I was diagnosed with MS in 1985. I was not told back then how important exercise was, but I did have young children who kept me active. I am having a problem with foot drop and my biggest problem is that I can't stand for a long period of time because my knees hyper - extend. What can be done for this? I have been to physical therapists but they haven't really done anything but stretch out my hamstrings and have me pedal for a few minutes on a recumbent bicycle. Is there a certain kind of physical therapist I should be seeing to help me with this problem?
Knee hyperextention associated with a foot drop is very common with MS. While it is important to work on controlling posture and strengthening various muscle groups, these remedies are often minimally effective once the leg gets too weak. The best solution is probably a three pronged approach:
1. First you need an Ankle foot orthotic (AFO) if you do not already have one; we generally prefer the carbon fiber dynamic AFOs but some people require more support than these offer
2. You probably require a hinged knee brace like a Swedish knee cage to prevent overextension of the knee ; you may be able to skip this step if you are not experiencing much knee pain
3. If your hip flexors are too weak to lift your leg forward, you may require a Knee flexor assist orthosis (KFAO)
Find a physical therapist who is a neurological specialist and a good orthotic specialist to work with to find an effective solution.
Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Director of Hillcrest Neurology
Professor of Clinical Neurosciences
University of California San Diego