Leg Length Discrepancy

What is Foot Drop?

Foot drop is a condition where the muscles in the front of the leg weaken, causing difficulty in lifting the foot and toes. It can happen due to nerve damage, injury, or underlying medical conditions. The condition can affect people of all ages and cause difficulties in walking and performing daily activities.

Lifting the foot up, an action known as ankle dorsiflexion is important for normal gait functions. Ankle dorsiflexion helps to clear the foot off the ground as our leg swings forward when we walk or run. Foot drop can cause tripping and falling, and can severely impact a person’s ability to carry out daily activities.

What Causes a Foot Drop?

Foot drop is primarily caused by injury to the motor nerves supplying our lower leg. Injury to the motor nerves can occur due to compression, trauma, infections (e.g poliomyelitis), genetic disorders (e.g Charcot-Marie-Tooth disease) or other health condition (e.g stroke).

Compression or entrapment of motor nerves occurs either from the direct pressure of nerves (e.g common fibular nerve injury), or by other body structures (e.g slipped discs). Traumatic injuries to the nerves commonly occur during surgery of the lower limb, fractures of the lower limb, or spine injury from a fall.

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What are the Signs and symptoms of Foot Drop?

Signs and symptoms include:

Unable to lift the foot up against gravity
Frequent tripping over the affected foot
Dragging the foot when walking
Needing to raise knee higher to walk
Foot “slapping” the ground when walking

Below are the typical ways that the body compensates when walking with a foot drop:

Increased flexion of the hip and knee
Lifting of the hip (hip hiking) of the affected limb
Circumduction of the affected limb (side swinging of the leg)
Increased sidewards swaying of the body

Signs and Symptoms Of Leg Length Discrepancy

Most mild cases of leg length discrepancy are asymptomatic as the body is able to compensate for the difference, which are signs that are typically noticeable.

Signs of leg length discrepancy include:

Pronation (rolling inwards) or supination (rolling out) of one foot
Abduction (angle outwards) of one foot
Tip-toeing on one foot
Flexion (bend forward) or hyperextension (bend backwards) of one knee
Hip tilt
Shoulder tilt

Symptoms of leg length discrepancy include foot pain, ankle pain, knee pain, hip pain, and most commonly back pain. Most symptoms are related to the musculoskeletal condition that the leg length difference has caused.

Conditions Associated with Leg Length Discrepancy

Conditions that are associated with leg length discrepancy usually affect only one lower limb, and they include: