Foot Drop: Why Does It Happen After a Traumatic Brain Injury?

A traumatic brain injury is a condition that occurs after an external or physical assault on the brain, disrupting its normal function. It can damage several nerves in the brain, causing patients to experience different neurological and muscular symptoms. One such example is the development of foot drop syndrome. 

Below is an in-depth discussion on everything you need to know about foot drop after TBI一its symptoms, causes, and treatment options.

What are the signs and symptoms of foot drop?

In the medical field, foot drop can also be referred to as peroneal nerve injury, peroneal neuropathy, foot drop palsy, or drop foot.

Foot drop is not actually a disease; it is a symptom of an underlying disorder, such as a TBI. It is a condition characterized by the body’s inability to lift or move the front part of the foot, hence its name. Most of the time, it occurs to only one foot but can also affect both feet simultaneously.

Foot drop may be a temporary or permanent condition, depending on its root cause. Patients with such conditions can usually experience the following symptoms:

  • Difficulty in walking or moving.
  • May develop an unusual gait over time
  • Muscle weakness in the affected foot
  • Muscle numbness or tingling

Patients with foot drop may raise their knees or thighs higher than usual when walking or moving. They may also drag the affected foot when walking or swing their legs to avoid dragging it on the floor. Over time, the patient may eventually develop gait problems if the condition is left unaddressed.

What are its causes?

Foot drop occurs when there’s an injury to the nerves, disrupting the normal flow of nerve signals between the muscles and the brain. The specific nerves that may be affected include the L5 nerve root, the sciatic nerve, and the deep, common, and superficial peroneal nerve.

Some of the specific diseases that cause patients to experience foot drop as a symptom include:

  • Nerve injury

-direct damage or compression to the peroneal nerve (nerves that controls the muscles in the foot and toes) can cause patients to suddenly experience foot drop. This specific nerve may be injured after trauma, such as knee dislocation, hip or knee replacement surgeries, or car accidents.

  • Brain and spinal cord injury

-Brain and spinal cord injuries usually stem from traumatic accidents, such as car collisions, sports injuries, or violence. Such incidents can cause brain and spine damage, leading to various conditions, such as the following:

  • Amyotrophic lateral sclerosis
  • Multiple sclerosis
  • Stroke
  • Alzheimer’s disease
  • Parkinson’s disease

  • Muscular dystrophy

-muscular dystrophy refers to a genetic condition wherein the gene responsible for maintaining normal muscle function becomes compromised. These abnormal mutations can interfere with the muscle fiber structure and function, thus affecting movement and causing disability. 

Some of the most common muscle disorders characterized by foot drop include Charcot-Marie-Tooth disease and polio. 

How is it diagnosed?

Doctors diagnose a dropped foot through a combination of physical examination and imaging tests. They will look at your gait, how you walk, and signs of muscle weakness in the affected leg. Your physician may also talk to you about your medical history and other symptoms you might have to determine the root cause of your foot drop.

Additionally, your doctor may order other diagnostic procedures to see if other structural damages might be causing the condition. 

  • Imaging tests such as X-rays, CT scans, or MRIs.
  • Blood tests (e.g., sugar level) to check for diabetes or potential toxin poisoning.
  • Nerve conduction
  • Electromyography

Once there’s a confirmed diagnosis, your physician will create a plan of care to manage your symptoms and treat the condition causing the foot drop.

What are the treatment options for foot drop after TBI?

Treatment options for foot drop caused by a traumatic brain injury may vary from person to person. But it will definitely include techniques that can address both the foot drop and the TBI. Some examples of therapeutic and rehabilitative activities include:

Physical and occupational therapy

One of the best ways to treat foot drop and other symptoms of a TBI is to induce neuroplasticity through physical therapy. 

Neural plasticity refers to the brain’s ability to reorganize itself to restore nerve connections and strengthen existing ones after trauma. One way to boost brain plasticity is to engage in regular physical activity since repetitive actions help build synaptic connections. 

Additionally, therapeutic exercises can help strengthen your leg muscles, improve their function, and enhance overall body mobility. Plus, it can also help reduce muscle atrophy and preserve the structural integrity of the muscles in the foot and ankle. Some examples of these exercises include:

  • Ankle dorsiflexion
  • Ankle adduction and abduction
  • Assisted toe raises
  • Heel raises
  • Ankle eversion and inversion
  • Hip rotation slides
  • Hip external and internal rotation

Your physical therapist will start these exercises by teaching the techniques and assisting you if necessary. In severe cases, your therapist will introduce the passive counterparts of these exercises wherein you’ll use your hands to move your affected foot. 


Your doctor or therapist may also recommend you use ankle foot orthotics (AFO) in combination with regular physical therapy. AFOs are specialized devices that provide support and stability to patients with lower limb conditions, such as foot drop. Some of its other benefits include:

  • Improving gait and physical function of the affected foot.
  • Enhancing the foot and ankle’s range of motion
  • Improves balance, ambulation, and mobility.
  • Prevents falling accidents and further injury to the foot.
  • Strengthens the affected limb and helps it return to normal function and activity.

Orthotics are lightweight devices you will wear on your foot or ankle to hold them at their normal position, especially when you move. Your physical therapist will determine the proper type of ankle brace that is suitable and safe for you to use.

Electrical stimulation

Functional electrical stimulation, or FES, is a type of therapy that uses low electrical current to stimulate muscle contraction. It aims to gradually restore motor function to the affected musculature by giving the muscles an electrical nudge.

Therapists typically use functional electrical stimulation together with rehabilitative exercises since FES can also enhance neuroplasticity.  


Most foot drop conditions caused by a traumatic brain injury may be managed using the techniques mentioned above. But for severe cases, then surgical intervention may be required. Various surgical procedures can be performed depending on the specific nerve or muscle injury. Some examples include:

  • Decompression of the affected nerve (e.g., spinal or peroneal)
  • Sequestrectomy
  • Tumor resection
  • Neurolysis
  • Nerve transfer
  • Tendon transfer

However, surgery will only be considered once every other treatment plan has been exhausted.


traumatic brain injury

Where to find the best brain injury rehabilitation centers?

If you or a loved one suffer from a foot drop after a TBI, then our neuro rehab facility can help with your recovery.

NeuLife Rehabilitation is a residential facility that provides 24/7 care and various post-acute therapies to patients with neurologic disorders. Our individualized programs aim to provide extensive medical and therapeutic care so patients can achieve maximum functional mobility and independence. 

Contact our post acute rehabilitation center at 800-626-3876 to learn more about our services. 


The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.



Dedicated to providing the highest caliber of care to individuals with brain injuries, NeuLife Rehabilitation is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF).
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