Drop foot

Drop foot is the weakness of the dorsiflexion muscles in the foot
The extent of the deficit depends on three factors: location, severity and duration of the injury
The most common cause of the drop foot is peroneal nerve neuropathy a problem often related to compression at the neck of the fibula at knee level where the nerve is superficial with minor tissue support

Peripheral:

Central:

Musculoskeletal:

Medical conditions:

History of habitual or prolonged squatting or kneeling
History of knee brace or recent cast
Recent weight loss (Slimmer’s palsy)
Overstretching of peroneal leg, usually happens after ankle strain or prolonged leg or ankle stretch
History of DM
History of alcohol abuse
Recent surgeries

Inspect legs for swelling, redness and other signs of trauma
Examine the lower and upper extremities for fasciculation, this would suggest extensive neurological problems such as motor neuron disease
Test the gait and balance: taking high steps is a sign of severe weakness of dorsiflexion muscles
Heels and toes walking exam: difficulty walking on the heel is a sign of Peroneal n. damage
Assess dorsiflexion muscle strength for peroneal nerve damage
Assess plantar flexion and inversion for tibial nerve function
Assess hip abduction for L5 root damage. Weakness of hip joint abduction on physical exam may differentiate
Check knee and Achilles’ tendon reflexes and plantar responses
Palpate the common peroneal nerve for local tenderness. Conducte Tinel’s sign for ‘pins and needles” in the nerve distribution

Immediate neurologist referral if the problem is acute and bilateral
Surgeon or orthopedic referral in case of compartment syndrome
Education on avoidance from leg crossing, squatting and kneeling if the compression of the nerve at the knee is a potential cause
Physical therapy if needed
Recommend shoes with ankle support to prevent ankle sprain