Why Do Legs Recover Faster Than Hands After a Stroke, But the Foot Still Can't Lift Up?

Written by：C.M.P. Melody 林医师

Have you noticed that some people who have had a stroke can walk, but their toe seems to always droop, as if they are "dragging their foot," sometimes even tripping over things?

Q1. Why Do Legs Recover Faster Than Hands?

We can think of our brain as a "great manager" that oversees our entire body.

🦶🏻 Your Feet Handle "Big Movements":

Our feet and legs are mainly used for large-scale, coarse movements like standing and walking. These actions require relatively simple commands from our "great manager." So, even if the "great manager" has been injured by a stroke, the part of the brain that handles these "big movements" tends to "wake up" and resume function more quickly.

✋🏻 Your Hands Handle "Delicate Work": 

Our hands, especially our fingers, are responsible for very delicate and complex tasks like using chopsticks, buttoning a shirt, or writing. These actions require much more precise commands from the "great manager," involving a more complex and dense network of "control circuits." After a stroke, these complex circuits are more easily damaged and are much harder to fully restore to their previous level of precision.

So, the "great manager" will prioritize recovering your most basic functions—getting you back on your feet and able to walk (even if it's not perfectly smooth), because this is the most important for survival.

Q2. Why Can't the Foot Still Lift Up?

Even after the legs can move, getting the foot to lift back up is a stubborn problem for many stroke survivors. There are a few reasons for this:

1️⃣ Muscle "Tug-of-War" Imbalance:

Our ankle's movement relies on two muscle groups in a constant "tug-of-war." One group lifts the toes up, and the other pushes the toes down (this is the muscle in your calf).

After a stroke, the "great manager's" control over these muscles is disrupted. The muscles that push the toes down often become very stiff and tight. They act like a tight rubber band, constantly pulling the foot downward. Even if you try to use force to lift your toes up, you can't "win" that tug-of-war, and your foot remains dropped.

2️⃣ Harmful Walking Habits:

If proper rehabilitation isn't done in time, some people develop a habit of "dragging their foot" or "swinging their leg out" to walk. These incorrect walking patterns make the downward-pulling muscles even tighter and stiffer, creating a vicious cycle that makes it even harder to lift the toes.

What Can Be Done?

Addressing this "foot drop" issue is where rehabilitation becomes so important.

🔸Physiotherapy: 

A physiotherapist will teach you specialized exercises to stretch the stiff calf muscles and strengthen the muscles that lift the toes. They will also guide you in learning the correct walking posture.

🔸Assistive Devices: 

Sometimes, a doctor or a physiotherapist will recommend wearing a specialized ankle brace (also known as an AFO or Ankle-Foot Orthosis). This device helps to hold the foot up, preventing it from drooping, and making you more stable when you walk so you're less likely to trip.

🔸TCM Support: 

TCM methods like acupuncture and Tui Na massage can effectively relieve muscle stiffness and pain, helping your ankle to relax and feel more comfortable. This makes the effects of your physiotherapy sessions even better.

Post-stroke rehabilitation is a very detailed process. To achieve the best recovery, you must first understand what went wrong with each part of your body and then use the right methods for training and treatment.