Bilateral foot drop and unstable standing

Are you saying your foot drop condition is new or getting worse? If so, you should see a neurologist.

Ankle-Foot Orthotics (AFOs) can compensate for foot drop. Modern AFOs are molded from a single piece of plastic and made to fit your feet. They are thin enough to wear inside ordinary shoes.

I have GBS and I am a physical therapist. I wear AFOs which eliminates foot drop and helps me more stable/balanced. I highly recommend AFOs. You do not need to quit your job!

I also had bilateral foot drop on both feet and months of physical therapy. I had to have surgery to correct the foot drop after the pt did not correct it. I am now back on my feet after two years:)

I agree with GH. However, they also make a carbon fiber AFO. https://www.alimed.com/afo/

Years ago I tried carbon fiber AFOs. Could have been 10 years ago. One of them cracked almost immediately. They told me no running, no jumping, no climbing, no golfing, nonsense. I went back to the ones GH describes. I do see many others wearing carbon fiber now.

There are at home exercises to help with your balance. One is to stand straight, feet together, ankles touching and cross your arms to opposite shoulders. Close your eyes. Do this between a door frame for something to grab onto. When you feel up to it, graduate to standing on a small pillow. Be very careful. Keep your eyes open at first if you must.

Do not quit your job. How will you provide for yourself if you quit?

JK – No my ankles were not pinned. It was to correct my foot drop. Transfer of single tendon, post tibial tendon, lengthening of achilles tendon/leg. It was a year ago, trying to find exact description; drowning in med papers and bills:(

Jill Brickley – It sounds like the surgery was completed because of nerve damage thus muscle(s) weakness and decreased motion in the ankle.

JK – For an orthosis decision, you need to take into consideration: ankle muscle(s) strength,side-to-side ankle stability, and ankle range of motion.I would love to wear carbon AFOs but my ankles need more support than what the carbon AFO is able to provide so I wear custom, molded AFOs. Check with a physiatrist or physical therapist or orthotist to determine the best AFO option.

Balance activities: 1) Practice tandem walking; 2) Try keeping your balance while standing with 1 foot in front of the other foot (heel-to-toe) for as long as possible, 3) switch which foot is in front: 4) stand on one foot for as long as possible; 5) stand on opposite foot.

Jill- thank you. No need to dig up paperwork. Your description is adequate. It also explains why I was only offered pins. Both my left and right tibials were compromised.

paronnee- thank you for the explanation and feedback.

minazeer – Perhaps a physical therapy evaluation will be helpful to help with balance activities and determining an appropriate orthosis to help with stability. Custom, plastic AFOs definitely can be limiting and impact your daily function!

P.S. I am a PT :]

Before you quit…Have you investigated other ways to keep your job? Depending on where you are, there should be rules/laws about disability accommodations. Something as simple as chairs/adjustable height stools could extend your current position. I’m guessing that as we age our previously controlled symptoms might creep back, similar to during periods of exhaustion.

I was born with foot drop- right foot (unrelated disability). PT at the hospital assumed the foot drop was a result of the GBS, so I was fitted for a set of orthotics which have caused very bad issues of their own…even 5 years down the road. (Bad fit= feet sliding= toes crushing= toenail issues= pain.) [long story] Proper fit is essential. (A few months after I started wearing them, the fit was so bad that the Orthotics Dude (not his official title) came to my home for a re-evaluation. He told me I’d have to wear them for the rest of my life. As he got into his car I said, “F*** that s***” and took the things off and threw them into my cellar. Then, after I got the things out of the cellar, I threw them into the garbage.

If you love (or even just really like) your job DO NOT give up. Figure something out.

minazeer- No. The exercise I described was demonstrated at at a GBS-CIDP Seminar.

As a general note- I have worn a single customized plastic AFO since 1980. I have worn bi-lateral customized AFO’s since the late 1980’s. I have the following comments:

1. AFO’s should not pinch, squeeze, slide or otherwise cause pain.
2. AFO fit should be re-evaluated periodically.
3. If you get a poor fit or poor service, change service providers.
4. I would much rather wear my AFO’s then stub my big toes, curling them under my feet and then walking on them.
5. I would rather wear AFO’s than trip over a small imperfection in the walking surface and fall flat on my face.
6. AFO’s are a nuisance when driving, so I take them off.
7. If I do not wear knee high nylon ‘stockings’ the plastic rubs and then burns the skin on my calves. Ouch.
8. AFO’s are a nuisance to wear while standing straight up and still. They are designed with a bias that causes undue pressure when not moving. So, I avoid standing still, preferring to not deal with the bias.

jk. An excellent review of important points re:AFOs. I understand that wearing sold ankle AFOs while driving is awkward, it took me awhile to acclimate. I don’t think I could drive without my AFOs. As with many activities, we have learned that living with GBS necessitates acclimations and adaptations. You can talk to an orthotist about an AFO with a hinged ankle (vs a solid ankle) allowing ankle mobility; there are criteria to be a candidate for a hinged AFOs.

I don’t know what you mean about “bias that causes undue pressure when not moving”, please explain.

paronnee- “bias that causes undue pressure when not moving” It means my AFO’s are formed with an angle of less than 90′ from the flat foot portion to the vertical support. Or, measured from behind the heel, there is more than 90′. Rather like a large letter L with the vertical not vertical.

Said another way. When I’m standing straight up, or attempting to, my braces tip me forward.

jk thanks for explanation. Following your explanation of the angle of your MAFOs, standing still would be difficult. In my experience, it’s an unusual setting for MAFO.

Hey! That’s another thing mine did- that forward tilt. I forget why “they” said it was necessary, but it took me several months after not wearing them to stop feeling like I was starting to fall. I thought it was just weird-little-me that had that happen to.
I have an aversion to nylons, so I got cotton/poly (still not ideal material) knee-highs, which were barely high enough for the orths. And since they were so high up my leg, removal for driving was impractical. (I rarely wear skirts/dresses/culottes/gauchos…) I wasn’t given the option of other types of torture devices, either.

I’m inspired to try running again!

Hi, I just wonder how you guys driving with footdrops? I am having footdrops for right side only so I have forced to use my left leg to drive.

Hello, I am also having foot drop on my right side only, my right leg is so much muscle loss for 8 months and then I gain back a little mobility of my foot for plantar flexion but not dorsi flexion and now it’s almost 1 year. My MRI result show there is no impingement on my nerve. I wanna ask is surgery can treat for my this situation?