I suffer from drop foot due to loss of muscle in my leg from a gangrene infection.
I am able to SBR and completed a sprint last year as a big personal “milestone” in my recovery but I am now looking to do my first HIM this November.
As I slowly increase my run volume, I am getting some, what I will call, Achilles tendonitis(so it feels). I have been working on modifying my running form to handle a forefoot strike to minimize injury and associated hip pain from an uneven gait.
I am curious if anyone out there has permanent drop foot and if they have any symptoms I mention, and how you went about increasing run volume without further injury.
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 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!
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
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!
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.
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.
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!!
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.
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 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.
