Have you looked into an orthosis to assist your dorsiflexion weakness?


just because I'm good at cutting and pasting:

http://www.ncbi.nlm.nih.gov/pubmed/22437999

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GatorRacer-
Is is safe to assume you're in Florida?

If you happen to be in the Boulder area, it would be great to get you in for a gait analysis with one of our physical therapists. Questions like this are extremely difficult to answer well as the answer has to be individualized to you.

I hope you're able to achieve your goals.

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I talk a lot - Give it a listen: http://www.fasttalklabs.com/category/fast-talk
I also give Training Advice via http://www.ForeverEndurance.com

The above poster has eschewed traditional employment and is currently undertaking the ill-conceived task of launching his own hardgoods company. Statements are not made on behalf of nor reflective of anything in any manner... unless they're good, then they count.
http://www.AGNCYINNOVATION.com

Have you tried the new AFOs designed for runners?

I do have a custom carbon fiber (aero lol) orthoic, however I abandoned using it after my last corrective surgery provided no improvement, and I came to the realization that this will be a life long disability. It wasnt the most comfortable to run in, and the nature of these devices results in pretty high impact heel strike. I may ultimately have to go back to using it, but I am stubborn and want to "do it myself" if possible.

Yes I am in south Florida. I have had a lot of PT and surgeries to help. I can run relatively comfortably, but my recovery time is long and thus hurting my run volume increase requirements for a HIM

Definitely give your AFO (or a different one) another chance. I think you will have to settle on having a rearfoot-plant on both feet. Otherwise (as far as I know), your asymmetry will continue.

I know a woman who has made a tremendous comeback with a foot drop following a surgical complication. She did/does a lot of PT and does wear some special orthotics, though nothing as large as that photo...I think just in her shoe. She went from being a KQ to barely walking/running, and then back to being a KQ. So it can be done. She has mental and physical toughness that most people don't. Good luck!

I do not feel I have asymmetry. I have video'd my run, and worked on using my good leg to match the stride of my bad side so that I am symmetric.

My issue right now is Achilles soreness/tightness due to not being able to elongate the tendon

Just something to keep in mind. From the sounds of it, by your lack of DF strength in your affected leg, your musculature is not "symmetric". Therefore, there is every reason to believe that a symmetrical looking gait might not be ideal for you, although most who assist you with rehabilitation will use that as their goal. Not saying a symmetrical-looking gait is BAD, just saying that when you have some sort of permanent asymmetry (bony or soft tissue), an asymmetrical gait of some kind might serve you better than "forcing" yourself to look symmetrical. This is in part the point of an AFO. By attempting to correct the bony/soft tissue asymmetry first, you subsequently can then have more confidence that a visual symmetry is a solid goal. Just something to consider. Good luck

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http://cyclussports.com/ - #ZeroPositive #CyclusSports
http://app.strava.com/athletes/355549
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Hi
I have a complete foot drop on left foot since 2001 due to a snowmobile accident.
I ran my first marathon with a conventional AFO (internal brace in the shoe like the picture above).
These internal brace can make a lot a of injuries to the foot.

I have design a new type of totaly external AFO for foot drop.
We have a US Patent pending for it. (also Canadian and PCT application)
I ran 13 full marathons since 2003.
It will be a revolution for active people with foot drop.
Its a support frame completely fitted outside the shoe and it has no bad plastic sole in the shoe,
It has is very good lateral stability and it is smooth during plantar flextion
It can also be install on mountain hiking boots,
If you want to have info ,
We will be searching for people to test it in a couple of weeks or month.
Bye!

(The sketches in the patent application are schematic from the first prototype 5 years ago)
http://www.sumobrain.com/...p/WO2011097723A1.pdf

Hi,

This is an interesting topic.
I'm a physiatrist in the Netherlands and interested in this type of AFO.
Can you tell me if it' s available in Europe?

Thanks!

Hi Ynsnits,


We are actually testing production prototypes and it's not yet distributed.
The real production should start in a couple of months. There is some minor desing adjustements to fine tune.
We plan to distribute in Canada, US, Europe and possibly worlwide. We will need a couple of acitve patient to test the brace.


I sent you more info in your private message box. Its available in your profile

With foot drop you will certainly be forefoot striking and more so firing the gastoc/soleus to give you the sense of stability as well as a likely exaggerated push-off to compensate for lack of toe clearance. This in turn leads to some achilles tendon strain. I have seen this is many runners with foot drop. There are bands (dictus, Ossur foot-up) which work well with mild foot drop, but you do need to "fight them" somewhat at push off. If there is no need for lateral stability/correction people can do well with them and tolerate wearing well as they have no in-shoe component of rigid shank component. I find that longer distance runners and faster usually require more since it only controls one plane of motion.

So….if you haven't tried a Toe-off AFO by Allard I would. It has an anterior leaf instead of posterior (back of your calve) with good energy return and flexibility to allow for dorsiflexion before push-off and "assist" with push-off with memory of materials. It can be tailored quite well to a minimal need and is very good for running. No vested interest. Since you likely have lower neuron damage, functional electrical stimulation is not an option.

Lots of assumptions not knowing your exact limits at the ankle and hearing you mention surgery as this could impact decision-making e.g grafting versus tendon transfer. I have seen plenty of marathon runners with complete focal foot drop do well. Good luck.

Cheers!

Thanks for all the further help. As an update to my original post, I have been running brace free for about a year now. I've done 2 sprints since and am training for a HIM.

I have had some ups and downs in training, but at the this time, I consider myself "pain free". I don't know if the nerve damage is masking things, and I worry about long term hip compensation consequence, but I tend to not worry about that.

As mentioned, my Achilles has been the hard part. I toned back my mileage and increased frequency and that helped. I've been building since with no long term soreness. I still get soreness after my runs though. Since I'm using my calves so much, I lose form on long distances because the strength isn't there.

I'm not as fast as I used to be(8:30mi vs 7:00mi) but I hope I can return there over time.

I understand the decision/rationale to run brace free and it would be my drive as well, however, it is simply a matter of what compensatory pattern (with or with) allows you to run to your desire. There is no questions there will be compensation with either, but if achilles issue continues to be a rate limiter than experimenting with other supports may be wise. The fact that you can run without is a great and it is possible that you may accommodate over time to improve/increase and stay injury free. It also tells me that a minimal solution would likely work e.g. toe-off as most conventional AFO's are not suitable (overbuilt) for your need/goals/tolerance. Long term without can also be a bit of a slippery slope as altered mechanics at the ankle will carry loads through the knee and hip (not to mention the forefoot) differently that can also lead to issues over time.

Last tidbit(s), you may want to investigate and then supplement running with some heavy load eccentric calve presses for the achilles tendon if that is indeed the culprit. Keep religious with heel cord stretching as the force bias across your ankle joint is not favorable (night splint?) and the shorter the heel cord the more work it will have to do in running as well as become a limit to your stride mechanics.

Best of luck.

I agree with this completely. The introduction to regular calf raises in the gym, and bodyweight pre-training has been critical in my ability to train pain free.

If i dont fully "warm up" my achilles before a run, it can be very painful.

I struggled with very limited arterial blood flow to my left leg for several years (while competing in tris). That condition caused something very similar to what you're talking about, because the muscles in my leg had minimal function during exercisse due to their being starved for oxygenated blood. You've lost muscle; my muscles simply didn't work, because they weren't getting enough oxygen.

Whenever I tried to do speed work, I would develop achilles tendonitis in my left ankle. It was a compensating injury caused by the fact that I was using muscles I shouldn't have been using, to compensate for the fact that I couldn't control my footfall with that leg. The solution for me was simply slowing down. At a slower pace, I wasn't having to compensate quite as much for the minimally functioning left leg, and thus I wasn't stressing the achilles. You might try just doing what you're doing now (no brace, no gait change), and just go slower. Not optimal from a podium perspective, but you may be able to ramp up the miles without achilles issues if you back off on your speed. I don't have the technical background of most of the other people who have posted to this thread; I just have the personal experience of a minimally functioning left leg, and I know what helped in my case.

For me, going slower is worse. When you go faster, you naturally use more of your hip and quadriceps to take your stride, and since you are lifting your leg more, less ground clearance is necessary to clear your gait.

It similar to why when people run faster, they tend to get better form and heel strike less.

My problem is my stamina isnt good enough to run fast for a long time!!

Hi Gator,

I ran my 14th marathon at Quebec City Marathon last week end with my external AFO.

42.2k with a foot drop brace, no problem, no foot injuries, didn't need to take any care of running pattern. :-)
Just run and focus on my race plan.
I send you a private message with links to some video, and more information.

Bye!

Please consider trying the Allard USA ToeOFF brace. Many athletes & triathletes wear it because it's made of carbon fiber & Kevlar, which make moving in it more natural & less painful than other brands. Check it out at http://www.toeoff.com & ask your physician to prescribe you the Allard brace. There is a 30-day trial in which you can return it - no questions asked.

Hope this helps!

Hi Saw you reply for running with Drop Foot.
I have DF in both leg, made my first Triathlon 2 weeks ago and now want more..
Need to for on running, so far i have been using Diktus band, and feel it does not offer enough support and ability.
Would be very happy to participate in testing your new device.

Hello Yochaig.

First of all, Congratulation for your race!!
Sorry for the delay, I did not come on the forum last week
I sent you a private message, It's available in your profile setting.
Thank you for your interest in the project.
It's only the beginning... :-)

Bye!

Hi, I'm François from Turbomed Orthotics,


This is the foot drop brace that allows me to run several full marathons. (see pics below)
We designed this new foot drop brace specially for active poeples in search comfort and peace during intense and long endurance activity.
It do not need any support plate or any member to penetrate inside the shoe.
It will allow you to walk, run hike as far as you want without any risk of rubbing injuries due to the brace. You can see it in action on Youtube...


Website: www.turbomedorthotics.com
Video:


I can assure you that the comfort of our new external brace have nothing in common with any conventional internal brace.
It can be fitted on shoes, boots and many kind of footwear. It can also be easily switch from one shoe to another.
It is very easy to push during plantar flextion while Its stiff lateral members offer a very good lateral stability.
Hope it will help everybody afflicted by drop foot to recover their full level of activity.


Visit us and feel free to leave us comments. info@turbomedorthotics.com
Regards
François

Hi GatorRacer

Just came across your post and appreciate it is an old one at this stage. I was actually searching for information on a new AFO after a physio asked me to have a look at the Ritchie Brace. I suffered a serious knee injury 30 years ago in 1989 during a Moto-x race. i have had a foot drop since 1989 and have competed in many sports after this accident including Martial Arts and Triathlons. I have used various AFO’s including the large moulded options that the NHS provide, these resulted in having to increase my normal shoes size by 2 full sizes. I moved to an AFO called a toeoff which was great but not very durable for sports and finally settled on the Swedish AFO https://www.alimed.com/...dom-swedish-afo.html. These are great as they are light, flexible and reasonably durable. They are comfortable for longer runs and you can also place them under the insoles in your running shoes for extra comfort.

I have been lucky enough to complete 2 Full Distance Ironman races 11:05 and 11:03 ( just cant get under the 11 hour mark). i would recommend a professional bike fit to avoid pain on the bike and a good run analysis to determine the best shoes for your gait, hopefully this will avoid the pain you are experiencing.

regards
Keith

 to throw into the pile -- I suffered from foot drop for years

you may try running with a negative drop in your affected foot. This will compel greater posterior chain engagement (though of course it could have blowback elsewhere). You will have greater heel impact but the recoil will help everything work better.

you won't find any decent running shoes with a negative heel drop so play with cutting heel out of insole in an old pair and giving it a go. A low tech idea worth trying.