Foot lifter paresis is a paralysis of the muscles responsible for lifting the foot. These are muscles that are located at the front of the lower leg and pull over the ankle joint to the foot. These muscles are called the anterior tibialis muscle, the extensor digitorum longus muscle and the extensor hallucis longus muscle and are all innervated by the same nerve, the fibular nerve.
If this nerve is damaged, the muscles can no longer work and the foot can no longer be lifted properly when walking. The nerve can be damaged in its course, in which case it is called a peripheral nerve lesion, but central damage can also occur, for example as a result of a stroke or a cross-section. The following articles may also be of interest to you: Pain at the ball of the foot, physiotherapy heel spur, physiotherapy foot malpositions
Exercises
Basically, exercises for foot lifter paresis must be performed consistently and regularly, even though it can be very demotivating at first to see no movement and changes right away. Stamina and endurance are required! Regeneration of nerve tissue takes a lot of time and it is important to set the right stimuli regularly and consistently.
Helpful exercises, which are presented below, could be:
- Put the foot in a sitting position
- Set a tactile stimulus
- Set a thermal stimulus
- Raise the forefoot passively
- Stretch the ankle joint
- Stretch the ankle joint, 2nd variation
You can start in a sitting position and try to put the foot resting on the floor on the heel. Depending on the extent of the lesion, no movement will probably be visible at all. Nevertheless, the movement impulse is processed centrally in the nervous system and thus serves the training.
It is important when exercising for nerve lesions to use as many stimuli as possible to stimulate the nerves. When exercising the movement, a gaze control should always be performed. It is best to do the exercise in front of a mirror and move your healthy foot along with it.
For example, the patient sits on a stool in front of a mirror. The legs are positioned at a 90 degree angle and are about hip width apart. Now the patient lifts the feet until they are on their heels.
It is possible that there is no movement on the affected side at all, but the patient should still think about the movement and always carry it out mentally. This can be very strenuous. The exercise should be performed consciously and concentrated about 10 times.
Then there is a break of about 1 minute and the exercise is repeated 3-4 times. This training can be done several times a day. Another stimulus that can be exposed to the damaged nerves is the tactile stimulus.
Here the patient can activate the paralyzed muscles by lightly tapping them. While the patient tries to tighten the foot with the foot lifter paresis, he gives short, clapping strokes to the muscles. When the foot is lowered, or during the relaxation phase, there is no slapping!
This exercise can also be performed several times a day in 3 sets of 10 repetitions. Concentration is also required here. A further aid is the use of thermal stimuli.
In physiotherapy, ice lollipops are often used in the treatment of foot lifter paresis. This is also possible for exercise at home. Instead of clapping the affected muscle, it can be exposed to a short, strong cold stimulus with an ice cube or similar.
Here too, the following applies: during exertion the cold stimulus should be used, while during relaxation the stimulus is absent. Furthermore, it is useful to train the movement of the foot passively if it cannot be performed actively or sufficiently to maintain the mobility of the joint. A belt or a towel can be used for this.
The affected forefoot is placed in a loop and when it is lifted, the patient can also passively lift the forefoot by pulling on the loop. The heel should remain on the ground if possible. There may be a slight stretching in the calf.
If no movement in the foot is possible, the ankle joint must be stretched to prevent the formation of a contracture. For this purpose, the patient can stand in front of a wall in a lunge step. The affected foot stands at the back, the healthy foot close to the wall.Now the patient can lean forward against the wall while the heel of the affected foot remains firmly on the floor.
This results in a stretching in the calf. The position should be held for about 20 seconds and can be performed 3 times in a row with short breaks in between. This exercise can also be performed several times a day.
If the patient cannot control that the heel remains on the ground during this exercise, he can alternatively place the affected foot against the wall. If necessary, this position from the seat is easier, since he can position the paralyzed foot better against the wall with the help of his hands. Now the patient tries to bring the knee closer to the wall so that he feels a stretch in the calf.
Electrical appliances can also be used, and splints are available for everyday use so that the patient can walk safely and as physiologically as possible. The therapist should work out a results-oriented training plan with the patient. Further exercises can be found in the articles:
- Exercises for an ankle fracture
- Exercises ankle joint
- Torn ligament at the foot – what to do?
All articles in this series: