May is stroke awareness month. When many people think of stroke, they usually think of the unfortunate manifestations that occur in the face and upper extremities. I would like to explain and review some of the common lower extremity events seen in the lower extremity after a stroke.

One of the most common issues seen after a stroke is a condition called “foot drop.” It causes weakness and/or paralysis that limits one’s ability to raise the top area of the foot. The foot or ankle drops down when the leg is lifted to take steps. If a person has foot drop, they can trip and fall if the foot and ankle are not supported by a brace. This weakness  can cause a foot slap as the foot is not clearing the ground.

Why does foot drop occur? Well foot drop can result when nerves are damaged during a stroke. These muscles on the (anterior compartment) front part of the leg help the body clear the foot during swing phase and control plantarflexion of the foot on heel strike. The muscles are can be damaged, and can become weak because of lack of use following a stroke.

A helpful solution is wearing an AFO (Ankle Foot Orthosis) which is a device that has an orthotic that supports the bottom of the foot and follows the back of the calf and usually has a strap that goes around the leg several inches below the knee.

Balance or one sided weakness is another manifestation of stroke and can also be an issue so using a walker or rollator is necessary as well.

Physical therapy and rehabilitative therapy is helpful and can result in partial and in many cases total recovery for this condition.

Your podiatrist can prescribe and recommend the proper foot orthoses after a stroke. And as always stroke patients should follow closely with their primary care physician and neurologist.