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Old 09-03-2011, 10:32 AM   #1
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Cool Drop Foot Exercises

As I wait for my drop foot to heal, I'm curious as to what exercises would be the best to do. Whether things take 6 months or 24 months to get back to 100% of what is possible, I need some help deciding what I should do.

What do I need to stretch and how should I do it? I don't want to overdo anything, so how many times a week? I've heard that there are things that if ignored can lead to permanent damage, which would be a miserable outcome.

I've finally become a Mayo patient and will get a second opinion on the neurosurgery and physical therapy within the next couple of weeks. I'm really excited about this development. Regardless of the time it takes to heal, I want to make certain that I've done all of my part.

So, those of you who have been through this before -- what exercises did you do to keep your ankle and leg at its best possible health? I've heard that the ankle is really important to keep limber and stretched. I think this applies to the calf as well. Advice from anybody?

 
Old 09-04-2011, 10:38 AM   #2
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Re: Drop Foot Exercises

I have the same thing.. I went through a back surgery 7 months ago, and they screwed up something and I came out with a drop foot on the opposite foot and leg that I had a problem with.
I started Physical T. a month ago, on the recommendation of my neurologist, and the PT people seem to think it will help. If you have nerve damage as I do it will take some time and it seems like nothing is happening for a long time.
I am getting tingling, and pinching type feelings in my left leg and they seem to feel that's good.
I am also curious about the mayo clinic, have you gone there yet and what are you impressions of the treatment or recommendations they have ?
The nearest one to me is in Phoenix AZ, so before I spend the money was wondering if it's worth it. I am in Las Vegas and the doctors here stink. None of them seem to know much about anything..
Thanks
Paul

 
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Old 09-04-2011, 11:08 AM   #3
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Re: Drop Foot Exercises

I'm glad you have an appointment with the Mayo Clinic, and hope it will provide some reassurance to you. I think you will find that they will confirm what your surgeon has already told you. Perhaps they will be aware of some latest research regarding foot drop that others are not. We'll keep our fingers crossed.

I think the basic exercises are important to keep the ligaments and tendons stretched out. I'm sure your PT has given you lists of ones to do. I just do ankle circles and flex and point my foot all the time when sitting at the computer, watching TV or when doing my back stretches.

Another one I like to work the small muscles of the feet is to throw a dish towel on the floor, and then gradually scrunch it all up using your toes. Lay it out flat and then use your toes to gradually scrunch and pull it toward you, so it ends up in a little heap by your foot. You can also pick up marbles with your toes and drop them in a bucket. I do these quite often as my toes on both feet are numb (mostly).

The PTs working with my aunt who had the stroke use therabands, looping one end around her ankle and tying the other end to a sturdy chair or table leg. Then she'd keep the heel on the floor and pull the foot from side to side.

You can probably find other stretches online that would be effective, too. I think the important thing is to keep the ligaments from shortening up and to keep the joint mobile.

 
Old 09-04-2011, 02:55 PM   #4
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Re: Drop Foot Exercises

Paul:

I haven't been to Mayo yet, but will go there in a couple of weeks. I'm fortunate enough to live near Jacksonville, FL, so going there is not a problem. Getting in -- now that was a problem. As soon as I find something out, I'll let you know.

I'm sorry you're having the drop foot problem. I've faced a lot of issues in my life and none of them have been more psychologically challenging than this drop foot mess. Hopefully, things are getting better for you. Maybe they will for me, too. My surgeon is really confused as to what might have gone wrong. He swears that he didn't come close to the L5 root. My CTs and Ct mylogram confirm what he says. He believes that some vibration might have stunned the nerve root during the surgery and has promised me that the drop foot will be gone by Halloween or so and that all of my nerve problems will be gone by the end of the year. I hope the second opinion from the Mayo neurosurgeon and PT doctor will confirm that prognosis.

No matter what, I just want to make sure that everything possible is being done. I've heard that the longer the healing time, the more permanent damage can occur in the ankle. That's the kind of stuff that I want to do the best to avoid. As teri says, maybe these guys have some new insight into the latest technology. As soon as I hear one way or the other, I'll spread the word.

Teri, those are the same things I've been doing to. Keeping the ligaments and tendons stretched properly is so important. How is your aunt doing?

 
Old 09-04-2011, 09:57 PM   #5
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Re: Drop Foot Exercises

My aunt has pretty much recovered from the colon surgery and is now back in outpatient PT -- she was very pleased as when they evaluated her last week, she had not lost anything during the time she was off having the surgery...which was July 20th. I'm not sure in what ways foot drop caused by a stroke is different from what happens as a result of spine surgery....She is making progress, but it is very slow. Of course, she is 89, too!

How long do you have to wait to see people at the Mayo Clinic?

 
Old 09-05-2011, 11:50 AM   #6
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Re: Drop Foot Exercises

Bracer..
As far as the drop foot exercises, at PT they have been given "instructions" from my neurologist as to what to work on with me regarding the drop foot and walking technique. They gave me a work sheet with many exercises for drop foot and how to practice walking with the numb foot and leg.
They also are doing the FES (functional electrical stimulation) and they are going to hook me up with their rep to see about getting one for home.
They tell me the TENS units are mainly designed for pain and there are different units for nerve stimulation which is what I need.
I got a prescription from my neurologist to see what portion insurance will pay.
Check with your PT people and see what they say..

 
Old 09-08-2011, 07:01 AM   #7
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Re: Drop Foot Exercises

I think what helps me is an EMS machine, similar to a TENS unit but works for the nerves. put it on non working muscle usually tibialis anterior and hope it begins to activate the muscle. Nerve damage can take a long time to regenerate if it regenerates. just takes time. Another test the Drs can do is EMG test, maybe mention that to them. Hope this info helps.

 
Old 09-18-2011, 09:35 AM   #8
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Re: Drop Foot Exercises

Hi Bracer ~

I believe you were headed to the Mayo Clinic this past week for an evaluation.

Were you able to learn anything about your foot drop? I hope you'll let us know how the appointment went...and, how you are doing.

TT

 
Old 09-19-2011, 10:03 AM   #9
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Re: Drop Foot Exercises

[QUOTE=tetonteri66;4844720]Hi Bracer ~

I believe you were headed to the Mayo Clinic this past week for an evaluation.

Were you able to learn anything about your foot drop? I hope you'll let us know how the appointment went...and, how you are doing.

TT[/QUOTE]

Hi, Teri!

I did go to the Mayo last week. All of my records had not brrn transferred yet, but the doctor told me a few things.

1) He thinks that my drop foot (left) and nerve pain (right) are not realted to the L5, but are indeed peroneal nerve problems. He based this on the physical exam he performed, which was short but more thorough than any other I have had post-hospitalization. He says that the amount of inversion I have combined with the other symptoms led him to that conclusion.

2) He thinks that I will begin to see substantial recovery within the next 2-5 months, with the numbness beginning to go away first. He includes the drop foot in this prognosis, which is remarkably similar in time frame to my surgeon.

3) He said that if my surgery had been performed at Mayo, I'd still be in a body cast (not exactly a cast, but you know what I mean). He didn't think it would make a difference in my recovery, however.

4) He said that if I don't have any recovery by November, then he will order another EMG.

5) He said that all of this opinion is very tentative, due to the fact that he has not looked at all of my reports or films. However, he said that he thought I had an 85-90% chance of complete recovery within a year, with most of that occuring in the next few months.

Good news, if it holds up. I've been told so many different things an this roller coaster ride that I'm at the "believe it when I see it" stage. However, I think that I've detected a slight change in my left tibialis anterior tendon. In the past, there has been virtually nothing there. In fact, one of my therapists spent about 5 minuts probling my foot a few weeks ago trying to find it, with no success. Over the past few days, I've seen some motion there and can feel what I think is the tendon starting to rise. It could be that the muscle is starting to more fully contract and that tendon is reacting. Like I said, it could be my imagination, but my wife noticed it to -- without me telling her exactly what to look for. I'm not able to heel walk on my left foot or pull the ball of the foot off the ground when standing yet, but maybe something will happen in the next few weeks. Little by little, change may be happening.

I do notice that I'm starting to have deep pain at the lower part of my incisions. Do you think this is do to the healing or to my increased activity at work combined with those inactove muscles. My surgeon says no jogging or running for at least three more months (of course, I can't do those with a drop foot anyway). My Mayo doc did suggest thinking about an AFO, but I'm not dragging my toes, even when tired and I've really been keeping that achilles in good shape.

I hope you're doing well. Have you heard from Linda or her husband (the fellow who was allergic to the bone graft and had drop foot)?

 
Old 09-19-2011, 10:56 AM   #10
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Re: Drop Foot Exercises

Linda hasn't been on the board since the last time she posted to you, at least as far as I have noticed.

I'm delighted you had a good report. I assume you are reporting what a neurologist said? I can't figure out why it would be the pereneal nerve and not be connected to your surgery at L-5. Why would it occur coincidentally with the lumbar fusion? Did he give you any explanation...or is it the "we don't really know...."

Regarding the pain at the end of your incision, is it a pain deep inside you, or do you mean literally, by the incision? It probably is related, one way or another, to your increase of activity...returning to your classroom, etc. I continue to be amazed at how long the recovery process can be. Here I am, fifteen months post surgery and I am just not feeling that I am getting some benefits from PT. I'm finally able to do some strengthening things without causing an immediate flare of sciatic pain.

I just joined a sports club last week that has several saltwater pools (no chlorine). I met with a trainer today who is going to design a program for me that I can do in the water. I swam laps on Friday and was really surprised not to have any bad after-effects over the weekend...so, I feel like I am still making progress.

I'm sure your progress seems horribly slow...but try to be patient. Try to stay positive and keep working at your recovery. It can be a long road....

 
Old 09-19-2011, 01:39 PM   #11
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Re: Drop Foot Exercises

Yeah, a neurologist said that. They seemed to work in groups at mayo, so I think he will get together with a surgeon and others before they come up with a plan of treatment and final prognosis. I think the symptoms and conflicting EMGs have these guys a little confused. Seems to me that the L5 must be involved and I think after this fellow sees everything he'll admit that is a likely possibility. The bottome line is they just can't say what is causing the problems other than some issues with the peroneal nerves. I have problems in both legs, but only in one hip (as shown by the second EMG) and this latest fellow didn't seem to have much faith in the part of the report that showed weakness in my left hip. That was the biggest reason that he zeroed in on the peroneal nerves, no matter the cause.

Edited to add this: I have definitely noticed one change, and that is to my left gluteus medius muscle. Once I was diagnosed with foot drop, I went on the internet and discovered that was one of the major muscles controlled by L5. I kind of flexed around (no smart comments, please ) and realized that muscle didn't behave the way it used to. Most of my doctors never performed the real test to determine weakness there. I did have one neurosurgeon back in July who said that he noticed weakness there. Well, a couple of weeks ago I realized that the difference I noticed before was now gone. And the doctor at Mayo tested the same muscle (the correct way) and told me it was OK. It could be that result that influenced his finding of no L5 involvement. I guess that would also show that the nerve has repaired itself that far down my left leg. How quickly does it repair itself? I've read and heard anywhere from less than 1 to up to 5 mm per day. If I split the difference and figure about 3 mm per day, that seems to approximately be the right area, though I'll be sure to ask about this next week when I see my primary neurologist, the fellow who noticed the weakness there to begin with. Maybe I'll actually get some real evidence of healing, though it would blow the 2-4 month time frame away and return me to the 6-12 months one that has always seemed most reasonable.

The problem is deep inside. I haven't had incisional pain in many weeks. It feels more like something in the back itself, though you know it could be the muscles there too. As long as I'm having drop foot problems and have the job I do while this fusion is healing, I think I'll have issues with my back. Once I'm able to really exercise, using both legs and my core, then I can begin to slowly get to what will be my new normal. Even if my foot drop begins to disappear soon, and I think it will, it'll be more than a year before I can even think about being completely 100%. It sure would be nice to see a little bit of real progress, though.

Last edited by bracer; 09-20-2011 at 05:24 AM. Reason: add the muscle changes

 
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