- All right, if you have foot drop
this video is gonna show you-
- Foot drop?
- Yeah, foot drop where that foot's dropping down, Bob.
It's gonna show you a fast way to work with it quickly
and then some long term fixes and exercise-
- Like a foot slap?
- Actually, it is Bob.
Yeah, you could call it foot slap.
Foot drop.
But if you have it, these people know it and it's not fun.
- No it is not.
- It really can change how you walk
and how you live your life.
- I agree.
- We've got some good ideas.
- ♪ Bob and Brad ♪
♪ the two most famous physical therapists on the internet. ♪
- All right, before we get into how to correct this quickly
and in the long term, it's really important
that you assess the range of motion of the ankles.
So Bob, we're gonna pretend, we've got the blue tape here,
this is the foot in question that has foot drop.
Now, it's important that we have adequate range
of motion so he can dorsiflex or pull his toes
up to make a proper gait or proper walking pattern.
So, what I'm going to do,
passive range of motion means Bob is relaxed.
I'm going to look at how far I can pull up the ankle.
So, on a good leg, you can see it goes up to here.
It's usually plus 15 degrees,
which I know that is roughly there.
The big thing is, you want to compare the the good side
to the bad side.
Now, if he can go up to 15 degrees, we're done.
We know he is got plenty of passive range of motion,
but if he goes like this
and we can't even get to neutral or where it's 90 degrees,
that's a problem. That's gonna have to be addressed
before you do any foot drop work.
So, we're just going to assume he passes a test.
We've got adequate passive range of motion.
Now, Bob's gonna put both feet out there
and we're gonna look at
active range of motion or what can his muscles do.
So, normal is to here and let's say this one goes that far.
So, pull this one up as far as you can go.
Pull that one up as far as you can go.
And you can see there's an obvious difference.
If you put the feet close together,
there's an obvious difference.
We've got a muscle strength problem.
We don't have a range of motion problem.
That's critical.
Once you get that past that point,
now I'm gonna show you can fix it quickly.
So, this next trick is something I actually learned
from a YouTube channel from someone who has foot drop.
(indistinct)
He's not in the medical field at all,
but he fixed his own foot drop.
And what he did is he took a bungee cord that you use.
- Four feet long.
- Yeah, four foot long or roughly.
And you use it, you know,
for your bikes when you're carrying, or if you're camping
and you're strapping things on your car, whatever.
Yeah, so you can go to the hardware store and get one.
You can also use, if you have bands,
tube bands for exercises, they'll work.
If you're gonna get one of these,
make sure it's the elastic type
not these rubber ones, these rubber bungee cords.
That'll never work.
You have to have something that has a lot, fair amount
of give, the elastic ones work quite well.
Now, what you're gonna do, we're gonna hook this through,
you have to have a shoe with laces.
Yep, get that in there.
I've got the tape on here to represent that.
So, what I did with that is I came up
to my belt and I looped it through my belt
and wrapped it around my waist and simply hooked it up here.
Now, if you have a pants with loops on it for the belt,
you can just hook that up to the loop, however it works.
But, you need to have it anchored so it comes
into the front of the hip and we have some tension here.
And what that does is when you walk with this
and it worked with this guy,
he showed his gait, which was very pronounced.
- Labored. - Yeah, very labored.
And he put this on, simple fix and he started walking.
- Look at that.
- Almost normal. - Beautiful.
So, we've got this nice bungee cord, doing
the dorsiflexion, instead of the anterior tib
and creating good gait.
Now, the thing about this is we don't expect you,
and you're probably wondering, well
I'm not gonna walk around for the rest
of my life with a bungee cord strapped to my ankle.
And that- - Training.
- It's training, exactly right.
We're gonna do this every day,
two or three times a day so that you can walk normally
and the leg and the muscles all assimilate.
- And the mind.
Everything works together on a normal gait pattern.
And it's gonna help you improve your gait pattern.
But unfortunately, if you do that, you also have to
do some exercises to get that anterior tib muscle
right here, the one responsible for pulling it up.
So you don't need this anymore.
And we'll work with that
and we'll show you six exercises for that.
Okay. I do wanna mention, you can,
instead of going this real homemade type route, get an AFO,
which is a ankle foot orthosis.
It's a ankle brace.
They're usually made out of plastic or sometimes
material with elastic pulls on it
so that it pulls your ankle up.
They can be cheap
from like $20.
- Off the shelf?
- Off the shelf.
Sometimes they work.
- Custom made. - Right.
And the custom made ones usually work better,
they fit better and they cost a lot more, anywhere
between 500 and a thousand dollars.
You typically go to a therapist or a professional,
get it fitted to you, and they do work well.
They're expensive.
And that, when you start wearing their those, you pretty
much assume you're gonna wear that AFO long term.
Not always.
I'm gonna show you some exercises.
Bob and I will work through those together.
So hold on.
Exercise number one coming up.
First exercise is easy.
It's simply a passive stretch to the muscles
so that you maintain that range of motion.
You can go up to a step like this with shoes on,
put your foot at this level and just relax.
Yep, and look at that.
What do you think of the socks today, Bob?
- [Bob] All right.
- The first stretch is to maintain your dorsiflexion
or going up like this.
And this, you need to do every day.
Very simple and very quick.
So, it's not a big deal.
One option is on the steps.
You can with shoes on,
hang off the edge like this and stretch both.
- [Bob] Be safe, don't fall.
- [Brad] Yep, yep.
Handrails is really nice.
If you don't feel comfortable with this, do not do it.
Other option, you can go to the wall, oh, sorry Danny
and do this stretch and that'll work.
Knee straight.
Hold it for 15 seconds or so.
And knee bend.
If you already have good range of motion
you don't have to hold it so long, five to 10 seconds.
But do it two, three times a day.
It becomes part of your life.
If you have a little tightness there, I would highly
recommend getting an incline board for stretching.
And they work very well.
- Or slant board.
- Yep, slant board.
You put your foot on there and stretch.
- [Bob] Brad made this one.
- Yeah, this is one I made.
If you can buy 'em, if you wanna make one
go Bob and Brad YouTube and put incliner slant board.
And you can see how to make it.
If you got someone handy around,
they got a little, some scrap wood.
Very cheap and very effective.
- Not me.
- This is a nice way to get those muscles working,
the anterior tib.
It's a sneaky way to do it, 'cause,
and it nice 'cause you don't have to think about it so much.
Your body will automatically want to
fire those muscle fibers.
Stand about a foot away from the wall.
You can have your hands here and touch.
And then you're gonna start leaning backwards
- [Bob] Again, be safe.
- [Brad] Yep, automatically your toes will want to pull
up because that's how the body's program.
It's a fall mechanism.
It's a reflex action.
- Oh reflex. - Yup
Which is a nice way to work it.
So you simply go back and do that five to 10 times
and see how that foot starts to rise.
You can see that Danny?
Yep, okay.
This next one is, works out really well.
You can take a book, a two by four.
Anything, I'm using a cushion, a Pete's choice cushion.
Doesn't matter as long as your heel can rest on it.
And you simply see if you can lift your ankle
up like this and back down slowly.
Now, if your weakness is so at a point where
you cannot even lift it up, it's not strong enough yet
then we need to assist it up and let it down.
I think what I'm gonna do is I'm going to actually,
you can use a cane underneath,
but if you got shoes on, just get some hook on,
a hook on it.
You know, if you have your-
- Bungee cord? - Bungee cord.
You can use that.
I'm gonna lift it up and now I'm gonna let it down slowly.
So, we're doing some eccentric strengthening.
Lift up, let it down slowly.
Eccentrically, your muscle will strengthen faster,
more efficiently as opposed to concentric,
which is the active range of motion going like that.
So, work with that.
Eventually you'll get that so you can let it down slowly.
And at that point you're probably gonna have lifting up
starting actively without problems.
Now, once you can get that point sitting
you wanna actually go standing and go weight bearing
and then do the same thing and start that.
You can also put the band on it and do the eccentric trick.
Just like I showed you in the seated position.
I don't know if I clarified this.
I know people are going to ask
in the comment section, how many times per day,
at least twice a day in the morning, in the evening,
three times a day would be good.
- Better.
- Once you get a routine down,
it's only gonna take five minutes,
maybe a few more minutes more than that to get through this.
- The more the better.
- Yeah, the more the better.
You know, you don't wanna,
there is a point of overdoing it.
Especially when you first start.
You don't wanna wear the muscles out.
- Right.
- Now this one you do need to have a foam cushion.
This is a Pete's choice, literally made for this.
Works for a lot of other things too.
But you don't have to have one of these.
You can just get a cushion
off of a piece of furniture, something that's squishy.
Be by the wall so that you can balance.
And we're simply going to move our body around.
It's nice if you have a cane or a balancing stick.
- Or somebody with you.
- Yep, somebody with you.
If you don't feel stable or, you know,
you can't get yourself,
someone needs to be there holding onto you so you're safe.
And you can just go for 30 seconds or a minute
of just wobbling around 'cause it's gonna help your balance.
Now, as far as the gait, remember you're still
gonna use the bungee cord system, so that it works
your gait pattern, this works your balance
in a standing position.
Because falling backwards when you don't have
active dorsiflexion, that's the side
you're probably gonna fall backwards to.
So, it's very important to work this as well.
And it's easy to do work.
- ♪ Stand by me. ♪
- Oh my God, Bob, I'm glad you did that
at the end of the video
because if you started singing earlier we'd be-
- We'd be gone. - Nobody watching us.
All right, so foot drop,
hopefully got some good ideas for you.
- I like the bungee cord.
- Yeah, the bungee cord is simply a simple,
sometimes the simplest things
and the cheapest things work the best.
- We're simple minds.
- Yeah, we're simple minds.
Simple minded people.
Yeah. Anyways. - Thanks.
- Good luck.
(upbeat music)