What are the causes of weak foot dorsiflexion?

Causes of weak foot dorsiflexion

Foot drop is caused by damage to the nervous system. Both central and peripheral structures can be affected:

• Central nervous system (1st motor neuron): Brain or spinal cord

• Peripheral nervous system (2nd motor neuron): Nerve course from the spinal cord to the musculature

The term peroneal nerve palsy is often used for a peripheral cause. In this case, the peroneal nerve (fibular nerve), which supplies the foot lifter muscles, is damaged. This form usually leads to flaccid paralysis of the forefoot lifters.

A central cause, on the other hand, often causes spastic paresis, in which increased muscle tension in the calf muscles is combined with weakness of the foot lifters.

Overview of common causes

• Stroke

• Multiple sclerosis (MS)

• Parkinson’s disease

• Herniated disc (especially L5)

• Craniocerebral trauma

• Hip or knee operations

• Nerve compression (e.g. on the head of the fibula)

Due to its superficial course on the outside of the knee joint, the peroneal nerve is particularly susceptible to pressure, impact or crushing.

Symptoms and effects in everyday life

Foot drop is particularly noticeable during the swing phase of walking. The forefoot does not lift sufficiently against the force of gravity, resulting in the so-called drop foot.

Typical consequences are

• Grinding the toe

• Stepper gait or circumduction

• Frequent trips and falls

• Uncertainty when walking

• Poor posture and pain in the back, hips and knees

If the gait disorder persists for a longer period of time, chronic complaints and additional orthopaedic problems can develop. Early treatment is therefore crucial.

Diagnostics for weak foot dorsiflexion

The diagnosis is made using a combination of:

• Clinical examination and gait analysis

• Strength test of the foot lifting muscles

• Neurological status (sensitivity, reflexes)

• Electrophysiological examinations (EMG, NLG)

• Imaging (e.g. MRI of the lumbar spine or knee)

The aim is to determine the exact cause and severity of the nerve damage.

Treatment options for weak foot dorsiflexion

Medically, the treatment of the underlying disease is the first priority. Various conservative and technical aids are also used:

Physiotherapy

Targeted training to strengthen the body, improve coordination and prevent falls forms the basis of any therapy.

Classic foot lifter orthoses

Peroneal splints passively stabilize the foot and prevent it from buckling. They offer quick safety, but only promote active muscle control to a limited extent.

Functional electrical stimulation with innoSTEP-WL

Functional electrical stimulation (FES) with the innoSTEP-WL is a modern and active therapy option.

The system works with an inconspicuous electrode cuff on the lower leg. During the swing phase, targeted electrical impulses are sent to the peroneal nerve. These impulses trigger a contraction of the foot lifting muscles so that the foot actively lifts (dorsiflexion).

Advantages of functional electrical stimulation (FES) with the innoSTEP-WL

• Active support for lifting the foot when walking

• More natural, dynamic gait pattern

• Reduction of trip and fall risks

• Prevention of muscle loss

• Promotion of nerve-muscle interaction

In contrast to purely passive orthoses, the innoSTEP-WL actively trains muscles and neuronal control and can contribute to long-term functional improvement.