Treating Foot Drop With A Brace
August 31, 2020
Foot drop is the term given when weakness in one or both feet makes you unable to point your toes up towards the sky, otherwise known as dorsiflexing the foot. When this happens, your foot remains in a dropped position when you walk, with your foot pointing downwards. This makes it difficult for your foot to clear the ground as you walk, putting you at risk of tripping and falling – or forcing you to compensate for the foot drop by excessively lifting and bending your knee and hip – which can cause a new series of problems over time.
Why does foot drop occur?Foot drop can occur suddenly following a specific event like trauma or an accident, or can gradually worsen over time. Often, the cause is related to the nerves in the feet and legs as they innervate the muscles of the feet and legs and help them function. This may be a symptom of a stroke, cerebral palsy, multiple sclerosis or peripheral neuropathy. You may even find that you have short-lived foot drop and numbness or tingling when you temporarily compress your nerve from sitting for too long in one place. Foot drop may also be related directly to the muscles, where your muscles weaken over time, which may be from periods of being inactive like after surgery, or from conditions or diseases like muscular dystrophy.
Why bracing for foot drop?A brace, or an ankle-foot orthotic (AFO), is a gold standard tool for helping manage a foot affected by foot drop because it supports the foot and ankle in a way that allows the toes and foot to clear the ground while the affected leg is swinging in gait, while also helping keep the foot stable and supported when the affected foot is planted firmly on the ground. Braces for foot drop have a frame that keeps the foot on a 90-degree (or thereabouts) angle relative to the leg. This frame extends beneath the ball of the foot, and doesn’t let the foot drop low enough to hit the ground, while also preventing the foot from slapping into the ground as you walk. Both of these features mean that not only is the risk of regularly tripping and falling greatly reduced, but the overall injury risk is also reduced from the improved stability and reduced forces through the foot compared to what it would take on if it slapped against the ground with every step.
Which braces are best for foot drop?When it comes to braces for foot drop, it’s more the features of the brace itself than one particular brand, in our opinion. There are many factors to consider aside from the design of the brace or AFO, including:
- The materials they’re made from and the weight of the material (which can range from plastics, metal, leather, carbon composite and more)
- Whether they’re custom-made from a scan or cast of your foot or off-the-shelf
- How much skin contact is best for you (if you have diabetes or are predisposed to foot/pressure ulcers, this is a biggie)
- Your weight and activity levels – and hence the longevity of your brace
- How much flexibility and motion the brace should allow
- Any existing swelling (and changes in swelling) in the feet and legs
- Any function requirements – like greater energy return with a spring, a rocker sole
- How the brace will function with your existing footwear