YT YouTube2Text

YouTube2Text → Transcripts → Foot Drop Explained

Foot Drop Explained — Transcript

by Dr. Gretchen Hawley PT, DPT, MSCS · 2,646 words · 391 segments · language en · Watch on YouTube

Open in transcriber Summarize with AI Download SRT/VTT

Full transcript

0:00Hello, hello, and welcome. Thank you so
0:02much for tuning back in. Today, we're
0:04going to be talking about foot drop, and
0:07specifically
0:09why it's happening. If you have ever
0:12caught your toe on the ground while
0:15you're walking, or shuffled your feet,
0:17or had a near fall while walking, so you
0:21almost fell but you caught yourself,
0:23foot drop or drop foot might be part of
0:27what's going on. And what I have found
0:30as an MS specialized physical therapist
0:32is that there's a lot of people who have
0:36foot drop, maybe mildly, maybe severely,
0:39and they don't even know that that's
0:41what they have. And today, what we're
0:43going to be talking about is what it is
0:46and why it's happening, because if you
0:49can understand why it's happening, then
0:52it's so much easier to start seeing
0:54improvements because you're doing
0:56exercises for the reason, the cause, the
0:59culprit
1:00why this is happening to you. And I will
1:03also be mentioning a few different
1:05things like exercises or braces that can
1:09help if you are experiencing foot drop.
1:19Let's just dive right into what is foot
1:22drop. My simple definition is that you
1:26have difficulty lifting the front part
1:29of your foot, so your toes and your
1:31midfoot when you're walking. And what
1:35that results in is stubbing your toe, or
1:39catching your toe, or shuffling gait, or
1:43there's this phrase called foot slap,
1:46and you'll know you have foot slap cuz
1:47you can hear your foot slapping the
1:49ground
1:51with every single step that you take.
1:54You might notice scuff marks in the
1:56front of your shoes where your toes are,
1:59you might notice that you are tripping
2:02over the front of your shoe, or that the
2:04front of your ankle muscles are more
2:07sore than they used to be. All of these
2:10are signs that you might be experiencing
2:13foot drop. Additionally, your walking
2:16might have changed. Specifically, you
2:19might be swinging your leg around more.
2:22This is called hip circumduction. Or
2:24maybe you're hiking your leg up more.
2:27This is called hip hiking.
2:30Those two things can happen when you're
2:32not lifting your ankle as much. So, lots
2:35of different ways, but if any of those
2:37sound like, "Yeah, I think I do
2:40experience that," then you might be
2:42experiencing foot drop. The reason that
2:45I think it's so important to identify
2:48this specific symptom as it relates to
2:50multiple sclerosis
2:52is because it can significantly increase
2:55your risk of falling. And it really
2:58boils down to two things. Number one,
3:00the clearance, the ability of your foot
3:04to clear the ground so that it you are
3:07lifting it high enough where you're not
3:10catching your foot on the floor and
3:12tripping or falling. And then, secondly,
3:15the timing. Your foot needs to lift at
3:18the appropriate time in your gait cycle
3:21or your walking cycle. So, if either of
3:24those two things are off, if you can't
3:26clear your foot enough because you can't
3:28lift it high enough, or the timing of
3:31lifting it is off, you significantly
3:34increase your risk of falling and or
3:38tripping.
3:39So, let's walk through a few of the most
3:42common reasons that foot drop occurs
3:45specifically with multiple sclerosis.
3:48The number one cause that I see is
3:53Specifically weakness in the front of
3:55your ankle muscles. These muscles are
3:58called either the tibialis anterior or
4:02anterior tibialis. The peroneal muscles
4:05are or fibularis muscles are on the
4:07outside, but these are the muscles on
4:09the front or front outside part of your
4:12ankle where their main job is to lift
4:16your foot up, your forefoot.
4:19So, if you are sitting on a chair and
4:21your feet are flat on the ground and you
4:24attempt to keep your heel down but lift
4:27the rest of your foot, those are the
4:29muscles that we're talking about here,
4:31those anterior tibialis muscles. You
4:35need strength in these muscles to lift
4:38your ankle up. And multiple sclerosis,
4:41as we all know, causes demyelination,
4:45which can make any movement
4:49more challenging or it can make a
4:52movement not possible. We are able to
4:55rewire our brain and find a new way to
4:57make it possible. That's what
4:59neuroplasticity is. We've got other
5:01episodes on that. But, if you have
5:04weakness in the front of your ankle,
5:06we've got to strengthen your ankle.
5:07We'll get to that in a bit. Another
5:09reason that is really common for people
5:12with MS of why your foot drop might be
5:15existing is tightness in the back of
5:19your lower leg, so your calf muscles.
5:22So, the first one was weakness in the
5:24front, this second one is tightness in
5:27the back. And with multiple sclerosis in
5:30particular, this can be a really common
5:32area for spasticity or muscle cramping
5:36or tightening. But, when your calf
5:39muscles tighten, it pulls your foot down
5:43and it pulls your heel up, toes down,
5:46which is the exact position of foot drop
5:49or foot scuffing. So, if you have
5:52tightness in that area, then the
5:55solution would be stretching that area.
5:58Again, we'll get to that in a second.
6:00The third reason that you could have
6:04foot drop, and this one is not discussed
6:07as frequently, but it's the sensation or
6:12lack thereof in the bottom of your feet.
6:15Our whole body has sensory
6:20stimulation,
6:21meaning we can generally tell if
6:25something is hot or cold or sharp or
6:28dull. We can feel things that touch us.
6:31But, as you might know, as someone
6:33living with MS, that can change with
6:36multiple sclerosis. And it's very
6:39possible that you might not be able to
6:41feel the bottom of your foot as much as
6:45your other foot or as much as you used
6:47to or maybe not at all or it's very
6:50limited. If you can't feel the bottom of
6:53your feet, and therefore you can't feel
6:55your shoe or you can't feel your sock or
6:59the ground, that is going to
7:02significantly impact what your foot does
7:05while it's moving. If it doesn't know
7:07where you are in space, if it doesn't
7:10know that you're supposed to lift your
7:12ankle at this time, then it's not going
7:14to. So, the solution for this would be
7:17improving the sensation in the bottom of
7:20your feet, which we'll talk about in a
7:22second. And last but not least, the
7:25fourth major reason for foot drop is
7:28lack of range of motion.
7:30Range of motion is more specific to your
7:35joint. It's less about your muscles, so
7:38it's less about weakness or tightness
7:41and more about your actual joint, the
7:43bony alignment of your ankle. If your
7:48joint is very stiff and rigid, and you
7:51can't move it up and down even when your
7:54ankle is fully relaxed, or you can't
7:57roll it in a clockwise or
8:00counterclockwise rotation, that again
8:03can significantly impact how your foot
8:07is going to move when you're walking.
8:09So, we want to work on ankle range of
8:12motion in addition to these other
8:14culprits if that is something that is
8:17causing your foot drop. Now, other
8:19factors that are worth mentioning
8:23that also contribute to foot drop. These
8:27aren't main culprits, but they are
8:29things that play a role are things like
8:32speed. So, our ability to move and use
8:36our muscles at a faster speed. The
8:39faster you walk, the less time your
8:41muscles have to lift, and the weaker
8:44muscles often can't keep up. Or balance.
8:48If you are unable to balance long enough
8:53for your leg to lift your ankle, then
8:56your foot drop is more likely to be
8:58present. Or stamina, or sometimes called
9:01endurance. If your ankle muscles do
9:05lift,
9:06but they fatigue quickly, which is very
9:09common in MS, then your foot drop is
9:12going to kick in sooner. You might
9:16notice this if your foot drop is fine
9:18for the first five, 10, even 15 minutes
9:21of walking, but then after those 15
9:24minutes or whatever it is, then it kicks
9:26in, it could be a stamina or endurance
9:29issue. It also could be a heat
9:31intolerance issue. When we are moving
9:35and walking, even if it's in cooler
9:37months, it increases our core
9:39temperature. And when your core
9:41temperature increases, any symptom can
9:43worsen, including foot drop. So, if you
9:47don't notice your foot drop for the
9:49first several minutes or length of
9:52walking, whatever distance that might
9:54be, but you do start noticing it
9:56eventually, it could be a heat
9:58intolerance issue. So, there's lots of
10:01additional things at play here, but
10:03these are some of the most common things
10:05to be thinking about and what we think
10:07about in The Missing Link as we are
10:09suggesting exercises and strategies
10:12based on what's happening specifically
10:14for you. So, as we move on to talking
10:17about what can actually help. Like,
10:20great, we understand, hopefully now, why
10:23this is happening and what might be
10:25happening in your specific situation.
10:27Now, it's also important that we're
10:29trying to reduce foot drop. So, what can
10:32we do? I often like to use a cane. It
10:35just seems to have a really great place
10:38for your foot to relax and for you to
10:41use your arms to help pull towards you.
10:44So, again, your ankle's trying to stay
10:45relaxed, and ideally you'd be feeling
10:48this stretch somewhere on the back of
10:50your calf, anywhere from your heel all
10:53the way up to behind your knee. The
10:55third culprit was sensation. So, my
10:58favorite tip here is to use a tool to
11:01help. So, I really love the company
11:04called Naboso. They have insoles,
11:08specific ones called Neuro Insoles, that
11:11you can put in your shoes, and they have
11:13tiny little pyramids all over the insole
11:16that allow you to help feel your feet
11:19more. If you can feel your feet more,
11:22the more your foot can do what it's
11:24meant to do at the right time. You also
11:27can use some desensitization exercises.
11:30We have a different episode and
11:32conversation about that. But
11:34essentially, you put your foot in a dry
11:39bag of dried rice or dried lentils, and
11:42you just move it around. We're trying to
11:44desensitize it and wake up the sensory
11:48neural pathways. You also could take
11:51your shoe off or your sock off and just
11:54use your fingernails, tap the bottom of
11:56your feet. We're trying to wake up those
11:58sensory nerves. And if the fourth
12:00culprit felt true for you, which is the
12:03ankle range of motion, so the joint, one
12:05of the best things that you can do is
12:08have your leg sitting on top of your
12:11opposite leg. So you're in this
12:13figure-four position, where one ankle is
12:16sitting on top of the other knee, and
12:19then you're just going to grab with your
12:22hand
12:23your foot. I like to grab around my
12:25forefoot and move your ankle around. You
12:29might have to use your other hand to
12:33hold your leg on. This leg that you are
12:37trying to relax, the ankle, should be
12:40completely dead weight. You can roll
12:42clockwise, counterclockwise, up and
12:45down, and you're applying a little bit
12:47of over pressure in all of the
12:49directions because we're trying to
12:50improve the joint range of motion.
12:53There's also other things that we can do
12:56that are not exercise related, such as
13:00AFOs or ankle foot orthoses. We had a
13:03somewhat recent podcast episode all
13:06about the differences between AFOs and
13:09ankle braces, and which ones do what
13:13things. So I will link that down in the
13:15show notes and descriptions, so you can
13:17check that out. But essentially, it's a
13:19form of a brace that either holds your
13:22foot in a specific position or assists
13:25your foot in lifting. You also could use
13:28support from things like electrical
13:31stimulation.
13:33We have an upcoming podcast episode on
13:36electrical stimulation and what it is,
13:38how it works, different examples out
13:40there. So, once that has been posted
13:43live, I'll also share that link in the
13:45show notes and description as well.
13:47Essentially, the way that it works is by
13:50stimulating the nerves that we are
13:52trying to strengthen. So, it helps you
13:55with lifting your foot.
13:57And I just want to remind you that using
13:59tools or devices, mobility aids like
14:03these things that I've mentioned, like
14:04the insoles, an AFO, an ankle brace,
14:08electrical stimulation, those things,
14:12ideally, are always done along with your
14:15exercises. You never want to use a
14:19supportive tool on its own without also
14:23pairing it with the strengthening
14:25exercises or stretching, whatever the
14:27culprit was for you. Unless your goal is
14:31just to improve foot drop in any way,
14:34shape, or form possible, not necessarily
14:36by improving your strength or your
14:38flexibility. If that's your goal, then I
14:41suppose you don't need to pair the two,
14:42but 99.9%
14:45of the people that I work with,
14:47they're looking to improve their
14:48strength and they're looking to not
14:50become dependent on AFOs or ankle braces
14:54or electrical stimulation. So, if that's
14:56your goal and you want to actually
14:59improve your muscles, not just depend on
15:02a tool, then you should always pair
15:05your exercises, strengthening,
15:08stretching, etc., balance with these
15:11tools. There are also shoes, you may or
15:14may not know about Cadence sneakers, but
15:17Cadence sneakers are specifically built
15:20for people with foot drop. I'm a big fan
15:23of those, again, especially when paired
15:25with your exercises.
15:27The whole goal is to keep you moving
15:31safely and confidently while also
15:34building the underlying strength that
15:38you need to see lasting improvements.
15:42So, if you do have foot drop and this
15:44really resonated with you, then just
15:47know that the exercises that I mentioned
15:50here are the exact type of work that we
15:53do inside The Missing Link Membership.
15:56Our members get MS-specific exercises
16:00and programs and calendars that target
16:03specific symptoms like ankle strength
16:05and gait, balance, endurance, etc.
16:09outlined specifically with which
16:11exercises to do each day and with
16:14demonstration so that you understand
16:16exactly what to do, how it should feel
16:19when you're doing it correctly versus
16:21incorrectly, ways to modify, and if you
16:23aren't feeling it in the right place,
16:25how to modify so that you do start
16:27feeling it in the right location. So, if
16:30you're looking for that level of
16:32guidance and structure and support,
16:34especially because MS is so different
16:37for every person and each day or each
16:39hour can be different, then you might
16:42want to check out The Missing Link. Our
16:44newest feature is Dr. Gretchen AI, which
16:47allows you to put in your symptoms and
16:50ask your questions 24/7. I have trained
16:53it in all of my knowledge possible, so
16:56you're able to ask the AI version of me
16:59your questions. If you don't prefer that
17:02option, we do have monthly Q&As as well,
17:05where it's actually me answering your
17:08questions. So, lots of ways for you to
17:10get the support and guidance that you
17:11need. If that does sound like something
17:14that you are interested in, I'll put the
17:16link down in the show notes and
17:18description so that you can see what the
17:21program entails and if it's a good fit
17:22for you and your goals.
17:25And just to recap, foot drop has real
17:29explainable
17:30causes and culprits and I personally
17:33think that's really motivating because
17:35it can give us real actionable solutions
17:39when you're aware of what it is that's
17:41causing it. And the fact that you're
17:44learning about this right now means that
17:47you're already doing something right.
17:49The more we can become aware of what's
17:51happening to our bodies and why it's
17:53happening, that can then lead to a
17:55solution, the better off we're going to
17:57be. So thank you so much for tuning in
17:59today. I hope you found this helpful.

About this transcript

This page contains the full transcript of Foot Drop Explained by Dr. Gretchen Hawley PT, DPT, MSCS, generated from the public captions YouTube serves with the video. The transcript has 2,646 words across 391 segments, with the original timestamps preserved so you can click any line to jump to that moment in the embedded player.

What you can do with it

Use the transcript to take notes, quote the speaker, build a study guide, generate a summary with ChatGPT or Claude via the YouTube Summary tool, or export it as a timed subtitle file with YouTube to SRT. You can also re-open it in the transcriber to translate the transcript into 100+ languages.

Free YouTube transcript tool

YouTube2Text is a free YouTube transcript generator — no signup, no daily limit. Paste any YouTube link and get the full transcript instantly, with timestamps, click-to-jump, translation to 100+ languages, AI prompts for ChatGPT, Claude, and Gemini, and exports to TXT, SRT, VTT, or Markdown.