One of the challenges of my disease is the impact is has on the way I walk, or rather the way I don't walk. People with ALS with a lower limb onset (legs like me) all get it. Toe Drop, also called Foot Drop, is a condition where your forefoot drops when lifted due to weakness, damage to the peroneal nerve or paralysis of the muscles in the back of the lower leg. It happens because I have difficulty moving my ankle and toes upward (dorsiflexion).
It's not only people with ALS who get toe drop; stroke victims get it as do people with back injuries or other damage to their nervous system. There are devices to help with this, things like an ankle-foot orthotic (AFO) or something called a Dictus. These devices basically strengthen the ankle or directly lift the front of your foot.
The problem with these devices is they both need shoes to work properly. So what do you do when you are at home, wearing your slippers or just your socks?
This is where I get into trouble. Toe drop gets worse when I get tired (or when I get a couple of drinks into me). I get tired at the end of my day. I am at home, relaxing, with my shoes off at the end of my day. So the time when I am most likely to have a bad case of toe drop is the very time when I am unlikely to be wearing a preventative device.
With toe drop, I tend to stub my toe on my carpet. When this happens, I fall down. This usually happens when I get tired (or when I get a couple of drinks into me). The only plus in this is that I tend to fall on carpet.
The only really consistent way to deal with toe drop while not wearing a device is through "high stepping". The more tired I get, the more you will see me do this. I will lift my foot higher than normal as I walk in an attempt to ensure my toe does not stub on the floor. This usually works, except when I get tired (or when I get a couple of drinks into me). Then I forget that I have ALS and toe drop. Then I stub my toe on the carpet and you know what happens next.
If you notice a theme here, please feel free to not comment. As for me, I will just lift my feet a bit higher.
Are you considering AFO"s ? I highly recommend them. But then I have been using them for about 25 years now. (!!wow that was fast!!) Anyway - they do save me energy that I don't need to expend with the 'high-stepping' and I guess from so much experience I usually don't trip when without them around the house. Usually, not always. I wear them continuously though until bedtime, pretty much have to. So ours is a house where about 1/2 of us wear shoes always. Just needs to be. I am just about to needing a cane when without the afo's, almost, not quite. Unless I have another head knock like I took last week, going from bedroom 3 steps to ensuite. AFO''s < God bless the inventor of these mobility treasures.
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