Houston Methodist. Leading Medicine

Foot FAQ

Question:

We don't know how it happened, but Dad managed to cut himself -- right through the tendon that helps him pick up his foot. He's not a candidate for surgery to repair the tendon. He has too many other health issues. But now he's unable to pick that foot up enough to clear the floor. We're worried he's going to fall and hurt himself. Would a brace or special shoe help?

Answer:

Tendon ruptures of the tibialis anterior are uncommon. That makes it tough to study and come up with effective treatment guidelines. The tibialis anterior is the muscle along the front of the lower leg that dorsiflexes the foot. Dorsiflexion means the tendon pulls the ankle up toward the face. Surgery is suggested in order to restore a normal gait (walking) pattern. Surgery may also be done to avoid a foot deformity. Conservative (nonoperative) care is more likely for older, inactive adults or when treatment has been delayed for three months or more. For elderly patients who can't handle surgery because of other health concerns, bracing and physical therapy may be in order. The therapist will evaluate current muscle function and determine whether or not an exercise program would help. In some cases, electrical stimulation may be needed to help stimulate muscle contractions. The goal is to strengthen the muscles around the ankle that can substitute for the damaged one. A special brace that will assist ankle dorsiflexion (pulling the toes up towards the face) can help with the foot slap commonly seem with this condition. Without the strength of the tibialis anterior to pull the ankle up, the foot slaps with a noticeable sound when the foot hits the floor. Some patients end up compensating by picking the foot up higher to avoid tripping. This gait pattern is referred to as a steppage gait. You are right to be concerned about this problem. Preventing falls is an important way to avoid further complications. Seek out the services of a physical therapist for this problem. Addressing it sooner than later is the best way to go. V. Sammarco, MD, et al. Surgical Repair of Acute and Chronic Tibialis Anterior Tendon Ruptures. In The Journal of Bone and Joint Surgery. February 2009. Vol. 91. No. 2. Pp. 325-332.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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