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Neurology (Expert Forum)
Foot Drop Noticed After Ankle Sprain
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Foot Drop Noticed After Ankle Sprain
by Totti10, Feb 02, 2006 12:00AM
I'm a 32 year old male. Approximately two weeks ago I suffered a sprained ankle at home, heard a popping noise, and felt a sharp pain. The pain subsided shortly afterward and I was able to walk on the ankle. The following day I noticed that I wasn't walking correctly and noticed that I had limited foot movement but no pain. I could not move the foot up towards me or out to the right (this was my right foot). My big toe also provided no resistance and was very weak. After seeing an orthopedic specialist, he suggested I may have stressed the nerve controlling these movements, prescribed an AFO brace, and stated that the full range of motion and strength should return, although it was difficult to say how long it would take. He stated that it was a very strange injury but that it was possible.
I've now noticed that I can move the foot to the right and that some of the strength has returned. My big toe is stronger but not 100%. However, I still have the foot drop and cannot lift my foot all the way up. Again, there is no pain and very little swelling in the ankle.
Is the "progress" I've made a good sign or should I seek a second opinion? Should I give it a few more weeks? I understand that you cannot diagnose over the Internet but any guidance you could provide would be appreciated. I'm very concerned because foot drop is associated with some serious conditions, including ALS. I hadn't noticed a problem prior to the accident but am concerned.
Thank you.
I've now noticed that I can move the foot to the right and that some of the strength has returned. My big toe is stronger but not 100%. However, I still have the foot drop and cannot lift my foot all the way up. Again, there is no pain and very little swelling in the ankle.
Is the "progress" I've made a good sign or should I seek a second opinion? Should I give it a few more weeks? I understand that you cannot diagnose over the Internet but any guidance you could provide would be appreciated. I'm very concerned because foot drop is associated with some serious conditions, including ALS. I hadn't noticed a problem prior to the accident but am concerned.
Thank you.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Feb 07, 2006 12:00AM
Foot drop can rarely be a presentation of some neuromuscular conditions such as mononeuritis, inclusion body myositis, or ALS. Usually the foot drop does not improve and as time goes by other signs develop making the diagnosis more apparent.
Your episode was associated with truama so perhaps it is more likely that this is the cause. Without knowing the nature of your injury, sometimes nerves get 'dinged' or 'burned' in a truama, football tackle etc. The nerve is usually just 'stunned' and recovers over a few weeks, although sometimes if severe enough the nerve can be damaged and may not recover 100%.
Truamatic sections or some other trauams of a nerve can be repaired surgically in some cases up to several months after the injury. One way your neurologuist can tell what teh severity or nature of any residual damage (stunning vs damage) is to get an EMG and nerve conduction studies - ask your doctor about this. The clinical improvement in the foot over weeks to months after is also one of the best ways of telling how bad the nerve injury was.
Good luck
Your episode was associated with truama so perhaps it is more likely that this is the cause. Without knowing the nature of your injury, sometimes nerves get 'dinged' or 'burned' in a truama, football tackle etc. The nerve is usually just 'stunned' and recovers over a few weeks, although sometimes if severe enough the nerve can be damaged and may not recover 100%.
Truamatic sections or some other trauams of a nerve can be repaired surgically in some cases up to several months after the injury. One way your neurologuist can tell what teh severity or nature of any residual damage (stunning vs damage) is to get an EMG and nerve conduction studies - ask your doctor about this. The clinical improvement in the foot over weeks to months after is also one of the best ways of telling how bad the nerve injury was.
Good luck