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Foot Drop
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Foot Drop

Hi,  So...I went to PT on Fri of this week and she mentioned that she's noticing foot drop on my right side. She said that I should tell my neuro.  Funny thing is - I just went to my neuro earlier this week and she just had me walk 5 steps and turn around and never mentioned foot drop. She also made me sit on the table and try to lift my thighs off the table as she pushed down and also pushed against my shins with her finger.  And just said, "OK, good."  I'm not for sure if either of these tests would test for foot drop.

After watching me walk back and forth across the room, watching my gait, my physical therapist doctor said she noticed this abnormalty.  She had me try to walk on my heels and I really couldn't do it.  Then she asked me to sit down and try to lift the front of my foot off the ground and I could barely do it on my right side.  My foot always feels numb/tingling on that side, more so than my left side.  And my hip always kills me on that side. In fact, earlier this week, I went in to my primary care doctor and had my first steroid shot in my hip in hopes that it might help.  Now I'm wondering if the hip problems might be related to the foot drop problem. I've fallen 2 wks in a row and caught my self on a table that I was luckily next to or I would have taken out the flat screen tv.  My right foot catching both times - it just seemed to get stuck or something.  When I started to go back to PT in Dec, after my surgery, the physical therapist I was seeing (before this other one I've been seeing in the same office) was saying at that time that she noticed foot drop and mentioned some device thing to consider.

I know if I call my neuro about the foot drop, she'll probably say that she just saw me and I didn't look like I had foot drop.  Her personality is kind of the type that doesn't like her opinion to be challenged. And, my PT lady says that her friend was actually fired from being a patient of my neuro. (I should ask why and what she did to get dropped)  

Who has had foot drop and what were your symptoms / experience with it?
Thanks so much guys!
-Kelly :-)  
Tags: foot drop
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1045086_tn?1332130022
I'm late to the party but here now and singing the same song as the others Kelly.

I trip over my own toes (right side mostly) 'catching' my shoe on the carpet or ground.  It is worse when I'm tired, or HOT or walking faster than usual.  (Ampyra might not be my friend if it allowed me to walk faster! lol)  My worst falls occurred when hurrying to my car in rainy weather.

I also think the PT notices my problems because that's her area of specialty.  She knows exactly what to look for and several ways to test for or observe it.  She also sees me doing physical activity over a period of time.  I can usually pass the doctor's tests pretty easily because (like I tell him), "I can do anything for a minute".  Just don't ask for much more or much longer than that ;-}

I'd ask for the PT to send a concise report of her observations/evaluation.  It should carry some weight if she can grab the neuro's attention with authority and brevity.  Sometimes they don't share at all or send pages and pages of data that aren't easy to sift through for a barely receptive neuro.

I love the idea of the electronic assistive solutions that stimulate normal ankle movement to restore a natural gait.  It seems that would maintain function and prevent pain in other joints of the legs and back as well.

Insurance companies are short sighted if they refuse to see the benefit in that IMO.  Wouldn't it be nice if these devices got cheaper as time passes and demand increases - like other modern electronics do?!  Medicare and Medicaid pay for cases of incomplete spinal cord injury?  Spinal lesions can make a pretty good case as an incomplete spinal cord disease.  Worth a try in my mind.

A cheaper alternative for milder cases (like mine)?   I've found good success wearing a shoe with a flat bottom and cut back area at the toe.  They allow me to 'roll' forward without the balancing issues involved when wearing a so-called 'rocker bottom' shoe.  I found what works for me in the Alegria brand.

Otherwise, in the rain I am resigned to the fact that I WILL be getting wet.  I make sure I walk at my regular pace, THINK about every step, remember to take my cane along and keep a clean towel in my car to dry off when I get there.  I think I've fallen only once (knock on wood) since being diagnosed and becoming more aware.

Mary
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24 Comments Post a Comment
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Avatar_f_tn
Hmmm, my foot drop problems are the same as yours are.  It come and goes.
I am fortunate that I have a good neuro but do admit I went thru a few first.  If your neuro won't listen to you, can you find another one?  It's important to have a good relationship with your neuro.

I find that if I wear hard shoes, my foot doesn't drag as much, but still swing it out abnormally.  Most of my drag and tripping comes with going barefoot or just with socks indoors.

Hope this helps some
Sarah
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1832736_tn?1325086568
I also suffer from foot drop on my right foot, I was falling a lot.  My foot would drag and catch and down I would go, it was rather embarrassing and painful, as it was always on the gravel parking lot, never on anything soft like a bed.  That was before I was diagnosed with MS or even had any idea what was going on.  Once I was diagnosed and had received 5 days of IVSM, my drop foot improved some, but I still suffer with it if.  I was working with a PT, she had arranged for me to meet with one of the specialist shops who make Ankle Foot Orthotics, (AFO) and discussed the possibility of getting one of their products, but I opted not to, at least for now.

Hope this helps,

Norm
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1896537_tn?1381903609
Hi Kelly,
I haven't got foot drop but I was just thinking that perhaps the physical therapist noticed it because she's more of an expert on physical movement's than the neuro. My neuro sounds like yours in that he doesn't like his views challenged but at the end of the day, no one person knows everything so I think you should go back and tell her about your foot.
Hope all goes well, Zoe
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1548028_tn?1324616046
I would have your physical therapist fax over all of the finding to the Neuro.  This is good in a couple of ways.  It keeps them updated on what you have had done so they don't repeat, can order additional information and keeps them updated.  Some dr's don't like to be challenged but I think like being kept informed.  Then, this comes from a professional to professional.  Goodluck and please be careful!  I am constantly worried when Jordan falls at random.  Been some close calls-he has right foot drop.
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Avatar_f_tn
I so agree with Ku111
hadn't thought of having the PT person "peer to peer" with the doctor might be more readily accepted by him professionally.

I'd be interested in learning more about the AFO gadget.
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1225331_tn?1333369369
I hadn't thought about that either - about asking the physical therapist to fax over the info.  That might be a good idea.  Especially since she knows how my neuro is.  I'll have to ask her if she would do that for me.
Thanks for your thoughts on this everyone.

-Kelly
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1337734_tn?1336238191
Hi Kelly,
I have foot drop in my left foot. I have been going to physical therapy for many years but my foot drop became really bad after my last relapse. :( My neuro suggested that I try a WalkAide. I met withe the WalkAide people. They testedme and fitted me with a WalkAide that they loaned me for 2 weeks. It was great! No more foot drop, no more tripping or falling! I liked it so much that I bought one and wear it all the time. Unfortunately my insurance company declined to cover it and it's very exoensive. The WalkAide company has filed an appeal which I am still waiting on, but I still think it's worth it. If you want to learn more about WalkAide, they have a face book page or you can just google WalkAide.  Good luck with your foot drop. Keep in touch!
Hugs,
Deb
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Avatar_m_tn
It is understandable why your Neuro didn't see your foot drop. When you see you Neuro he might observe your walking for maybe at most 5 minutes. On the other hand at PT They would see you walking for most of the appointment time and also after you have tired.

When I first developed my right foot drop it was also my PT that first noticed it. It always get worse as I tire during the day and it was several appointments later before I happened to have an appointment later in the day when my Neuro saw the foot drop.

Dennis
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Avatar_m_tn
Thank you for that information about WalkAide.  For years I have been tell my doctors that I almost wish the would cut off my legs and give me computer controlled ones. I currently wear an AFO on my right foot all of the time which helps keep me from tripping over air, But it is hot and uncomfortable. Besides when I sit down I fall the last foot or so because I can't bend that ankle to get my weight centered.

When I see my Neuro this coming week I am suppose to talk with him about an AFO for my left foot as well as the foot drop is now affecting that foot as well. I printed out the info from their web site to show to him to see if that might be a better way to go for both feet.

Dennis
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1225331_tn?1333369369
Thanks for the WalkAide info Deb.  I'm glad that it's helped you.  Too bad your insurance is fighting to pay for it.

Dennis, you know, I was just sitting here thinking the exact same thing. Mine does seem to be a bit intermittent and mine seems to be more present when I'm tired.  Maybe I should walk around a bit before I go in to see my neuro next time. Then maybe she'll see it.  :-)
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1760800_tn?1406757051
I too suffer from foot drop I wear an afo but am getting it modified to reduce the amount of plantarflexion I have.  I do hate it as well cause it is hot and uncomfortable sometimes!  My PT talked to me about Bioness similar to walk aid.  I am going to talk to my neuro about it to see if she can write me a prescription for it and then battle with my insurance co!  LOL  Anything has to be better than the afo!  
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1437229_tn?1296073620
I have bilateral footdrop.  I was fitted with AFO's for both legs.  The plastic ones are hot in the summer, and cold in the winter.  The new graphite ones are much better.  They adjust to your body temperature, and do not need to be as large to do the work of keeping those toes out of the carpet.

I have used the Bioness extensively, and it is amazing.  I wore them on both legs.  They work so well.  Their system seems to be less obtrusive then the WalkAide system.  The BioNess affords you a lot of adjustability, too.  They are terribly expensive, but well worth the attempt to get your insurance to cover the cost.
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1225331_tn?1333369369
Wow, I just looked up the price on the Walkaide and the Bioness and it looks like they range from $4500 - $5500.  That IS expensive!!  Especially if insurance doesn't cover any of it.  
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1760800_tn?1406757051
Talked to the people at Bioness and they are sending a rep to see me next week to see how the device is and if it will work for me - then we battle insurance co.  If I need to I will see if I can get financial help to pay for this -  While i am reluctant to ask for financial help with most things this could be life changing and if it works for me - then so be it I will swallow the pride and ask for help -  
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Avatar_f_tn
does Bioness offer financial like the drug companies do?
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Avatar_f_tn
FootAide company just got back with me.  Medicare and Medicaid only covers for "incomplete spinal cord injury", so that will help anyone on these insurances.  Lets me out for sure........
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1045086_tn?1332130022
I'm late to the party but here now and singing the same song as the others Kelly.

I trip over my own toes (right side mostly) 'catching' my shoe on the carpet or ground.  It is worse when I'm tired, or HOT or walking faster than usual.  (Ampyra might not be my friend if it allowed me to walk faster! lol)  My worst falls occurred when hurrying to my car in rainy weather.

I also think the PT notices my problems because that's her area of specialty.  She knows exactly what to look for and several ways to test for or observe it.  She also sees me doing physical activity over a period of time.  I can usually pass the doctor's tests pretty easily because (like I tell him), "I can do anything for a minute".  Just don't ask for much more or much longer than that ;-}

I'd ask for the PT to send a concise report of her observations/evaluation.  It should carry some weight if she can grab the neuro's attention with authority and brevity.  Sometimes they don't share at all or send pages and pages of data that aren't easy to sift through for a barely receptive neuro.

I love the idea of the electronic assistive solutions that stimulate normal ankle movement to restore a natural gait.  It seems that would maintain function and prevent pain in other joints of the legs and back as well.

Insurance companies are short sighted if they refuse to see the benefit in that IMO.  Wouldn't it be nice if these devices got cheaper as time passes and demand increases - like other modern electronics do?!  Medicare and Medicaid pay for cases of incomplete spinal cord injury?  Spinal lesions can make a pretty good case as an incomplete spinal cord disease.  Worth a try in my mind.

A cheaper alternative for milder cases (like mine)?   I've found good success wearing a shoe with a flat bottom and cut back area at the toe.  They allow me to 'roll' forward without the balancing issues involved when wearing a so-called 'rocker bottom' shoe.  I found what works for me in the Alegria brand.

Otherwise, in the rain I am resigned to the fact that I WILL be getting wet.  I make sure I walk at my regular pace, THINK about every step, remember to take my cane along and keep a clean towel in my car to dry off when I get there.  I think I've fallen only once (knock on wood) since being diagnosed and becoming more aware.

Mary
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1225331_tn?1333369369
I'm like you Mary, I don't think I'm at the point where I believe the foot drop systems are necessary for me just yet.  And they look even less attractive when I see the cost.  However, I do see why people want to use them, even though they are very expensive.  

I think I'm going to steal what you say that you tell your neuro, because it's true and makes sense.  "I can usually pass the doctor's tests pretty easily because (like I tell him), "I can do anything for a minute".  Just don't ask for much more or much longer than that."

Thanks everyone,
Kelly

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1225331_tn?1333369369
Hi again.  Does anyone notice footdrop at night?  I think I have it more at night, then during the day. It feels like my right foot has been hanging forward a lot the last few nights.  

And, unless I try to hold my other foot underneathe it (or a pillow) to bring it up so that my right foot is flat, it seems to hurt quite a bit, especially above the ankle.  Anyone else ever hear of this happening?

Thanks!!!
Kelly
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1760800_tn?1406757051
From what my PT has told me it is because at night you are fatigued,  You walk around all day and by the end of the day you are just plain tired.  That is why an afo works - it makes walking less of an effort so you are not as tired at the end of the day.  My afo is being remade and I have not had it for two weeks and see a huge difference in my fatigue level.  So even if your foot drop is not that bad an assistive device will make it easier on you all day so that you do not become so fatigued!
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Avatar_f_tn
sometimes raising the heel of the good foot helps the bad foot swing forward better.....works for me....

mine is worse after I am tired.......usually use it as an indication I've been overdoing it!

Bionee system got back to me $6,500.......OUCH.............can hear my Medigap N policy screaming now!!!!!  Don't think it or Medicare will touch it.
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1045086_tn?1332130022
What you are describing at night could also come from spasticity Kelly.  Many people get tighter in the evening or night hours.  I'd mention it to your PT and ask her advice.  Finding a solution to this problem can avoid bigger ones down the line.

Besides, it is sometimes good to get this type of thing documented in your records with her and/or your doc.  I know you considered applying for disability at one time.  If you come to that point again it could be important to have a written record of disability progression.

I have seen a variety of devices in catalogues that can be worn while sleeping to keep the foot in a neutral position.  They are often made of soft material with a piece that pulls the toes up to maintain a 90 degree angle at the ankle.  They help prevent footdrop and contractures (and treat plantar fasciitis).  More than a few designs are available OTC and are reasonably priced (certainly less than $ONE K - or even $100).  Your PT might have a suggestion of a good style to start with.

Ouch Sarah.  It sounds easy but I don't think your solution would work for me.  Sounds like walking with a high pump on one foot and a flat on the other.  It might work short term (and if you aren't going far) but could also establish an abnormal gait that throws other body parts out of whack.  Unfortunately, it's all too possible to cause ourselves > one additional problem if we aren't careful about choosing a solution for the original.

There's always something (or several) to work on isn't there?
Mary
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1225331_tn?1333369369
I'm definitely going to discuss this with my physical therapist - and then I'll make sure that the info gets passed on to my neuro. At this point I'll'm in the in-between stage. I guess maybe looking into something a step before the afo or walkaide. We'll see.  

hanks for sharing everyone.  I really do appreciate it.

-Kelly
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Avatar_m_tn
Sometimes i drag my left toe could i have ms.
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