PODIATRY 

STROKE & THE FOOT

A stroke or CVA can have massive consequences on the lower limb.

Foot Drop describes the inability to raise the front part of the foot due to weakness or paralysis of the muscles that lift the foot.  It is the symptom of an underlying problem, rather than the disease itself.  

As a result, individuals with foot drop scuff their toes along the ground or may catch their toe on the floor as they advance their weak leg, putting them at risk of stumbling and even falling.  Another compensation is to bend the knees to lift the foot higher than usual to avoid scuffing, which causes what is called "steppage" gait.  Tightness or spasticity in the calf muscles can add to the difficulty of lifting the foot.  This can result in postural instability (leading to higher risk of falls), increased fatigue and increased muscle demand on the rest of the body.

The most common solution for drop foot is the use of a splint worn in the shoe called an Ankle Foot Orthosis (AFO).  These fix the foot at a suitable angle so that the toes can clear the ground.  Often this can be issued by an orthotist after an assessment.

Often there is also a loss of sensory feeling in the foot as a result of the damage from the stroke.  This is termed Peripheral Neuropathy and can itself cause problems with the feet.  Some people may experience temporary numbness, tingling and pricking sensations (paresthesia), sensivity to touch or muscle weakness.  Others may suffer more extreme symptoms, including burning pain (especially at night) muscle wasting or paralysis.

Other effects of a stroke can be thickened or misshapen toe nails, dry skin, callus or hard skin build up, corns or ingrowing toe-nails.  These symptoms can develop quite some time (even years) after the initial stroke. 

Podiatrists are health care professionals who can give advice on how to understand, treat and manage these symptoms.  They are regulated by the Health & Care Professional Council (HPC).

How to contact a Podiatrist

You can get referred to a local NHS podiatrist for an assessment of your foot problem via your GP, neurologist or other suitable health professional.