All About Foot Drop Surgery (Tendon Transfer)

If you have foot drop, a surgery called tendon transfer may be among the treatment options your doctor recommends. Let’s go over what foot drop surgery entails and what you can expect from tendon transfer for foot drop.

Before we dive in, let's make sure we're all on the same page about what foot drop actually is.

When someone has foot drop, they struggle to lift the front part of one or both feet fully. It's not just a minor inconvenience - it can really mess with your ability to walk normally. Instead of a smooth, easy stride, your feet might slap against the ground with each step.

Navigating obstacles? That can become a real challenge and safety concern.

If you are not sure if you have foot drop, there are a variety of tests that can be used to try and assess whether you have the condition. Talk to your doctor about your concerns, and which tests may be best for you.

Foot drop is not a disease in itself. It is a symptom. It may be caused by a variety of conditions such as cerebral palsy, multiple sclerosis, diabetes, stroke, and acute injuries. 

There are multiple treatment options depending on the severity of your foot drop, its underlying cause, and how recent it is.

Your doctor may recommend any or all of the following: foot drop surgery, physical therapy, exercise such as walking and stretching, nerve stimulation, and/or wearing a brace. 

There are several different types of foot drop surgery: tendon surgery (our main focus in this post), nerve decompression surgery, and surgery to fuse bones in the foot and/or ankle.

Who is a candidate for foot drop surgery? If your foot drop case started recently, your doctor may recommend nerve surgery. But if your foot drop has been an ongoing issue for a long time, it is more likely that your doctor will recommend one of the other types of surgery like tendon transfer. In order for this surgery to work, your ankle must still have muscle function.

With a tendon transfer, the surgeon transfers a working tendon from a different part of your foot. It is then able to take over the work that your muscles are no longer able to perform, allowing you to regain movement in your foot.

Even though you will still not have your original range of motion and strength back afterwards, you should be able to stop using a brace to walk after you recover.

After your foot drop surgery, you will need some time to recover. To give yourself the best chance at the most favorable outcome, you also will need to have physical therapy. The tendon that has been transferred to a new location and function needs to be trained to work properly in that role. 

The amount of time it takes to recover from foot drop surgery depends on the exact procedure you get as well as other individual factors. But it is usually around 3-4 months. 

• During the first 10-14 days after surgery, you should avoid putting weight on the foot, and it should remain elevated.
• After 14 days, the stitches can be removed.
• Your foot will need to be in a cast for the first 6 weeks, after which it can come off. Weight-bearing should be minimized for this period of time.
• After the cast is removed, 8-12 weeks of physical therapy begins. You can walk, but you will have to wear a boot designed for special support. 
• The boot is replaced with a brace after swelling goes down sufficiently.

Eventually, you should reach a point in your recovery when you can stop wearing the brace.

While surgery for foot drop can be very effective if performed at the right time, no surgery is without risks of potential complications.

It is possible for an infection to develop following foot drop surgery. If the infection is deep enough, it can even cause the tendon to tear or the surgery to fail. 

Other possible complications include hematoma, blood loss, or injured nerves.

The majority of the time, tendon transfer for foot drop has a good outcome. In this study, 84.61% of the cases had good outcomes. While 11.54% of the cases had fair outcomes, only a single case had a poor outcome (no response). You can read additional data in the linked study as well.  

The researchers noted that success is most likely in cases where a common peroneal nerve lesion was involved, as opposed to those where a sciatic nerve lesion was involved. 

The same study also says that men under the age of 30 seem to have the best outcomes. 

If you are living with foot drop, you may feel frustrated about the difficulties involved with walking, and how they impact your everyday life. You may have a hard time doing simple chores like going to the store, driving, or exercising. 

But there are things you can do to make living with foot drop easier and safer both before and after surgery.

Your doctor is going to urge you to go on regular walks. That may sound daunting given your condition. But it is necessary in order to re-train your body to walk with a correct gait. 

In fact, in many scenarios, it is not even necessary to get surgery for foot drop. All a patient needs to do is walking, stretches, and physical therapy.

As we mentioned, however, if you do need surgery, then walking is going to be part of your recovery process to re-train your transferred tendon as well.

One way you can make it easier, more enjoyable, and safer to walk with foot drop is to wear a shoe designed for people with this condition. We recommend the Cadense Original Adaptive Shoe for men and women .

This shoe has a special feature called “variable friction technology.” This patented feature allows the wearer to “glide” over obstacles and uneven surfaces if they are not able to fully lift the front parts of their feet. 

This prevents the wearer from needing to lift their feet off the ground in an unnatural way to clear obstacles.

It also makes the wearer less likely to trip over obstacles or uneven ground, resulting in fewer falls and injuries. 

Another reason to choose this shoe if you have foot drop is its lightweight materials, which help to minimize fatigue.

In addition, the shoe’s fit is snug, but not constricting, and the wide base offers excellent stability. To see all of our footwear for this condition, browse our full collection of shoes for foot drop.