by Mitch Hauschildt, MA, ATC, CSCS
One of the questions that I often get when I teach is about taping stroke patients and/or people with a neuropathy of some sort. Inevitably. the issue of helping people with foot drop seems to come up. I make it very clear in my courses (and want to here as well) that I don’t treat stroke patients and the vast, vast majority of my patients are young, healthy and neurologically intact. Thus, I don’t bring as much credibility to this topic as other people might. With that being said, given the fact that I personally deal with Multiple Sclerosis on a daily basis, I know an understand the struggles of dealing with a neurological medical condition. And, foot drop is one of my biggest complaints when I get fatigued thanks to my chronic medical condition.
I have been playing around with several different taping options for dealing with foot drop over the years and I have settled on a tab taping technique that seems to work the best. If you are a consistent reader of my blog, you will know that tab taping is a great way to combine the neurosensory effects of tape with a mechanical component to assist the body with a specific motion. Tab techniques are usually aggressive, but very effective.
A tab technique is the only time that we actually teach using stretch with tape within our Rocktape courses. What we have found is that when you use stretch on tape, the likelihood that the skin gets irritated is much higher than without stretch. That is a major driving factor for staying away from stretch. However, if you use a tab under the stretched tape, you can put a lot of stretch with less likelihood that you will irritate the skin. That’s part of the reason it is such a great technique.
With the foot drop tab technique, we are basically going to recreate an ankle foot orthosis (AFO) with the tape. It is cheap, easy to fit into a shoe and very comfortable to wear. And, depending on the patient’s specific situation, you have a couple of different options that you can use.
I find that most people who struggle with foot drop do so in such a way that their smaller toes tend to drop more than their first toe. This ends up with them basically in a position of plantar flexion and inversion while they walk (or run in my case). For this person, I am going to anchor the tape onto the lateral side of the foot and then run diagonally across the front of the foot and on to the medial side of the lower leg with a steep angle. The opposite would be true of the individual who has foot drop that leaves their first toe dropping more than their smaller toes.
Check out the video for full details, but the application starts with a tab placed over top of or just below the front of the ankle with the patient positioned such that their ankle is in plantar flexion. Then anchor the tape on the lower leg and bring it up until it catches the tab. Don’t put any stretch on the tape until after you have stuck it down to the tab. Place your thumb on the tab to both keep it from coming off of the tab and also pushing the talus posterior as they move into dorsiflexion. Put a lot of
stretch on the tape, picking the proper angle to maximize the improvement in the individual’s symptoms. Finish by spiraling around the lower leg with no stretch on the tape.
This is a great application because you are taking advantage of both the mechanical and neuro sensory effective of the tape. Use it on your next foot drop individual and let me know how you like it!