How Does A Stroke Affect Your Feet?

How Does A Stroke Affect Your Feet

More than 475,000 Australians are currently living with the after-effects of suffering from a stroke – a figure that’s set to increase to one million by 2050. With one in four people predicted to have a stroke in their lifetime, and one stroke occurring every nine minutes here Australia1, understanding how to help those affected with their mobility and foot health is an important part of what we do here at The Podiatrist.

What happens when you have a stroke?

A stroke occurs when the brain’s blood supply suddenly becomes interrupted. This may occur from a blocked blood vessel, known as an ischaemic stroke, or from the blood vessel rupturing and bleeding out, known as a hemorrhagic stroke. As your brain doesn’t receive blood and oxygen, which is essential for cell life and function, parts of the brain can become damaged, resulting in impairments around the body – including the feet and legs.

Symptoms of a stroke can vary greatly from person to person, and often depends on how long the brain was deprived of oxygen and the specific areas of the brain affected. Common effects include paralysis, speech impairments and difficulties with swallowing, vision and thinking.

How can a stroke affect the feet?

Studies of those admitted to a stroke rehabilitation unit showed that three-quarters had foot & leg problems that required podiatric care to help optimise mobility and quality of life. Muscle wasting, paralysis and changes to the sensations are the three most common problems affecting the feet and legs – and as a result, leave those affected with a number of secondary problems including:

  • Peripheral neuropathy – the loss of sensation in the feet and legs. When we lose our ability to feel what’s happening in the ground below and around us, we become vulnerable to sustaining injuries, cuts and wounds and not knowing they’ve occurred. If we don’t know to care for any problems and don’t take the right precautions to protect the damaged area, we may worsen the injury and be vulnerable to infections and foot ulcers
  • Foot drop – even though we don’t really think about it while walking, we rely on our muscle strength and function to hold our foot up (relative to the ankle) when we walk to avoid our toes hitting the ground and potentially causing us to trip and fall. If a stroke has left you with muscle weakness or paralysis, you may not have the strength and control to do this, leaving you appearing to drag your feet along the ground during walking
  • Spastic paralysis – the combination of involuntary muscle contracture with muscle weakness leaves some stroke sufferers with an equinovarus deformity where the foot is severely contracted inwards. This can make it very difficult to walk, as the outside of the foot takes all the weight and pressure – which it definitely isn’t designed to do nor does it have the strength or function to do so effectively
  • Reduced flexion at the hips and knees – without adequate strength and in the presence of paralysis, the knees and hips may not be able to function like they used to when it comes to bending the knees and hips – essential components in a smooth and healthy gait pattern. This can leave a person making many compensations and completely changing the way they walk to optimise their efficiency – which can bring with it a new set of unique problems and pains
  • Corns, calluses & cracked heels – the new pressures on the feet from changes to a person’s gait pattern can often leave them with corns, calluses or cracked heels
  • Toe deformities, ingrown toenails & thickened toenails – like above, new pressures on the feet can leave a person vulnerable to changes in the shape of the toes (like hammertoes and claw toes), as well as ingrown toenails and thick, difficult-to-cut toenails

How podiatry helps the feet affected by stroke

Short version: greatly to help optimise your comfort, mobility and reduce your risk of complications and pains.

Longer version: The way that your stroke is affecting your movement and your feet and legs can vary greatly from someone else, so every patient has a unique treatment plan that revolves entirely around the best ways to help improve comfort and mobility while managing risks. This may include:

Getting you in the right footwear

– the definition of ‘right’ will vary depending on your symptoms. We’ve got to consider the weight of your shoes (especially if you have muscle weakness), the width, any accommodation requirements for any deformities, managing your risk of damage to the skin from rubbing in areas of high pressure, your falls risk and hence stability requirements of the shoes, and much more

Orthotics – orthotics are custom-made to meet the needs of your feet. These may be foot orthotics, or ankle-foot orthotics, and are 100% tailored to your symptoms and foot characteristics

  • Splints & braces – these devices can help support the feet with problems like foot drop, muscle contracture and more
  • Foot health check – we regularly check the feet and legs for any warning signs, or problems that you’ve missed or haven’t been able to feel
  • Nail & skin care – we can reduce the thickness of your toenails, remove corns and reduce calluses, treat ingrown toenails, and manage cracked heels and wounds
  • Ulcer care – we’ve had fantastic results in helping manage difficult-to-heal ulcers using the bodyflow system. See the before/after of one patient’s ulcer after using this treatment.
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