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.
Craniocerebral trauma
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.
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.
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.
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).
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.
If you are interested in the innoSTEP-WL or would like to know whether the system is suitable for you, we will be happy to advise you personally. We can also provide you with information on medical prescriptions and possible cost coverage by health insurance companies.
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More safety when walking starts with the right support – for a more active and self-determined life.
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