FES for Foot Drop and Weakness: Shropshire Physiotherapy

FES stands for functional electrical stimulation. It uses small electrical pulses to make a weak muscle contract at the right moment during a movement — most commonly to lift the foot as you walk, when foot drop is causing the toes to catch.

How FES works

A small device delivers pulses through electrodes on the skin over the nerve supplying the target muscle. For foot drop, that usually means stimulating the common peroneal nerve to lift the front of the foot during the swing phase of your step, timed by a sensor so it fires at the right point in the gait cycle.

The immediate effect is a more reliable toe clearance and, for many people, a smoother and safer walking pattern. There is also interest in the longer-term effect — that repeated, correctly-timed practice may help retrain the movement itself — though how much of that carries over varies a great deal between individuals.

Who it may suit

FES for foot drop is most often considered where weakness follows an upper motor neurone problem — after a stroke, with multiple sclerosis, after a brain or incomplete spinal cord injury. It depends on the nerve below the level of the problem still being able to carry a signal to the muscle, which is why it is not suitable for every cause of foot drop.

Where foot drop is caused by direct damage to the peripheral nerve or to the muscle itself, FES may not produce a usable contraction. This is why assessment matters before buying anything: the same symptom can have very different underlying causes, and they do not all respond the same way.

FES or a splint?

This is the question most people actually arrive with, and the honest answer is that it depends, and that they are not mutually exclusive.

• An AFO or foot-drop splint is mechanical. It holds the foot in position, works regardless of whether the nerve responds, needs no batteries or setup, and is generally cheaper. For many people it is the practical everyday answer.
• FES is active. It produces a real muscle contraction rather than holding the foot passively, which some people find gives a more natural walking pattern, and it involves the muscle rather than resting it. It costs more, needs setting up and charging, and requires a responsive nerve.

Plenty of people use a splint day to day and FES within rehabilitation sessions, or use a splint while trialling FES. If you are weighing up the mechanical options, the foot drop support guides cover splints, AFOs and braces in detail, including how AFOs compare with braces.

FES is part of rehabilitation, not a replacement for it

A device that lifts your foot does not, by itself, address why the foot is not lifting. Alongside FES, rehabilitation typically involves targeted exercises, strength and control work, balance retraining and walking practice. FES is most useful as one component of that, which is also why it is worth being assessed by a physiotherapist rather than ordering a device and hoping.

Being assessed in Shropshire

Healthsec Rehab, led by Jacob Youngson, uses FES as one of the treatment options available within rehabilitation programmes, alongside conventional exercise-based therapy and, where appropriate, hydrotherapy. An assessment would look at the cause of the weakness, whether the nerve responds, how you are walking now, and whether FES, a splint, exercise-based rehabilitation or a combination is the sensible route.

The clinic covers large parts of Shropshire including Shrewsbury, Telford, Oswestry and Ludlow, with home visits and clinic appointments both available.

Starting with a phone call

A free 15-minute telephone consultation can establish what is causing the weakness, what has been tried, and whether an assessment for FES is worthwhile.

Get in touch: call the clinic on 01743 630 138 or email Jacob. If nobody is free, leaving a voicemail gets a call back within 24 hours.

Please mention Mobile Physiotherapist.co.uk when you call.

About Jacob Youngson

Jacob Youngson is an HCPC registered physiotherapist (PH122755) and Head of Physiotherapy and Rehabilitation at Healthsec Rehab, providing physiotherapy across Shrewsbury, Telford and wider Shropshire. The team works with evidence-based rehabilitation technology including FES, alongside musculoskeletal, orthopaedic, complex care and neurological caseloads.

Read Jacob's profile or call 01743 630 138.

Please mention Mobile Physiotherapist.co.uk when you call.