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Understanding Nerve Stimulation for Foot Drop Treatment: How It Works

therapist discussing with patient why nerve stimulation is a good foot drop treatment

Foot drop is characterized by the inability to lift the front portion of the foot toward the shin, known as dorsiflexion. The inability to execute this movement is caused by the miscommunication between the brain and the affected muscles.

Fortunately, there are various types of treatments that can help manage and improve foot drop. One foot drop treatment in particular, nerve stimulation, is beneficial in stimulating the muscles and encouraging neuroplasticity – the brain’s natural ability to heal and rewire itself.

This article will discuss how nerve stimulation can improve foot drop, lower the risk of further injury, and help promote recovery.

What Causes Foot Drop?

The brain is responsible for sending nerve signals to the muscles telling them when to contract and relax. When the areas of the brain responsible for controlling movement are affected by a neurological injury like TBI or stroke, the muscles are unable to receive appropriate signals. As a result, movements like dorsiflexion (lifting the foot toward the shin) can become impaired, resulting in foot drop.

Another common cause of foot drop is a nerve injury, or damage to the peroneal nerve. The peroneal nerve is a branch of the sciatic nerve that wraps around the back of the knee up to the front of the shin. Because the nerve is very close to the surface, it can become easily damaged, especially after an injury.

The peroneal nerve is particularly important because it controls the muscles that lift your foot. Thus, damage to this nerve can impair dorsiflexion and result in foot drop, making it difficult to walk and safely navigate around.

Damage to the peroneal nerve can occur from sports injuries, childbirth, or hip or knee replacement surgery. However, there are other activities that can compress this nerve and increase the risk of foot drop. 

Activities that can contribute to foot drop include:

  • Wearing a leg cast for long periods: Wearing plaster casts that enclose the ankles for long periods can exert pressure on the peroneal nerve and increase the risk of damage and foot drop.
  • Prolonged kneeling or squatting: Squatting or kneeling for long periods of time can also add pressure to the peroneal nerve and increase the chances of foot drop.
  • Crossing your legs: Habitually crossing your legs can compress the peroneal nerve on the uppermost side.

If you wear a leg cast or have an occupation that requires kneeling or squatting (such as laying tile on the floor) for long periods of time, it’s important to consult with your doctor. They can evaluate you and check for any foot drop symptoms. Understanding the symptoms and risk factors can help you take the proper steps toward recovery.

Symptoms & Risk Factors of Foot Drop

Individuals with foot drop may experience a combination of symptoms, depending on the underlying cause and severity. Some may drag their toes while walking, while others may lift their knees higher than usual to prevent dragging.

Other symptoms of foot drop may include:

  • Muscle weakness
  • Tingling sensation in the legs
  • Numbness
  • Decrease in muscle strength or mass
  • Difficulty holding footwear

Symptoms of foot drop can increase your risk of tripping, falling, and further injury. To prevent this from happening, it helps to take preventive measures such as clearing clutter from the floors, ensuring rooms and stairways are well-lit, and avoiding the use of throw rugs.

Still, while taking precautions may be necessary, it’s important to treat the root cause of foot drop. Your doctor can provide you with a proper diagnosis and treatment plan that is suitable and safe for you.

How Can Nerve Stimulation Help Treat Foot Drop?

Although managing foot drop can be challenging, there are many treatments available. Treatment depends on the cause of your foot drop and the severity. For example, when foot drop is caused by a neurological injury like stroke or damage to the peroneal nerve, the best way to treat it is to rewire the brain with neuroplasticity.

Neuroplasticity helps strengthen the neural connections needed to execute a movement, like dorsiflexion. It is best activated through high repetition of foot drop exercises. The more a movement is practiced, the more the brain will recognize that movement and strengthen its neural connections.

While rehabilitation exercises are essential to treat the root cause, it can be particularly challenging for individuals with limited to no mobility. Fortunately, there are other ways that neuroplasticity can be engaged, such as functional electrical stimulation.

Nerve stimulation involves placing electrodes on the lower leg muscles and sending electrical impulses through the skin. These electrical impulses help create a contraction in the affected muscles of the foot. Activating these muscles helps encourage dorsiflexion and stimulates the brain. When used consistently, it may help reduce foot drop.

Functional electrical stimulation provides many benefits, but studies have shown that it is most effective when combined with rehabilitation exercises. Ask your therapist to train you to use a functional electrical stimulation machine to know where to place the electrodes and how to safely operate the equipment.

As your mobility improves, it’s important to participate in therapy and practice foot drop exercises. Your therapist may even show you how to simultaneously combine functional electrical stimulation with your foot drop exercises.

While functional electrical stimulation is usually a non-invasive treatment, in some cases electrodes are surgically implanted in an individual’s legs. If you are interested in this treatment to help you improve foot drop, it’s important to consult with your doctor.

They can ensure nerve stimulation is a safe and appropriate treatment for you. Your doctor and therapist can also provide you with alternative treatment options that are suitable for your condition.

Alternative Options to Nerve Stimulation for Foot Drop

While functional electrical stimulation is one of the most effective treatments for foot drop, it may not be appropriate for everyone. Fortunately, there are other methods that can help you manage the symptoms of foot drop.

For example, many therapists recommend using ankle foot orthotics, or an AFO brace. AFOs provide support to the foot and ankle and help prevent the toes from dragging on the floor. This helps lower the risk of tripping, falling, and further injury. 

However, AFOs are compensatory strategies meaning they do not treat the root cause of foot drop. It’s important to work closely with your therapist because they can provide you with a proper rehabilitation plan to support your recovery even if you use an AFO brace.

Additionally, for more severe cases of foot drop, surgical interventions may be necessary. This can include nerve transfers or decompressive surgery. Be sure to talk to your doctor to explore all your options before considering surgery.

Understanding Nerve Stimulation for Foot Drop

Foot drop can make it difficult to walk, perform daily activities, and navigate safely on your own. While there may be various causes of foot drop, some of the most common include peroneal nerve damage and the disruption in communication between the brain and affected muscles.

Fortunately, foot drop can be improved through a combination of treatments. For example, functional electrical stimulation is a great way to encourage muscle contraction, especially for individuals with limited to no mobility. However, nerve stimulation is most effective when combined with foot drop exercises.

We hope this article helped you understand how nerve stimulation can help manage foot drop and motivate you to practice rehab exercises.

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