What is the medical term for dragging your feet when walking?

Medical Term for Dragging Feet When Walking

The medical term for dragging feet when walking is "foot drop" (also called "drop foot"), which refers to the inability to properly lift the front part of the foot during walking. 1

Causes and Mechanisms

Foot drop occurs due to weakness or paralysis of the muscles responsible for dorsiflexion (lifting the foot), particularly the anterior tibial muscle and other muscles innervated by the peroneal nerve. This results in the characteristic dragging of the toes or forefoot during the swing phase of gait.

Common causes include:

1. Nerve damage:

   • Common peroneal nerve compression at the fibular neck (most frequent cause)
   • L5 radiculopathy
   • Sciatic nerve injury
   • Peripheral neuropathy

2. Central nervous system disorders:

   • Stroke with resulting hemiparesis
   • Multiple sclerosis
   • Cerebral palsy (often undiagnosed in children)

3. Muscular disorders:

   • Muscular dystrophy
   • Myopathy

Clinical Presentation

Patients with foot drop typically present with:

• Dragging of the toes during walking
• Tripping or stumbling, especially on uneven surfaces
• Compensatory gait patterns (high stepping or hip circumduction)
• Increased risk of falls and injury
• Possible ankle equinus contractures over time

Diagnosis

Diagnosis involves a thorough neurological examination to determine the location of the lesion. Key diagnostic steps include:

1. Neurological examination to assess muscle strength, reflexes, and sensation
2. Gait analysis to observe the pattern of foot dragging and compensatory movements
3. Electrodiagnostic studies (nerve conduction studies and electromyography) to localize the site of nerve injury and assess severity
4. Imaging (ultrasound, CT, or MRI) to identify structural causes along the nerve pathway

Management

Management depends on the underlying cause but typically includes:

1. Orthotic devices:

   • Ankle-foot orthosis (AFO) - helps stabilize the ankle and improve gait safety 2
   • These devices enable patients to walk better and more safely with severe foot drop 1

2. Electrical stimulation:

   • Functional electrical stimulation devices (surface or implantable)
   • The ActiGait implantable stimulator has shown significant improvement in maximum dorsal extension of the ankle at initial contact 3

3. Physical therapy:

   • Strengthening exercises for dorsiflexor muscles
   • Gait training
   • Range of motion exercises to prevent contractures

4. Treatment of underlying causes:

   • Addressing nerve compression
   • Managing neurological conditions
   • Correcting habitual behaviors (e.g., leg crossing that may compress the peroneal nerve)

Special Considerations

In children, toe walking (which can appear similar to foot drop) may have different etiologies:

• Idiopathic toe walking
• Neurological conditions (62% of cases referred to neurology from orthopedic surgeons) 4
• Cerebral palsy (37% of neurological cases) 4
• Autism spectrum disorder (15.7% of neurological cases) 4

Prognosis

Prognosis depends on:

• The underlying cause
• Severity and duration of symptoms
• Timeliness of intervention

Early intervention is crucial to prevent complications such as falls, injuries, and permanent contractures. With appropriate management, many patients can achieve improved gait stability and safety.