Clinically reviewed by What is foot drop
Foot drop means the muscles that lift the front of the foot have become weak, so the foot does not clear the ground when you walk. The toe catches, and you trip on door sills, uneven streets and stairs. People describe it as panja uthta nahi.
It is a sign, not a disease. Something has interrupted the nerve supply to those muscles. The assessment has to find where: the nerve at the outer knee, the nerve root in the lower back, or the brain after a stroke.
Many people notice a slapping sound as the foot lands, or that they lift the knee high to swing the foot through.
Symptoms you might have
- The front of the foot will not lift, so the toes drag along the floor
- Tripping, especially on steps, door sills and uneven ground
- A slapping sound as the foot lands
- Lifting the hip higher, or swinging the leg outwards, to get the foot through
- Numbness or tingling on the top of the foot and the outer shin, where the same nerve supplies the skin
- The front of that shoe or sandal wearing out faster than the other
- Usually one foot. Both feet together is less common and needs medical assessment
Why it happens
- Pressure on the peroneal nerve at the outer side of the knee, the commonest cause. Long squatting, sitting cross-legged or crossing the legs are the usual triggers, as is a tight cast or brace
- A disc in the lower back pressing on the L5 nerve root, usually with back and leg pain
- Stroke, where the weakness starts suddenly with other changes on the same side
- Long bed rest, rapid weight loss, or lying with the leg rolled outwards
- Diabetic neuropathy and other nerve diseases
- Injury: a fracture around the knee, a deep cut, or a nerve damaged during surgery or by a wrongly placed injection in the buttock
When you should see a physiotherapist
Come in early. A dropped foot that is splinted and treated properly keeps walking safely while the nerve recovers. Left for months, the ankle stiffens into a fixed downward position, and that becomes a second problem on top of the first.
See a doctor urgently if the weakness is getting worse week by week, if it is spreading up the leg, if both feet are affected, or if your hands are becoming weak too. Progressive weakness needs a medical diagnosis first.
Go to a hospital the same day if foot drop comes with numbness around the groin or back passage, loss of bladder or bowel control, or weakness in both legs. Go immediately if it starts suddenly with a drooping face, a weak arm or slurred speech, which means a stroke.
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How it is treated
Treatment has two parts running at the same time. Making walking safe now, and taking the pressure off the nerve so it can recover.
- An ankle foot orthosis, a light splint worn inside the shoe that holds the foot up. It stops the tripping immediately and is the most useful single thing in the early weeks
- Calf and ankle stretching every day, to stop the ankle stiffening into a fixed downward position while the muscles are weak
- Electrotherapy to the weak muscles at the front of the shin, to maintain them while the nerve recovers
- Exercise therapy, strengthening for the foot lifters as soon as any flicker of movement returns, then progressive loading
- Gait retraining, so the hip hitching and high stepping habit does not stay once the foot recovers
- Manual therapy to the ankle and foot, and to the lower back where that is the source
- Changing the cause, which usually means changing how you sit and squat
Most foot drop from nerve compression recovers without surgery once the pressure is off. Surgery is considered for a nerve divided by injury, or for a disc causing weakness that keeps worsening.
Exercises, and what to avoid
What helps
- Ankle lifting practice: heel on the floor, pulling the foot and toes up, many short sessions a day
- Calf stretch against a wall, 30 seconds, three times, every day without fail
- Walking with the splint on, so the pattern you practise is a normal one
- Toe raises and heel walking once there is useful strength back
What to avoid
- Sitting cross-legged, squatting for long periods, or crossing one leg over the other
- Walking without the splint on stairs or uneven ground, where a trip means a fall
- Barefoot walking on rough ground, particularly if the top of the foot is numb
- Pushing a weak muscle to exhaustion. Short frequent practice builds more than one long session
What you can do at home
Wear the splint whenever you are walking, including inside the house. It is not giving up, it is what prevents a broken wrist or hip from a fall.
Do the calf stretch every day. This is the thing people skip, and skipping it leaves lasting stiffness.
Clear the floor at home. Loose rugs, raised door sills, wires and uneven steps are what catch a dragging toe.
Check the top of the foot and the toes if the skin is numb, because you can injure it without feeling it.
Heat on the calf makes tight muscles feel easier, but neither heat nor ice speeds up nerve recovery.
How long it takes
Foot drop from pressure on the nerve at the knee, with the cause removed early, often improves within six weeks to three months.
Foot drop from an L5 nerve root usually recovers over three to six months, and tends to follow the leg pain settling.
Nerves regrow at roughly a millimetre a day. That is why a nerve damaged at the knee takes months to reach the foot muscles, and why nothing speeds it up beyond keeping the muscles and joint ready.
If there is no movement at all by three months, ask your doctor about nerve conduction testing. Some injuries are too severe to recover fully.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
پاؤں ڈراپ میں پیر کا پنجہ اٹھنا بند ہو جاتا ہے۔ چلتے وقت انگلیاں زمین پر رگڑتی ہیں اور شخص بار بار ٹھوکر کھاتا ہے۔
عام وجہ گھٹنے کے باہر والی نس کا دب جانا ہے۔ لمبے وقت تک اکڑوں بیٹھنا یا تنگ پر تنگ رکھ کر بیٹھنا اس کا سبب ہے۔ دوسری وجہ کمر کی ڈسک یا فالج ہے۔
سب سے فائدہ مند چیز اے ایف او اسپلنٹ ہے، جو جوتے کے اندر پیر کو اوپر رکھتی ہے۔ اس سے گرنے کا خطرہ بہت کم ہو جاتا ہے۔
روزانہ پنڈلی کی کھنچاؤ ضروری ہے، ورنہ ٹخنا نیچے کی طرف اکڑ جاتا ہے۔
اگر کمزوری روز بڑھ رہی ہے، دونوں پیروں میں ہے، یا پیشاب کا کنٹرول خراب ہو، تو فوراً ڈاکٹر کے پاس جائیں۔
Roman Urdu
Foot drop mein pair ka panja uthna band ho jata hai. Chalte waqt ungliyan zameen par ragharti hain aur banda bar bar thokar khata hai.
Aam wajah ghutne ke bahar wali nas ka dab jana hai. Lambe waqt tak ukroon baithna ya tang par tang rakh kar baithna is ka sabab hai. Doosri wajah kamar ki disc ya falij hai.
Sab se faida mand cheez AFO splint hai, jo joote ke andar pair ko upar rakhti hai. Is se girne ka khatra bohat kam ho jata hai.
Rozana pindli ki stretch zaroori hai, warna takhna neeche ki taraf akar jata hai.
Agar kamzori roz barh rahi hai, dono pairon mein hai, ya peshab ka control kharab ho, to foran doctor ke paas jayen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
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Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
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Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
What causes foot drop?
Will my foot drop recover?
Do I have to wear a splint?
Is foot drop a sign of a slipped disc?
Is foot drop after a stroke permanent?
Related conditions
- Carpal tunnel syndrome treatment
- Bell's palsy treatment and exercises
- Sciatica treatment and exercises
- Diabetic neuropathy treatment
- Numbness and tingling in the hands and feet