Weakness of dorsiflexion of the foot

What is foot lifting weakness?

A weakness of dorsiflexion of the foot describes a disorder of the extensor muscles of the lower leg. This consists of the anterior tibialis muscle, the extensor digitorum longus muscle and the hallucis longus extensor. The task of the muscles is to lift the foot or toes, where the term “foot lifter” comes from.

Weakness of foot dorsiflexion can have various causes, which can be traced back mainly to restricted nerve function or, more rarely, to deficits in the muscle, joint and tendon apparatus. Foot lifting is part of a wide variety of movement sequences, as well as the normal gait. Therefore a weakness leads to enormous restrictions in the patient’s life and should be treated as best as possible.

The causes

A frequent cause of weakness of dorsiflexion of the foot is a stroke. This involves destruction of brain matter, which can also affect the centers and nerve tracts responsible for movement. The consequence is that the subordinate nerve cords in the spinal cord and those directly connected to the muscle can no longer be controlled by the brain.

As a result, the muscles become weaker or even completely paralyzed. Other central neurological diseases, such as multiple sclerosis, also cause damage to brain tissue, which can lead to similar symptoms. If the cause is not central, the course of the nerves can also be disturbed on another level.

For example, a herniated disc often leads to a narrowing of the spinal cord, in which the motor nerve fibers may also be trapped. Serious injuries to the legs (especially the knee and ankle) or operations can result in direct nerve damage. The development of nerve tumors (so-called neurofibroma) may also impair the function of the affected nerve.

Even after correct treatment of a leg injury – for example a fracture – the nerve can still be damaged: if the cast is applied too tightly and not relieved, there is a risk of external pressure damage. In addition to the nervous system, it is also possible to look for causes of existing foot dorsiflexion weakness in the musculoskeletal system itself. Injuries to muscles and tendons, chronic joint changes such as arthrosis or inflammation (arthritis – joint inflammation, myositismuscle inflammation) can temporarily or permanently restrict the foot lifter function, depending on the cause.

You can read more information on this topic here: OsteoarthritisThe most common cause is a herniated disc in the lumbar spine (lumbar spine). This causes the intervertebral disc (a small cartilaginous cushion between the vertebral bodies) to protrude into the spinal canal, displacing the spinal cord and impairing its function. At the level of the lumbar spine, the nerve cords that are responsible for controlling the movement of the legs and feet run.

This is where the commands from the brain are transmitted to the muscles. The nerve that controls the foot lifts is called the nervus fibularis profundus. Its fibers leave the spinal cord at the level of the 4th and 5th lumbar vertebrae.

They then move through the upper and lower leg in a thick bundle of nerve fibers, the sciatic nerve, through the thigh to the lower leg. At its exit or above its exit point, the nerve can be affected by the herniated disc. Depending on the severity of the herniation, the result is weakness or even paralysis of the lower leg extensor muscles.

Muscle weakness and movement disorders are not uncommon symptoms of a herniated disc and are usually accompanied by severe pain and sensation (tingling, numbness). To treat weakness of dorsiflexion of the foot, a combination of surgical and physiotherapeutic measures may be necessary.

Hip surgery is a major surgical procedure that is regularly performed in surgical clinics.

In Germany, for example, more than 240,000 hip prostheses are inserted every year. One risk during the operations is the injury of nerve tracts, as the surgical site is anatomically close to various nerve structures. The nerves supplying the gluteal muscles (buttock muscles) are most at risk.In the depth, below the gluteal muscles, the sciatic nerve comes out of the pelvis, which contains the fibers that control the foot lifts.

It continues to pull on the back of the thigh in the knee bend. In case of a variable course, adhesions or carelessness of the surgeon, the nerve cord can be injured during such a comprehensive operation (like the hip surgery). The resulting weakness of dorsiflexion of the foot can be accompanied by further symptoms – this depends on the extent of the nerve injury.

You can find more information on this topic here: Hip prosthesisA stroke results in vascular occlusion or bleeding in the brain. The affected areas determine the severity of the symptoms. If the cerebral cortex is affected where the center of movement is located, disorders of this kind occur.

The opposite side of the damage is always restricted because the nerve pathways for movement cross to the other side on their way to the muscle. A weakness of dorsiflexion of the right foot therefore suggests a stroke of the left hemisphere and vice versa. Stroke is one of the most common reasons for weakness of dorsiflexion of the foot or paresis.

Paresis is a characteristic symptom of cerebral infarction. The course of the movement restriction depends largely on prompt treatment and early training of the musculature as part of the rehabilitation measures. Multiple sclerosis (MS) is a chronic inflammatory nervous disease.

In this disease a so-called demyelination occurs: the envelope substance of the nerve cells in the brain and spinal cord is increasingly lost, which slows down or even hinders the transmission of stimuli. The impairment of nerve function affects various organ systems as well as movement. In the course of the disease, weakness of dorsiflexion of the foot can also occur for this reason.

There are different forms of multiple sclerosis. The disease can occur in phases with (partial) regression of the symptoms or continuously progressing. Accordingly, weakness of dorsiflexion of the foot can also recede if it occurs during an episode of the disease. Since there is no therapy for MS yet, it can only be slowed down in its development. Consequently, there is only limited treatment for weakness of dorsiflexion of the foot.