will love to hear that!”
    Use it !!!

  • Octavian
    3 years ago

    For those who cannot afford Ampyra it is an extended release version of 4-amino pyridine which you can have compounded for approximately $60 a month. The walkaide and bioness equipment is very expensive. I achieved a very similar result with a TENS unit. The Bioness representative assed my walking with the TENS and didn’t feel he could improve on that. I put one pad on the right side of my right kneepit and one towards the front a little lower. You can tell when it is in the right place because your toes will arch up. $50!

  • Lindsay
    4 months ago

    For those who cannot afford Ampyra, the drug company has a prescription assistance plan where, for people who qualify, may get the drug at either a reduced cost or at no cost to them.

  • Devin Garlit moderator author
    3 years ago

    Thanks for mentioning that! Always good to hear about as many options as we can!

  • VickiW
    3 years ago

    I know the foot drop all too well. It is so frustrating. The toe of the soles of my shoes are worn out (especially the left). Walking with foot drop is EXHAUSTING!!!! I strained to walk from the parking lot into the grocery. Once inside I could use the shopping cart to help me through the store. My doctor was more than happy to assist by completing the necessary paperwork in order for me to obtain a disabled parking permit. I hate to use it but I know if I don’t, I will ended up exhausted. Fortunately, no one has commented. I have gotten some odd looks though. I’m not even sure how I would respond. I have been using physical therapy to help strengthen my legs plus improve my balance and coordination. I also started taking Ampyra (the walking pill). I’m sharing the article on my Facebook timeline so my friends know just one of the challenges MS patients experience. Thanks for the article.

  • Devin Garlit moderator author
    3 years ago

    Thanks for reading and commenting! It really is such an exhausting symptom. Good luck with Amprya, I tried it and it didn’t do much for me, but, I know multiple people that have been helped by it! Thanks for sharing, that’s always my goal with my articles, not to only help those with MS but to help enlighten and explain what we go through to others!

  • y71mo1
    3 years ago

    As far as using the handicap tag I say use it,we have earned it with falls we take and the energy we use once we get to where we’re going and the pain we silently suffer the days after. I have had ms for more than 10 years. I have a suggestion; get a handicap license plate, It’s not like we will ever get over the mess. Plus with the plate you don’t have to mess with the placard,which I sometimes think people use other peoples placard just to save themselves a few steps; the steps we struggle with.

  • Devin Garlit moderator author
    3 years ago

    You may be right about the plate, not sure why I never think to investigate that. As far as using it, I know I give others that same advice, I find I have trouble listening to myself though. Thank you so much for reading and commenting!

  • Karen
    3 years ago

    My best friend has neither MS nor Parkinson’s, just foot drop. She takes a medication called carbidopa levodopa. It was prescribed for dopamine responsive dystonia. She said as soon as she started taking it her foot drop disappeared and she walks normally. This might be something to look into.

  • Devin Garlit moderator author
    3 years ago

    Thank you fore mentioning it, I will look into it! Thanks for reading!

  • Kim Dolce moderator
    3 years ago

    Devin, this is the best description of foot drop I’ve read, and a good, clear enumeration of the various treatments for it as well. Thanks for putting it out there for the readers, we need to see this information on a regular basis. So much territory to cover that a service provider won’t or can’t explain. An MS patient is, once again, the best resource for info on symptom management. I really enjoy your writing, keep ’em coming!

    Kim

  • Devin Garlit moderator author
    3 years ago

    Thank you Kim! This is such a common problem but I know I never see a ton of information about it. I’d even gone through several neurologists before I got some of this info!

    I enjoy your writing as well!

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