You are walking Mr. Henderson to the dining room when you notice the toes of his left foot drag slightly across the carpet with every step. He catches his toe, stumbles, but you steady him before he falls. This gait abnormality is likely foot drop, and recognizing it is crucial for preventing serious falls and skin injury in your residents.
What is Foot Drop?
Foot drop is not a specific disease itself, but a symptom or sign of an underlying neurological, muscular, or anatomical problem. It refers to the difficulty or inability to lift the front part of the foot (dorsiflexion). This causes the toes to point downward and drag on the ground while walking. It often results from nerve damage, muscle disorders, or brain conditions like a stroke.
Why Foot Drop Matters in Your Daily Care
For a CNA, foot drop is a major red flag for fall risk. If a resident cannot lift their toes, they are highly likely to trip on rugs, door thresholds, or even their own feet. Beyond the immediate danger of a fall, the constant dragging of toes can lead to skin breakdown, open sores, or infection on the top of the foot. Your observation and intervention directly impact their safety and mobility independence.
What You’ll See During Your Shift
You will notice a distinct change in how a resident walks. The gait often looks like a “steppage” pattern—where the resident lifts their knee higher than normal to swing the leg out so the foot doesn’t catch the floor. You might also hear a distinct “slapping” sound as the foot hits the ground.
“Nurse Jamie, I assisted Mrs. Rodriguez with her walk this morning and noticed she is swinging her left leg out significantly to clear the floor. Her toes are dragging, and she almost tripped on the transition strip in the hallway. It looks like new foot drop on her left side.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Assuming a resident is just shuffling or being “clumsy” due to age and not reporting the change in their gait.
Pro Tip: Always check the resident’s shoes. If they have foot drop, they often need an Ankle Foot Orthosis (AFO) brace or high-top sneakers to keep the foot at a 90-degree angle. Ensure these are worn during ambulation to prevent tripping and protect the skin from friction.
Memory Aid for Foot Drop
Think “High Knee and Slap”:
- High Knee (They have to lift the leg high to avoid tripping)
- Slap (The foot hits the ground flat and hard)
This helps you quickly visualize the abnormal gait during your rounds.
State Test Connection
This may appear on the CNA exam under “Observation and Reporting” or “Restorative Skills.” You might be asked to identify safety hazards for a resident with a foot brace or recognize the need to report a change in gait.
Related Care Concepts
Foot drop is closely linked to peripheral nerve care and stroke recovery. Understanding this condition connects to your knowledge of Range of Motion (ROM) exercises—maintaining ankle flexibility is vital—and ambulation assistance, ensuring you provide the right level of support to prevent falls.
Quick Reference
✓ Key signs: Toes dragging, “slapping” gait, lifting the knee excessively high ✓ When to report: Sudden onset (could indicate a stroke), new tripping episodes, skin redness on toes ✓ Care reminders: • Apply AFO/braces as ordered before ambulation • Keep walkways clear of obstacles and loose rugs • Perform ankle ROM exercises per care plan • Inspect the top of the foot and toes for skin breakdown daily
Catching foot drop early means you can intervene before a fall happens. Keeping a close eye on how your residents walk is one of the most important things you do for their safety.