How do I get my foot eversion working? I can barely tell if I'm getting any eversion, but my inversion is pretty good. Should I continue to strengthen the inverters? And what more can I do about eversion. This is causing me to still drag my foot and any tips would be appreciated

Thank you for your response, I'll wait to hear from your physical therapist, andbBest wishes to you also 

Hi Ksilvia,

Thanks for your question. It’s very common to have an imbalance in muscles around the foot and ankle after a stroke. To give the EnableMe community some background, the invertors are the muscles around the ankle that pull the foot inwards. The evertors are the muscles that pull the foot outwards.

Often we find that the evertors are weak, and there is an imbalance between the invertors and evertors. This can be particularly troublesome during walking as your ankle/foot is less stable when you put weight through it, and you may be more likely to ‘catch’ your toes on the ground when you walk.   

Sometimes weakness of the evertors is the main problem. Other times, spasticity is also present in the invertors (high muscle tone causing the foot to be pulled inwards). When spasticity is present, you may need to address the spasticity in the invertors as well as strengthening the evertors.

I’d recommend having an assessment with a physiotherapist to identify the main issues that are causing your foot to drag when you are walking. E.g. spasticity, weakness, changes to your sensation that make it more difficult for muscles to work. The physiotherapist will then be able to create a treatment plan - treatment will differ depending on what is contributing to the problem.

If spasticity is present, you may need to be referred to a Spasticity Clinic. This is a clinic with a team of health professionals to assess and treat spasticity with both medical management and therapy.

Many people benefit from wearing a brace (an ankle foot orthosis) that sits inside your shoe, to support your foot and ankle. The brace works by keeping your ankle stable so that you are less likely to roll the ankle when you put weight through it, and helps prevent your foot from dropping and dragging/catching on the ground. The physiotherapist can work out whether a brace is suitable and trial this with you.

Strengthening the evertors is important. Specific exercises will depend on the level of weakness and whether other issues are present. In general, start by doing movements that bring your foot outwards without having to work against gravity – so you might start by moving your foot outwards when you are lying down. As you build your strength, you can work against gravity, add resistance, and do exercises when you are standing e.g. using a ‘balance board’. Functional electrical stimulation (FES) can also be useful to help stimulate muscles around the ankle when weakness is an issue.

If you are living in Australia, you can access a physiotherapist through your local community centre or hospital outpatient department (you may need a GP referral). You can also receive rebates for private physiotherapy through a Chronic Disease Management Plan – speak with your GP.

The EnableMe community may have some thoughts and ideas about what exercises and treatments worked for them – you can also contact us on StrokeLine (phone 1800 787 653 Mon-Fri 9am-5pm AEST) if you’d like to chat with us over the phone.

Best wishes,

Katherine (Physiotherapist – StrokeLine)  

Thank you so much, I was told weakness in my hip was a problem by one therapist and another said it was my foot being weak. Spasticity isn't an issue but yes everything you said makes sense, I thought continuing to strengthen my inversion would translate into some eversion return. But I'll definitely start targeting my eversion with your suggestions. Thanks again for the advice