Steppage gait is the inability to lift the foot while walking due to the weakness of muscles that cause dorsiflexion of the ankle joint.
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When you have “foot drop”, you walk with a steppage gait pattern. The anterior tibialis muscle, which is located in front of the shin bone, is what causes foot drop. Therefore, in order to lift your foot and ankle when walking, the anterior tibialis muscle contracts. By doing this, you may avoid catching your toes on the ground and ensure that your foot clears the floor. A steppage gait may occur if the anterior tibialis is weak or paralyzed. For example, this indicates that you move forward with considerable hip and knee flexion. In order to clear your foot over the ground and prevent tripping, you lift your leg sharply off the floor. If you have a steppage gait pattern after a sickness or accident, your physical therapist can assist.
Causes of Steppage Gait
The muscles responsible for elevating the front of the foot are weak or paralyzed, which leads to foot drop. Foot drop may result from several factors, such as:
The nerve in your leg that handles the muscles involved in elevating the foot is most frequently the cause of foot drop (peroneal nerve). Injuries to this nerve can also occur during knee or hip replacement surgery, which can result in foot drop. Foot drop can also result from a spinal “pinched nerve” damage to a nerve root. Diabetes makes people more prone to nerve conditions that are linked to foot drop.
Muscle or Nerve Disorders
Foot drop is a condition that actually gets worse through several types of muscular dystrophy, a genetic condition that causes gradual muscle weakening. Likewise, conditions like polio and Charcot-Marie-Tooth disease are also possible.
Brain and Spinal Cord Disorders
“Foot drop” can also occur as a result of conditions that damage the spinal cord or brain, including ALS, MS, and stroke.
Symptoms of Steppage Gait
A foot drop might make it difficult to walk. You can’t lift the front of your foot, so to prevent dragging your toes or tripping, you have to lift your leg higher than usual. When the foot strikes the ground, it could generate a slapping sound. This is called a steppage gait. You can have tingling or numbness on the top of your foot or shin, depending on the reason for “foot drop”. Depending on the reason, “foot drop” might affect either one or both feet.
Treatment for a Steppage Gait
Physical treatment directed at the anterior tibialis muscle is used to treat steppage gait patterns. You can strengthen your anterior tibialis by performing certain ankle workouts. When a patient performs calf stretches, the ankle’s range of motion will continue without reduction. Your physical therapist could suggest gait training or other activities help you walk better. To enhance your total proprioception (your awareness of the position and motion of your body), they can recommend balance activities. To help your anterior tibialis muscle function better, your physical therapist may potentially decide to employ neuromuscular electrical stimulation (NMES).
Your muscle is artificially contracted during this form of electrical stimulation, which helps it work properly. Your physical therapist may suggest back exercises to relieve pressure on your sciatic nerve in order to treat anterior tibialis weakness brought on by sciatica. The exercises are intended to enable proper signal transmission up and down the sciatic nerve in your low back. What is causing foot drop determines how to treat it. In certain instances, curing the underlying issue will also cure foot drop. “Foot drop” could be irreversible if the underlying condition is persistent or chronic. Physical and occupational therapy could help certain patients.
Possible Treatments for Steppage Gait:
- In order to support the foot and keep it in a more natural posture, use braces, splints, or shoe inserts.
- Physical therapy can improve your walking by stretching and strengthening your muscles.
- By using nerve stimulation, the nerves and muscles of the foot can be retrained with the use of nerve stimulation.
- To try to heal the nerve or release the strain on it, surgery may be required. Your doctor could advise fusing the ankle or foot bones to treat long-term foot drop. You could also have tendon surgery. This involves moving a functioning tendon and its accompanying muscle to a different area of the foot.
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