Drop Foot

[Badonnelly]

I have an on-going struggle with drop foot when track riding. This is a condition caused by a crushing of the perineal nerve which runs around the knee causing paralysis of the leg muscles that control raising the foot (i.e. can't shift up). I do have pre-existing sciatic nerve damage from a previous back injury but never have issues riding my S1000rr on the street--only on the track. By the end of a track day, I've always had some paralysis but by the end of 2 full CSS days in May, my left foot was totally numb to the point I badly turned/sprained my ankle and felt no pain at all! I've switched out and altered leathers to relieve pressure on the kneecap to no avail and even wearing track pants two sizes to big didn't help. This week I had to quit a track day after only 3 sessions because of drop foot regression. My acupressure specialist, who knows nothing about motorcycling told me that I'm putting too much pressure on the balls of my feet. Of course, that's exactly what I do to drive my knee into the tank in order to lock on. My body position is pretty good, my hips are turning in when the inside knee drops. I've been strengthening my legs and hips at the gym to the point where I'm actually showing bruising on the inside of the knee.

 

My question is whether any of you have dealt with drop foot before and how did you cope? I am willing to get custom leathers to address pressure in the knee area (I think I have abnormally long femurs). I'll even consider trading in my S1000rr on a more ergonomic upright bike but find it hard to believe that I can't fix this with technique adjustments even if it means departing from orthodoxy. Bottom line is that I want to preserve my ability to ride on the track!

 

Details:

-Started track riding at CSS in 2012.

-Completed levels 1-4

-Relatively fast B group rider NESBA and TPM

-L2 burst fracture in 1990 plane crash

-Always have some numbness in left foot and right thigh due to back injury

-After 10 minutes of track riding, I can feel the left foot starting to tingle. Last track day, I started getting a little drop foot in my right foot!

[Hotfoot]

I don't know anything about this condition, but I do have a couple of thoughts - if your acupressure specialist thinks that too much pressure on the ball of the foot is the source of the problem, maybe you could try to relieve that a little:

 

Can you find a way to lock onto the bike without doing so much of a calf-raise? Possibly adding some Stomp-Grip or changing the position of it if you already have it? That might put less pressure on your foot AND possibly reduce muscle tension in your leg or pressure on your knee.

 

What kind of foot pegs do you have? Some rearsets have round or octagonal footpegs that provide great grip and easy pivoting off the foot, but put an intense pressure in one small spot on the bottom of your foot. Could you go to a wider, flatter peg, or maybe even one with a rubber pad on it like you see on some touring-type bikes? That could reduce the pressure and the vibration; might compromise your peg-grip but could be better overall than having your foot go numb.

 

What kind of boot and sock do you use? Maybe a thicker-sole boot or a thicker sock or a gel-pad insert in your boot could help diffuse the pressure on your foot.

 

I've never had an issue with drop-foot but I have experienced pain and numbness in my foot when I was using a rounded footpeg and thin-soled boots. A slight change in my foot position helped, so I wasn't pressing right on the center of the ball of my foot (where apparently it was putting pressure on a nerve), and gel inserts in my boots helped a lot, too.

 

You may also want to check how tight your boots are on your calf, I have had students who had numbness in their foot due to pressure on the calf from the boot being too tight and/or the leathers folding uncomfortably at the calf under the boot.

[Lnewqban]

I have an on-going struggle with drop foot when track riding. This is a condition caused by a crushing of the perineal nerve.........

 

Sorry about your problem.

 

You mean the peroneal nerve:

 

http://en.wikipedia.org/wiki/Common_fibular_nerve

 

http://www.nlm.nih.gov/medlineplus/ency/article/000791.htm

 

It seems that you should adjust the ergonomics to keep your lower back straight (to keep damaged vertebra from pinching the nerve) and to keep lees angle of knee bending (to have back of knee less compressed).

[Badonnelly]

Thank you both for your inputs. I've been concentrating so much on the knee area (leathers too tight) because thats usually the main cause of PERONEAL nerve issues that I hadn't considered the foot and calf. After my May incident, I replaced the stock pegs with Driven rearsets in hopes I could lower my feet enough to reduce the knee bend. Last two track days with the Drivens (round pegs) on the lowest setting were cut short due to foot drop. My thought now is actually to raise the pegs to reduce the distance to the tank and not have to flex the calf as much to lock on. I dont think lowering the pegs is really an option anyway since my toe sliders are grinding away at this setting. Btw, I do have Stompgrip installed. I've both used thick motocross socks and thin athletic socks but might try a different boot. Maybe something in my Astars SMX-r boots is causing a restriction in the calf or ankle area. Since I'm in the market for new leathers, perhaps I should consider over boot pant legs--hmm. Now, Lnewqban's suggestion to adjust ergonomics to keep lower back straight may ultimately be the solution. A solution is evident in the old joke: "Doc, it always hurts when I ride on the the track.....well, don't ride on the track". DA, DAT, DUM! I am trying to avoid that one. Maybe its time to consider the Helibars. The extreme solution, short of quitting, is a supermoto bike. I'd do it , but I sure do love my S1000rr! Thanks again guys. Your time to respond to this kind of boring subject points to the passion you have to this sport and its participants. The people draw me to this endeavor every bit as much as any adrenaline rush!

[Badonnelly]

Oh, I forgot to mention that I made an appointment with the neurologist next week. If anyone that read my post is dealing with similar issues, I'll be sure to let you know what pressure points he's concerned about.

[Dylan Code]

I've seen a number of riders with the problem including one of our coaches, Lyle.

 

It appears to be caused by pressure on the front of the lower leg (shin) as you already know.

 

I'm thinking that a thin soccer-style shin guard may solve it, and possibly putting the leathers outside the boots instead of tucked in.

 

A different brand/fit of boots would be something to look into. Essentially you don't want any focused points of pressure along the shin as I understand it.

 

I've seen about 8 people with the problem in the last 5 years.

 

Dylan

[Badonnelly]

Thanks for the reply, Dylan. Funny you should mention the boot thing. I put in an order for some "in" boots a few weeks ago and just got an email that they will arrive from Italy on Monday. Great minds must think alike. It also appears after trying on many off the shelf leathers that while I'm a normal slim build guy, I must have freakishly long femurs. As soon as I spread my legs (as in a corner), the leathers pull into my inside knee so excessively as to leave a dent below the meniscus where the peroneal nerve is. I hope that between the "in" boots and my wearing track pants two sizes too big for my waist, I'll get a handle on this drop foot thing. I have made decision to cease all track riding : ( until I heal and see the neurologist which I've had to reschedule for the end of this month. I'll keep updates on this post just in case there's someone out there that runs into this issue.

[Fajita Dave]

Have you thought about getting custom fitted leathers? There is a company in VA that makes them but I have no idea what their name is anymore. It was 4 years ago when I looked into it. It could be a last resort and it would be an expensive option!

[Badonnelly]

Thanks, Dave. Again, the thoughts and recommendations from folks on the forum are terrific and validate the direction I'm on. The only reason I bought the oversized pants were because I passed on my new Teknic Xcelerator one piece suit that put too much pressure on my knees to my 15 year old son (lucky guy!) and needed something quick to get through the season. I've tried several off the rack suits and Pilot USA's "standard" fit suit and all fit me well except for the hip to knee length being too short when I spread my legs. Once I know for sure that the nerve issue is healing well enough to invest more in the solution, I'm going to get the suit made at Pilot USA. I think My Dainese "in" boots and proper length suit legs will at least eliminate that part of my equipment from equation as far as possible crush injury culprits. If that doesn't fix it, I think I'll be left with the unpalatable solution of replacing the. s1000rr with a more upright ergo bike. Speed Triple r, Tuono v4, Hypermotard sp would be at the top of my list but I really don't want to shop for a track bike--love my Beemer!

[Badonnelly]

Oh yeah, I think Alden Lee might have been the VA leathers company but I don't think they are making them anymore. I am fortunate that as an airline employee, its pretty easy for me to get out to the west coast and get fitted in person.

[Badonnelly]

Just in case anyone is interested in this drop foot issue, here is my report from my visit with the neurologist. The good news is that by my own estimate I have recovered 70% of my strength in the left foot which was verified by the doctor's test that showed a 25% degradation (pretty close!). The really good news is that he is not only impressed by my rate of recovery, he sees no reason for me to give up track riding as long as I use a bit of good sense. The main culprit is the crushed peroneal nerve injury caused by pressure in the knee area by too tight leathers. The Pilot USA guys measured me and verified that my femurs are proportionately longer than most guys by 3.5 cm. Doesn't seem like much, but the pressure on the knee coupled with a 30% degradation of the trunk nerve (due to a broken back in 1990) which runs down my thigh contribute to the drop foot.

 

So besides getting some customized leathers, I think I will not be doing back to back track days to give the nerves time to recover. Obviously, cutting my track sessions down a bit might help too. While "locking on" is an important technique I think I must learn to do it in a more relaxed way (not flexing my calf muscles to the max extent possible for the entire session). The neurologist said that my peroneal nerve injury will heal in time even if I repeat it. Personally, I think I'll take measures to reduce the injury in. The future by not riding back to back track days, maybe cutting sessions down and definitely getting leathers that fit my freakish legs?.

 

If anyone has suffered from track induced drop foot, I hope this report offers some encouragement. My visit to the doctor today certainly has me a bit relieved!

[Hotfoot]

Just in case anyone is interested in this drop foot issue, here is my report from my visit with the neurologist. The good news is that by my own estimate I have recovered 70% of my strength in the left foot which was verified by the doctor's test that showed a 25% degradation (pretty close!). The really good news is that he is not only impressed by my rate of recovery, he sees no reason for me to give up track riding as long as I use a bit of good sense. The main culprit is the crushed peroneal nerve injury caused by pressure in the knee area by too tight leathers. The Pilot USA guys measured me and verified that my femurs are proportionately longer than most guys by 3.5 cm. Doesn't seem like much, but the pressure on the knee coupled with a 30% degradation of the trunk nerve (due to a broken back in 1990) which runs down my thigh contribute to the drop foot.

 

So besides getting some customized leathers, I think I will not be doing back to back track days to give the nerves time to recover. Obviously, cutting my track sessions down a bit might help too. While "locking on" is an important technique I think I must learn to do it in a more relaxed way (not flexing my calf muscles to the max extent possible for the entire session). The neurologist said that my peroneal nerve injury will heal in time even if I repeat it. Personally, I think I'll take measures to reduce the injury in. The future by not riding back to back track days, maybe cutting sessions down and definitely getting leathers that fit my freakish legs.

 

If anyone has suffered from track induced drop foot, I hope this report offers some encouragement. My visit to the doctor today certainly has me a bit relieved!

 

Wow, it is great news that you have recovered so much of the strength in your foot, and that you don't have to worry about pressure on your knee in the future causing permanent damage.

 

Thanks very much for posting this follow up, it is good info to have for future plus it's nice to know you are making improvements and have ideas for managing it.

 

In case you don't already have this in your leathers, a lot of manufacturers now have a stretchy material for leathers that can be used in bendy areas like the underside of the knees, make sure your next set of leathers includes this, it really does make them a lot more comfortable.

[Badonnelly]

Thank you so much for the support and info. Yes, Pilot USA seems to equip their EVO leathers with this material.

 

[Lnewqban]

Just in case anyone is interested in this drop foot issue, here is my report from my visit with the neurologist. The good news is that by my own estimate I have recovered 70% of my strength in the left foot which was verified by the doctor's test that showed a 25% degradation (pretty close!)..........

[Cobie Fair]

I'm going to shoot this link to one of my coaches. I think he solved his drop foot with change of boots, and a lot of visits to his chiropractor.

 

CF

[lwarner]

Cobie's right about the boots, that's what caused it and ultimately what I changed to prevent a recurrence.

It was pressure along the outside of my shin halfway between my knee and ankle that caused it. I'd been trying some new boots and there was just a TINY bit of pressure at the top of the boot, not enough to bother me until I took them off and had no dorsiflexion.

I tried on MANY pairs of boots and got a pair of Alpinestars Supertech R's because there is an inner and an outer boot and you can adjust tension separately, with the inner boot equalizing the tension very well, snug without any tight spots and the outer boot has a ratchet on top that I am very careful not to tighten... I actually keep mine as loose as common sense allows.

Nothing to do with the knee in my case.

It took around 6 months for me to get back to normal, the neurologist I saw told me nerves take a while to heal and to be patient.

I'd also be curious whether you ride with the ball of your foot on the end of the peg, in which case there's going to be a high PSI on that little spot, or if your foot is flat across the whole length of the peg and the pressure is spread over the larger surface area?

[Badonnelly]

Thanks for sharing your experience, Iwarner. I wouldn't be surprised if all you mentioned are contributing factors in my case. I did try the Dainese "in boot" and suit designed to work with the "in boot" just for that reason. Unfortunately, my femurs were just too long for the off the rack suit and caused the excessive pressure in the knees. I am in the market, still, for new boots and your comment about the inner boot design of the Supertech R makes sense. I'll give them a try.

 

On the technique side, I ride on the balls of my feet and lift weights specifically to increase lock on strength--maybe to a fault. My acupressure guy actually agrees with you and thinks I'm putting too much pressure on the balls of my feet. Once I get back on the track, I'm going to have to play around with foot position and perhaps even reduce how much pressure I put on the tank with my knees. I actually get bruising where my knees come in contact with the tank. Eventually, I'll probably have to come up with a slightly unorthodox lock on solution since my prior back injury is always going to put me right on the edge of a drop foot recurrence.