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Foot drop braces: from soft lift straps to rigid supports
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- Soft foot-up strap that attaches to shoelaces. Best for: Mild toe drag while you wait to be assessed. See options on Amazon
- Off-the-shelf plastic AFO for drop foot. Best for: Steady foot drop when a clinician agrees an off-the-shelf brace is suitable. See options on Amazon
- Extra-depth shoes with removable insoles. Best for: Wearing any in-shoe foot drop brace. See options on Amazon
- Long cotton socks. Best for: Wearing under an AFO or strap cuff. See options on Amazon
Foot drop needs a diagnosis first
Mayo Clinic describes foot drop as difficulty lifting the front of the foot, and stresses that it is a sign of an underlying neurological, muscular or structural problem rather than a disease in itself. The most common cause is compression of a nerve in the leg, the peroneal nerve, which can follow a knee injury or hip or knee replacement surgery. Other causes include a pinched nerve in the spine, stroke, multiple sclerosis and ALS.
Mayo Clinic advises seeing a healthcare professional if your toes drag when you walk. Foot drop can be temporary or permanent, depending on whether the cause can be treated, so a brace bought before that visit may only be a stopgap.
The main types of foot drop brace
| Type | How it works | Suits | Trade-off |
|---|---|---|---|
| Soft lift strap (lace-up or ankle-cuff style) | An elastic strap pulls the forefoot up from the shoe's laces | Mild toe catch, as a stopgap while waiting for assessment | Little side-to-side ankle control; only works in laced shoes |
| Off-the-shelf plastic AFO | A shell behind the calf and under the foot holds the foot up | People a clinician agrees can use a ready-made brace | Generic shape can rub; needs roomier shoes |
| Off-the-shelf carbon AFO | A carbon fibre shell or strut in place of plastic | People a clinician agrees can use a ready-made brace | Less adjustable; must match your size closely |
| Custom AFO | Made for your leg by an orthotist | Most long-term or complex foot drop | Needs a referral and fittings |
Mayo Clinic notes that a brace on the ankle and foot, or a splint that fits into the shoe, can help hold the foot in a normal position. Our ankle foot orthosis page explains fitted AFOs in more detail.
Shoes and socks for a brace
Royal Berkshire NHS Foundation Trust's AFO guidance is a useful checklist for any in-shoe brace:
- Take the brace with you when buying shoes, and allow at least one shoe size increase with good width.
- Choose lace-up or hook-and-loop fastenings, which give the most adjustment.
- Use shoes with a removable insole to make room.
- Keep heels no higher than 1 to 1.5 cm.
- Wear a close-fitting cotton sock between skin and brace.
Breaking in a brace and checking skin
Royal Berkshire suggests building up wear gradually, from 30 to 60 minutes on day one to several hours by day four, with full-time wear taking at least two weeks. Check the skin each time the brace comes off: red marks where it pressed should fade within 30 to 60 minutes. Sores or blisters mean stopping and asking for the brace to be adjusted. This matters more if foot drop comes with numbness, which Mayo Clinic lists as a possible symptom.
Beyond the brace
Mayo Clinic lists physical therapy to strengthen the leg and keep the knee and ankle moving, with stretching to prevent calf and heel stiffness. Nerve stimulation and surgery are options for some causes. Mayo Clinic also notes habits that press on the peroneal nerve, such as crossing the legs, long periods of kneeling or squatting, and a leg cast that ends just below the knee.
What to look for when you buy
Soft foot-up strap that attaches to shoelaces
Best for: Mild toe drag while you wait to be assessed
An elastic strap from an ankle cuff to the laces lifts the forefoot as you step, without a shell inside the shoe. Mayo Clinic notes braces can help hold the foot in a normal position.
Watch out: Little ankle control and only works with laced shoes; not a substitute for a clinician's assessment.
See options on AmazonOff-the-shelf plastic AFO for drop foot
Best for: Steady foot drop when a clinician agrees an off-the-shelf brace is suitable
A plastic shell behind the calf and under the foot holds the forefoot up in the shoe, the type of in-shoe splint Mayo Clinic describes.
Watch out: Generic shapes can rub; check skin each time, and stop if sores or blisters appear.
See options on AmazonExtra-depth shoes with removable insoles
Best for: Wearing any in-shoe foot drop brace
Royal Berkshire advises allowing at least one shoe size increase, good width and a removable insole to fit an AFO.
Watch out: Take the brace with you when trying shoes; keep heels to 1 to 1.5 cm.
See options on AmazonLong cotton socks
Best for: Wearing under an AFO or strap cuff
Royal Berkshire recommends a close-fitting cotton sock between skin and brace, with long socks helping protect the skin.
Watch out: Avoid thick seams where the brace presses.
See options on AmazonQuestions people ask
- Can I buy a foot drop brace without seeing a doctor?
- You can, but Mayo Clinic advises seeing a healthcare professional if your toes drag when you walk, because foot drop is a sign of another problem that needs diagnosis.
- What is the difference between a foot drop brace and an AFO?
- An AFO is one kind of foot drop brace, a shell that runs behind the calf and under the foot. Soft lift straps are another kind that work from the shoelaces.
- Can foot drop go away?
- Mayo Clinic says it can be temporary or permanent, depending on whether the cause can be treated.
- Do I need bigger shoes for a foot drop brace?
- For an in-shoe brace, usually yes. Royal Berkshire suggests allowing at least one size increase and choosing shoes with removable insoles.
- How long should I wear a new brace at first?
- Royal Berkshire suggests starting with 30 to 60 minutes on the first day and building up over at least two weeks.
Sources
- Foot drop: symptoms and causes (mayoclinic.org), Mayo Clinic
- Foot drop: diagnosis and treatment (mayoclinic.org), Mayo Clinic
- Guidelines for the use of an ankle foot orthosis (AFO) (royalberkshire.nhs.uk), Royal Berkshire NHS Foundation Trust