Five signs of MS foot drop and how orthotics can help
Orthotist Rebecca Collingwood explains how to spot the signs of foot drop early, and how an orthotics service can help.
What is foot drop?
Foot drop is a common symptom for people with multiple sclerosis (MS). It happens when there’s a weakness affecting the foot. It’s sometimes referred to as ‘drop foot’.
The definition of foot drop is a weakness in the muscles that lift the foot and ankle (called the dorsiflexors).
What causes foot drop?
In people with MS, foot drop is often caused by the nerve messages between the brain and the legs being disrupted. This makes walking difficult as the foot or toes drag. And it increases the chances of a fall.
Five early signs of foot drop in MS
As an orthotist, here are five key signs I see in clinic that may indicate you’re experiencing foot drop:
- Difficulty stepping over small objects
- Feeling as though you’re regularly dragging your foot or toes
- Lifting your leg higher when you’re walking to avoid catching your toes
- Noticing you’re regularly stumbling or falling
- Finding walking tiring because you constantly have think about picking up your leg
These symptoms can make it challenging to walk on uneven surfaces and trail long distances. Or even carry out daily tasks like climbing stairs or navigating pavements.
If you notice any of these symptoms, contact a healthcare professional so they can assess your dorsiflexion strength. Recognising symptoms early can reduce your risk of a fall and speed up access to an orthotic service. And help you regain your mobility and independence.
What to expect in an orthotics appointment
As a clinician I regularly see people who’ve struggled with foot drop for a long time. Often this is because they don’t know there’s help available. Lots of people have no knowledge about what an orthotics department provides.
Orthotics is an NHS service that can prescribe external devices that help with movement. Restoring ‘biomechanical function’ is the technical description. Foot drop is a commonly treated condition in an orthotic clinic.
As part of your appointment, an orthotist will take a thorough history of your symptoms. This will be followed by an assessment of the severity of your foot drop and how it’s impacting your daily life.
This information helps an orthotist decide the most suitable prescription to meet your needs. Depending on severity, devices can be custom made or off the shelf - it depends on your needs.
How foot drop orthotics can help with foot drop
Orthotics that help with foot drop are known as ankle-foot orthoses (AFOs) or sometimes referred to as splints. If an orthotist thinks the weakness comes from further up the leg they may consider a knee-ankle-foot orthosis (KAFOs).
An AFO can be very light weight, made from carbon fibre and fit discreetly inside a shoe. Sometimes they’re made from plastic if you need a more custom design. You’ll need to have a cast taken for a custom design. And you’ll have several fitting appointments to make sure the fit is right.
Occasionally an orthotist may fit a device to the outside of a shoe, if the foot drop is less severe. For example, one made of fabric that attaches to the laces. Sometimes a metal device known as a caliper can be added to the outside of the shoe. For this you’ll need to drop a pair of shoes into the hospital to be adapted.
The aim of all these devices is to improve your ability to lift your foot when you walk. And to reduce the risk of a fall.
Tell us what feels right and when things don’t
It’s important to be an active participant in your orthotics appointment. For example, we want to know if you are comfortable with a particular choice. Often there are several prescription choices and an orthotist can tailor your prescription to your preferences as best as possible.
Orthotics help many people with MS who have dropped foot. If you have any of the five key signs, speak to your GP or MS nurse. They can refer you to an orthotics service. Foot drop can often be spotted early and there are usually multiple prescription options available.
A good orthotic device can help to reduce your fatigue, improve walking confidence and regain your independence.
