Associated symptoms

A weakness of dorsiflexion of the foot is often accompanied by other symptoms. Depending on the cause of the muscle weakness, other nerve tracts or elements of the musculoskeletal system can also be affected by the damage. If it is a far-reaching impairment of nerve tissue, this can manifest itself in sensations such as tingling, pain or numbness.

In addition, stroke patients often experience restricted movement of the equilateral arm, paralysis of facial muscles or speech problems. If the weakness of dorsiflexion of the foot is due to a herniated disc, there is usually an additional strong pain at the level of the vertebrae, which radiates into the affected leg. Inflammations in the leg area are characterized by redness, swelling, overheating and local pain. In the case of a direct mechanical injury to the muscles or nerve, severe pain and bleeding are the result.

Diagnosis

The diagnosis of weakness of dorsiflexion of the foot can be made relatively easily. The examiner determines the force with which the patient can lift the foot. A scale from 0 to 5 is used, ranging from complete paralysis (0) to normal force and movement control (5).

In addition, a distinction can be made as to whether the movement can still be performed against resistance (4), against gravity (3), or with the force of gravity (2) cancelled. Also a palpable muscle activity can be recorded, but with no active movement (1). If the diagnosis is to be confirmed, an EMG (electromyogram) can also be requested. This involves inserting needles into the muscles to be examined and measuring the excitation conduction. In this way, deficits can possibly be displayed.

The treatment options

The treatment of weakness of dorsiflexion of the foot depends entirely on the cause. The therapeutic goal should be to restore the nerve’s functional capability as completely as possible. If this is no longer possible due to extensive damage, complications such as malpositioning (e.g.In the case of weakness of dorsiflexion of the foot due to direct nerve injury or severing, the chances of recovery are relatively poor.

An attempt can be made to rejoin the nerve endings with a suture, but this rarely leads to success. Physiotherapy is the main focus of therapy for weakness of dorsiflexion of the foot. On the one hand, the surrounding muscles should be strengthened so that they can take over the functions of the affected muscle groups; on the other hand, the foot lifter should be exercised to prevent the muscle tissue from receding and to improve the function of the nerve through regular stimulation.

In addition, splints can be applied to the foot and lower leg to bring the foot into a stable position and thus make walking much easier. Functional electrostimulation (FES) is another treatment option: it takes over the function of the nerve by directly stimulating the muscle and causing it to contract. It is also possible to train muscles that have been completely separated from the nerve supply.

The activation also has an effect – as with physiotherapeutic exercises – on the restructuring of the supplying nerve and promotes healing. When using splints in cases of weakness of dorsiflexion of the foot, various principles can be applied. There are different mechanical aids that help the patient to achieve stabilization in the ankle and thus facilitate walking.

The splints can be adapted to the degree of foot dorsiflexion weakness. If there are only slight restrictions, the splint can, for example, only cover the ankle joint. If there is a higher degree of weakness or even paralysis, more extensive measures are necessary.

Usually, a support plate under the sole is firmly connected to a bracket that is attached to the lower leg with straps. In addition to the mechanical principle, splints can also be used, which make use of functional electrostimulation (FES). The splint is a band attached to the lower leg, which contains electrodes for electrical stimulation and activates the muscles from the outside through the skin.

The choice of the appropriate splint must be based on the individual wishes of the patient and the probable course of healing (as well as the prognosis) must be considered. Orthoses are externally attached aids which are intended to enable the patient to maintain a healthy posture and movement. The term “splint” also falls into the group of orthoses, which is more commonly used in the language.

In the case of weakness of dorsiflexion of the foot, various orthoses can be used, which are mainly adapted to the degree of muscle weakness. If the foot dorsiflexion weakness is of a minor degree, an ankle joint orthosis (splint or bandage) is sufficient. This is put on like a stocking and helps the patient to stabilize the ankle joint while walking.

If there is already a tendency to develop a malposition (e.g. pointed foot) or if the foot dorsiflexion weakness is very severe, other foot orthoses can be used. These usually have a base plate on which the sole of the foot rests. A fixed guide connects the base plate to a belt or bandage which is attached to the lower leg.

This prevents the foot from folding down while walking and promotes a natural sequence of movements. The orthosis can often be worn under clothing, which increases the patient’s comfort. In functional electrostimulation (FES) – a form of electrotherapy – electrodes are attached to the muscles from outside.

The electrodes trigger a contraction of the muscles through electrical stimulation. In this way, the muscles are tensed and thus trained, even though they have no or insufficient contact with their supplying nerve. Consequently, an FES can slow down or even stop a regression of the muscles.

Furthermore, the resulting movement of the foot can be used to make walking easier for the patient. Another important point is the declining excitation of the damaged nerve. The regular activation can promote a re-connection of nerve cells if there is no serious damage in the tissue.

Thus, under certain circumstances, the functionality of the nerve can be restored and foot dorsiflexion can be cured.Kinesiotape are self-adhesive, elastic tapes that are applied directly to the skin and are used in a wide variety of diseases. Their effectiveness has not yet been scientifically confirmed, but “Tapen” still has a large following. It is supposed to help especially with muscular problems and diseases of the locomotor system.

In case of an existing foot lifter weakness, the tape is applied in two layers. The course of the tape starts at the inner edge of the foot and leads over the back of the foot to the area of the outer ankle and the outer lower leg. The tape should thus have a holding function and give stability to the foot that is sinking when the dorsiflexion of the foot is weak.

Many physiotherapists qualify for the correct use of Kinesiotape in addition to their normal training, which is why the application should be carried out by such professionals. Other aids can also support the patient in everyday life. The first thing to look out for is sturdy and safe shoes.

Since the patient has already lost stability due to weakness of dorsiflexion of the foot, the right shoes help to stabilise the gait and prevent tripping due to the ground. It is also possible to use walking aids. The possibilities range from walking sticks to crutches on both sides to a rollator.

Since the aids are sometimes perceived as stigmatizing, information should be provided on the possibility of using orthoses or FES (functional electrical stimulation). If there is a severe weakness of dorsiflexion of the foot or even paralysis of the corresponding musculature, which cannot be compensated by any other aids, the use of a wheelchair may be necessary. In everyday life, other technical equipment can then be used which can guarantee independent care (e.g. (stair) lifts in multi-storey dwellings).