If you think you have foot drop, your mind might jump right to an AFO (ankle-foot orthosis) as the go-to solution. While an AFO can be very effective in certain situations, it’s not your only option. In fact, there are several AFOs for foot drop alternatives that may help preserve your ankle strength and improve your walking.
By understanding the warning signs and taking early action, you can explore less restrictive interventions that support your mobility without fully immobilizing your ankle. In this post, we’ll break down what foot drop is, how to spot it early, and the best alternatives to try before moving to a more rigid device like an AFO.
By the way, have we met? I’m Dr. Gretchen, an MS Specialist and founder of The MSing Link—an online wellness program, book, and podcast designed to help people with multiple sclerosis feel stronger and walk better. My goal is to share practical, effective solutions so you can feel more in control of your symptoms.
Ever caught your toes on a rug or noticed your foot slapping the ground when you walk? You may have experienced foot drop. Foot drop happens when the muscles responsible for lifting your toes toward your shin (primarily the tibialis anterior) aren’t working the way they should.
Many people think of foot drop as an inability to lift the toes at all, but it can present in different ways:
In people with neurological conditions like MS, foot drop is often caused by weakness, poor muscle activation, or nerve pathway disruption between the brain and body.
Ready for the good news? The right strategies can make a big difference in how your foot and ankle move—sometimes without needing an AFO. Many of my clients with MS have made incredible strides in reducing foot drop through MS-specific exercises, which we’ll talk about more in a later section.
Catching foot drop early can seriously impact how well you’re able to manage it. In an episode of The MSing Link podcast about MS foot drop warning signs, I break down the subtle clues that many people overlook. (I’ll include the full episode below so you can watch it later!)
Here are the key warning signs of foot drop:
Even if you only notice one of these signs, it’s worth paying attention to and mentioning to your PT. Mild foot drop can progress if left untreated, but early intervention can help you keep your independence and avoid falls.
Foot drop may be inconvenient, but it’s also a safety issue. If you’re catching your toes or altering your walking pattern to avoid tripping, your risk of falls increases. Over time, compensations like hip hiking or swinging your leg around can also lead to hip, knee, or back pain.
By acting early, you can:
The earlier you begin targeted exercises, balance training, and supportive interventions, the more likely you are to maintain (or improve) your walking pattern without needing a rigid brace.
There are several effective AFOs for foot drop alternatives that can help you walk more safely while still encouraging your ankle to move and strengthen. The best choice will depend on your unique needs and goals, so take time to explore your options.
Here are some of the best AFO alternatives to explore:
The foundation of any foot drop program is strengthening the muscles that lift your foot, as well as the surrounding muscles that support your gait. My go-to starting point is ankle dorsiflexion:
If you have classic foot drop, lifting may be the hardest part. If you have more of a foot slap pattern, lowering slowly may be the bigger challenge. Either way, this exercise targets the tibialis anterior—the key muscle for clearing your toes when you walk.
I also recommend strengthening your hips and knees, since those muscles contribute to lifting your foot and keeping your stride efficient.
Tight calf muscles can make foot drop worse because they pull the toes downward, making it harder to clear your foot when you walk. A simple calf stretch can help release that tension:
If standing is too difficult, you can also stretch your calves from a seated position using a towel or resistance band around your foot to gently pull your toes back toward you.
Making calf stretches part of your routine can improve flexibility and give your toes more freedom to lift, reducing the severity of foot drop. Try it out this week and see how it feels!
When you walk, you spend roughly 60% of the time on one leg while the other swings through. If your single-leg balance is shaky, you have less time to lift your foot and clear the ground.
Practicing safe, supported balance exercises (like standing on one leg with a stable surface nearby) can give you extra time for each step, making it easier to lift your toes and reduce your tripping risk.
If exercises aren’t enough, lightweight braces can give you a boost without fully restricting your ankle movement. However, keep in mind that these AFO alternatives are only suitable for people with some degree of movement in their ankle.
Here are two great options I recommend for people with MS foot drop:
Both allow you to use your existing ankle strength while providing extra clearance for your toes. This can be a good middle ground between no support and a rigid AFO.
If you want both assistance and active muscle retraining, the Cionic Neural Sleeve is a cutting-edge alternative. It looks like a sleek leg sleeve and uses sensors with gentle electrical stimulation to activate the right muscles at the right time while you walk.
Benefits may include:
While it comes at a steep cost (about $260/month for the first year) and isn’t for everyone, it can be a great fit for people who still have ankle strength and want an option that encourages movement.
For more on the Cionic Neural Sleeve, check out this review blog I shared!
Despite the benefits of these alternatives, there are times when an AFO is the safest and most effective choice. You might want to consider an AFO if:
An AFO can provide stability, prevent your foot from dragging, and give you the confidence to walk safely. It’s all about choosing the right tool for your needs.
Even if you start using an AFO, pairing it with strengthening exercises can help you maintain as much muscle activity as possible.
Foot drop doesn’t have to mean losing your independence. By learning to spot the early warning signs and exploring AFO for foot drop alternatives, you can keep moving with confidence.
Your mobility is worth protecting, and the right tools can go a long way. That’s why I created my free MS Mobility Equipment Guide, packed with:
Skip the trial-and-error and get straight to the solutions that help you move better and enjoy more of your daily life. Download your free guide today and take the next step toward walking with more strength, balance, and independence.
Have questions about foot drop alternatives or which option might be best for you? DM me on Instagram @doctor.gretchen—I’d love to hear from you!
Dr. Gretchen Hawley's The MSing Link offers a comprehensive guide to taking control of your MS symptoms and improving your mobility through MS-specific exercises and strategies.
6000+ copies sold in over 13 countries!
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As a physical therapist & Multiple Sclerosis Certified Specialist, I have spent the last 10 years teaching people with MS how to feel more confident & empowered through MS-specific exercises and strategies.
If you want support and encouragement, plus a healthy dose of tough love, come follow me on Instagram (@doctor.gretchen) or on YouTube @DoctorGretchenHawley. It's where I share daily tips, tricks, and information about new offers — plus, you’re bound to feel more empowered, hopeful, & motivated after watching each post and video!
Questions? Email me at Hello@DoctorGretchenHawley.com
