I work in healthcare and routinely provide hands-on care to recovering trauma patients. I frequently see cases of foot drop. It is not uncommon in lower extremity injuries when there has been nerve damage. I also see it a lot in diabetics. Over the years I have become very familiar with the condition. You would not think my own diagnosis would have come as such a surprise. I had been having textbook symptoms for months. Yet, I was completely oblivious.

Foot drop is quite common in people with multiple sclerosis. It is often one of the initial symptoms that drive people to seek medical attention. I did not know this. My initial symptom was a buckling right knee. That started in November 2020. By December, I was experiencing weakness in my entire right leg. I could still hike but needed more breaks. My leg felt like a hundred pounds of jello. Every step was exhausting. At this point, I still thought my knee was the main culprit. I was also starting to consider that I was contending with a nerve issue. I had tweaked my lower back in the gym less than a year earlier. It would make sense, except I was in no pain. Everything I knew about nerve damage told me I would be hurting, or at least feeling pins and needles. I had none of that. By January, the foot drop started.

I was out for a winter hike. The trail temporarily shared a route with a winding, one-lane road through the mountain. There were houses scattered here and there. The scene was very reminiscent of where I grew up and I was comfortable with my surroundings, even with a few large guard dogs barking in the background. I always carried dog treats and bear spray. I left it up to the dogs to tell me which they wanted. For the record, I have never pepper-sprayed an animal and usually came home without treats. Nevertheless, you still play it safe. As I came upon a house with a large sleeping dog in the yard, I decided the best game plan was to sneak by.

Trying to sneak past did not go as planned. I knew my leg had been getting heavier as the hike continued on. I had a lot of miles planned for the day. At this point in my life, I had not yet been diagnosed with MS. I just knew something was wrong with me and I knew it was getting worse. I found out that taking frequent breaks helped. My symptoms would subside for a few moments and then return. I was still thankful for the glimpses of relief. That day, on that road, is when I can confidently say my foot drop symptoms first became evident. Looking back, I can recall stumbling here or there on previous hikes. I remember times when it felt like the bottom of my shoe was constantly scraping across the ground. Those were apparently precursors. That day was undeniable.

Trying to sneak by the dog was useless. I had little control of my right leg and no control of where my right foot landed. Every step involved hiking my right hip in order to help my foot clear the ground as my leg swung forward. My foot landed with a loud slap on the pavement with every step. The stealthier I tried to be, the louder it seemed to get. I could not control it. I was completely aware it was happening. I would grit my teeth and try to make it stop. I would hold my breath so my body would have one less thing to focus on. I used every ounce of will in my body. I was no match for whatever was doing this to me.

My foot slapped the ground for fifteen miles that day. As with every other symptom I had experienced up to that point, I had no pain. I was even more convinced it was a nerve issue stemming from my lower back. This would also be when I began to consider there could be a neurological issue at play, as well. Whatever was happening was not resolving on its own. It was worsening. It was time to seek medical attention.

For me, the “foot slap” seemed to simply be a transition phase. It did not last long before my foot drop turned into not being able to completely lift my right foot and dragging my toes across the ground with every step. As my foot drop became progressively worse, so did my ability to hike long distances. I would spend hours in the woods stumbling over every root and rock that stuck up from the ground more than an inch. I would spend entire hikes watching the ground a foot in front of me for trip hazards.

The other thing I noticed was the mounting fatigue. It was mentally and physically taxing. My body was trying so hard to lift my toes from the ground. My nervous system was struggling with every step to get messages through broken pathways from my brain to my foot. I started using hiking poles for balance and to take some effort from my failing leg. They helped, but not enough. Being on my feet for most of the day at work was also becoming intolerably exhausting.

This is also when my ability to cycle started to be affected. Mountain biking involves riding over obstacles, like roots and rocks. Our pedals are always precariously close to striking something. Foot drop made every pedal stroke a hazard. Unable to flex my foot, my right toes were always pointed down and in danger of getting caught on anything I was riding through or over. Even being extra careful, I still had a lot of close calls that left my ankle sore for days. Even on the road bike, I would hyperextend my ankle and I was unable to flex it through the pedal stroke. Every minute on the bike was a minute closer to serious injury.

I have a lot of limitations when it comes to mobility. While foot drop has been a significant factor, it is one that I feel I have the most control over due to the use of ankle-foot orthosis (AFO) devices. My follow-up to this post will be dedicated to AFOs and what they have done for me. It will also take an entire post just to talk about what goes into finding the right AFO (spoiler alert: it takes a lot of patience). Trust me, it is totally worth it when you find the one.