Slap gait , Steppage Gait . Foot Drop – Everything You Need To Know – Dr. Nabil Ebraheim
Educational video describing the condition slap / steppage gait. Foot drop.
Slap gait occurs due to weakness of the foot and ankle dorsiflexors which allows the foot slap down on the floor with each step. Slap gait is a heel gait abnormality that can be diagnosed by hearing the patient walk. With a normal walking gait, the heel strikes the ground first followed by controlled relaxation of the foot and ankle dorsiflexors in order to allow the forefoot to come in contact with the ground. Foot drop gait or steppage gait is due to total paralysis of the ankle and foot dorsiflexors (tibialis anterior muscle).
Steppage gait
It is sometimes called “drop foot gait” or “ neuropathic gait”. A common symptoms of foot drop is a high steppage gait that is often characterized by raiing the thigh up in an exaggerated fashion while walking. The patient will have difficulty in clearing the toes during the swing phase. The patient must externally roatte the leg or flex the hip or knee to raise the foot high enough to avoid dragging the toes along the ground. The leg is brought up high off the ground by flexing the ipsilateral hip and knee so the toes will not drag on the ground during the swing phase. Steppage gait is due to complete paralysis of the ankle and foot dorsiflexors. If the patient has foot drop then they have to have a high steppage gait or else they will trip on the foot and fall forward.
The ankle and foot dorsiflexors are supplied by the peroneal nerve which is part of the sciatic nerve. The sciatic nerve starts in the lower back and runs through the buttock and lower limb. In the lower thigh, just above the back of the knee, the sciatic nerve divides into two nerves, the tibial and peroneal nerves, which innervate different parts of the lower leg. The common peroneal nerve then travels anterior, around the fibular neck, dividing into superficial and deep peroneal nerves. The deep peroneal nerve gives innervation to the tibialis anterior muscle of the lower leg which is responsible for dorsiflexion of the ankle. Conditions that cause foot drop :
•L4-L5 disc herniation: a herniated disc compressing the L5 nerve root may cause foot drop,
•Lumbosacral plexus injury due to pelvic fracture
•Sciatic nerve injury due to hip dislocation, the common peroneal division of the sciatic nerve is commonly injured during fracture dislocation injuries involving the hip.
•Injury to the knee as knee dislocation: in the event of knee dislocation it is important to check for common peroneal nerve and popliteal artery injury.
•Established compartment syndrome: foot drop is late finding. Ischemia more than 6-8 hours may cause irreversible changes to the muscle. Fasciotomy should be done early. 4 hours of ischemia may be tolerated, but by 8 hours, the damage is often irreversible.
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Educational video describing the condition slap / steppage gait. Foot drop.
Slap gait occurs due to weakness of the foot and ankle dorsiflexors which allows the foot slap down on the floor with each step. Slap gait is a heel gait abnormality that can be diagnosed by hearing the patient walk. With a normal walking gait, the heel strikes the ground first followed by controlled relaxation of the foot and ankle dorsiflexors in order to allow the forefoot to come in contact with the ground. Foot drop gait or steppage gait is due to total paralysis of the ankle and foot dorsiflexors (tibialis anterior muscle).
Steppage gait
It is sometimes called “drop foot gait” or “ neuropathic gait”. A common symptoms of foot drop is a high steppage gait that is often characterized by raiing the thigh up in an exaggerated fashion while walking. The patient will have difficulty in clearing the toes during the swing phase. The patient must externally roatte the leg or flex the hip or knee to raise the foot high enough to avoid dragging the toes along the ground. The leg is brought up high off the ground by flexing the ipsilateral hip and knee so the toes will not drag on the ground during the swing phase. Steppage gait is due to complete paralysis of the ankle and foot dorsiflexors. If the patient has foot drop then they have to have a high steppage gait or else they will trip on the foot and fall forward.
The ankle and foot dorsiflexors are supplied by the peroneal nerve which is part of the sciatic nerve. The sciatic nerve starts in the lower back and runs through the buttock and lower limb. In the lower thigh, just above the back of the knee, the sciatic nerve divides into two nerves, the tibial and peroneal nerves, which innervate different parts of the lower leg. The common peroneal nerve then travels anterior, around the fibular neck, dividing into superficial and deep peroneal nerves. The deep peroneal nerve gives innervation to the tibialis anterior muscle of the lower leg which is responsible for dorsiflexion of the ankle. Conditions that cause foot drop :
•L4-L5 disc herniation: a herniated disc compressing the L5 nerve root may cause foot drop,
•Lumbosacral plexus injury due to pelvic fracture
•Sciatic nerve injury due to hip dislocation, the common peroneal division of the sciatic nerve is commonly injured during fracture dislocation injuries involving the hip.
•Injury to the knee as knee dislocation: in the event of knee dislocation it is important to check for common peroneal nerve and popliteal artery injury.
•Established compartment syndrome: foot drop is late finding. Ischemia more than 6-8 hours may cause irreversible changes to the muscle. Fasciotomy should be done early. 4 hours of ischemia may be tolerated, but by 8 hours, the damage is often irreversible.
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super informative video, really helped me in revision for my medical exams <3
I have this problem, i hope you notice my comment, so that you further discuss the situation of my leg
I am doing tendon transfer surgery
Please can you tell me how to heal🙏
I went in to have blockage removed from my urethra I was in surgery for 6.5hrs when I woke up I was in extreme pain I had developed compartment syndrome in both my legs now I’ve got foot drop in both my feet this happened in may Hoping physical therapy helps but fearing I have permanent damage sense it took 16hrs for me to be diagnosed with compartment syndrome. Thanks for the video helps me understand what’s going on.
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how do i stop slap gait?
What is exercise we do
Thank you. This happened to me from delivering my baby/c section. It helps explain everything very well. It will help me articulate things better to my dr.
This was a very helpful video, Thank you!
Did anyone else come here to hear the slaps
You r the perfect
Great video. As a diabetes and YouTube educator, examining patients' gait is part of my routine too!
does that mean slap gait is a milder form of steppage gait?
I have trouble walking as my toes feel numb and feel like the middle two slap a little can you have a partial or slight foot drop coz that’s what it feels like .
extremely helpful, thanks a lot
great video thanks!!
Thanks for the video. Can you give me remody pls…
Thank you… Very helpful educational video!
Hi sir
Sir Muje footdrop ki problem hai
2008 normal pain in my lower limbs
Dr Vasan is operated my l4 lt and s1
thank you very much it is great video
I developed this gait and paralysis of my right foot 2 weeks ago (with burning lower back pain for months prior). My Dr said it's probably my Fibromyalgia :/
The video is awesome. Really thanks! I'm a student of physiotherapy and rehabilitation department. 🙂
Thank you sir… You are a good teacher 😍
Thanks For Video Sir
Nice video, thanks a lot! 😊😊 2/9/2019
Ugh still not what I’m looking for… 😩 I’ll be walking just fine then all the sudden, my foot like stops working, and my foot falls on it side, and I almost fall over. Later my foot hurts soo bad On it’s side, and it’s always my left foot.
I'm 34 and have had a mild gait since I was 4 years old. Also, that same gait leg is slighty turned in.
1:14 steppage gait