The Treatment of Dorsiflex Weakness

Dorsiflexion Weakness and its Implications for Walking

Dorsiflexion is the act of raising the foot upwards towards the shin. It means the flexion of the foot in the upward direction. Dorsiflexion weakness is, therefore, the inability to raise the foot or toes from the ankle or the movement is limited (Dolan and Gordon). Depending on the extent of muscle weakness, the condition can be either temporary or permanent and can occur in one or both feet. It may cause an inability to perform a movement. It is a problem for walking because dorsiflexion allows for the forward movement of the shin (tibia), relative to the position of the foot. Dorsiflexion is essential for efficient force production and application and the correct positioning of the body.

The Role of Tibialis Anterior Muscle in Dorsiflexion

Your affected muscle, the tibialis anterior, gradually lost its effectiveness due to under usage after the operation period. The muscle is located in the upper two-thirds of the lateral surface of the shinbone. It is responsible for motion and inverting the foot and holds up the longitudinal arch of the foot. The deep peroneal nerve innervates the muscle. The muscle functions as a stabilizer of the ankle during the contact phase of walking as the foot hits the ground (Malloy et al.). The muscle also aids in balancing the leg and talus on the other tarsal bones so that the leg remains in the vertical position despite walking on uneven grounds. The tibialis anterior is, therefore, a significant muscle in activities that require leg movement, such as walking, running, or kicking.

Treatment with Functional Electrical Stimulation (FES)

To strengthen the muscle, the use of functional electrical stimulation (FES) will be applied. It is a technique that uses electric current to strengthen and encourage muscle contraction and can significantly improve your ability to walk. The FES device includes electrodes, a stimulation unit, a power source, and a mechanism to turn on and off the stimulation depending on the stride phase. To enhance dorsiflexion and ankle eversion, the physiotherapist will apply electrical stimulation to the common peroneal muscle, which recruits muscles controlled by both the superficial and deep peroneal nerves. The stimulation is made in sync with a stride so that it takes place during the swing phase (when there is no ground contact with the foot) and stops during the stance phase (when the foot rests on the ground). The FES effectively replaces the signal that travels from the brain through the spinal cord and stimulates the muscle into action (Malloy et al.).

How FES Works and its Benefits

The machine does not electrocute your leg. The electrodes are only placed on the front of the shin and the side of the calf to stimulate the peroneal nerve in charge of dorsiflexion. The electrical impulses are then sent to the nerves within the muscle (Dolan and Gordon). The stimulation of the nerves causes the muscle to contract, and eventually, the limb will move. This improves the efficiency and safety of walking. It is incorrect to say that your muscle did not know how to contract before. The muscle gradually declined in effectiveness due to under usage after the surgery. The under usage is what caused the dorsiflexion weakness in your left foot. The treatment will strengthen the muscle, which will, in turn, improve the speed, efficiency, and appearance of your walking pattern. It is the hope of this treatment that you move past the progression plateau you are currently in.

Work Cited

Dolan, Katelyn E., and Jennifer R. Gordon. Exploring the Effects of Limb Dominance and Injury History on Weight-Bearing Dorsiflexion Asymmetry: A Clinical Case Series. 2018.

Malloy, Philip, et al. “The Association of Dorsiflexion Flexibility on Knee Kinematics and Kinetics during a Drop Vertical Jump in Healthy Female Athletes.” Knee Surgery, Sports Traumatology, Arthroscopy, vol. 23, no. 12, 2015, pp. 3550–3555.