With all the changes that occur both to our body’s and our lives around when we are expecting and after bringing home a new baby, it is easy to ignore pain or discomfort that may occur in the feet and legs. This will allow you to better assess from the comfort of your own home how your feet and legs are coping with pregnancy, what you can do yourself to help or whether further treatment is required.
MY CHANGING BODY
Pregnancy triggers many different changes in a woman’s body. During pregnancy there is an increased release of a hormone called relaxin. Relaxin is produced by the ovary and the placenta and has an important job in preparing the body for childbirth. This hormone is responsible for relaxing the ligaments in the pelvis and softens and widens the cervix. Many people are unaware that the release of this hormone effects the whole body and not just the pelvis. Changes in the feet that can occur due to the increased ligament laxity, include flattening of the arches, instability of the ankles and knees and a possible contribution to lower back pain.
Naturally women also gain weight during pregnancy and this in addition to the newly growing bump can cause a woman’s center of gravity to completely alter. This change can cause a new weight bearing stance and add pressure to the feet and knees.
Two of the most common foot related complaints experienced by pregnant woman are foot pronation and edema. These complaints can lead to pain in the heel, arch or ball of the foot.
It is important for all pregnant woman to learn more about their foot health during their pregnancy to help make this nine month period more enjoyable.
FLAT FEET
Excessive pronation is commonly referred to as flat feet. Flat feet occurs when the arch of the foot flattens out upon weight bearing and the foot rolls inward when walking. This can create stress on the foot and ankle area and cause inflammation of the plantar fascia. The plantar fascia is the band of tissue that runs from the heel to the forefoot. This can make walking very painful and increase strain on the feet, calves and sometimes the back. Oftentimes this over pronation is caused by the relaxin hormone or by weight gained during pregnancy but it can also be prominent in woman who have flexible feet, flat feet and in woman who are obese.
There are a couple of effective ways to treat excessive pronation during pregnancy. Pregnant woman should avoid walking barefoot for long periods especially on tiles. Often at this time of life comes also a significant lifestyle change where women often go from working fulltime in a largely sedentary job and a well adjusted lifestyle routine outside of that, to being busy on your feet all day at home often with no shoes on. Consequentially one good conservative treatment is simply with proper fitting footwear. Choose comfortable footwear that has good arch support and good shock absorption.
Excessive pronation can also be treated with orthotic therapy. These orthotics should be designed to provide adequate arch support and medial rearfoot posting to correct the over-pronation. Ready made orthotics are available from chemists however custom made orthotics that are accurately shaped to your foot are more likely to provide the support needed.
It is important to treat over-pronation to not only reduce pain but to also prevent other foot conditions from developing such as plantar fasciitis, heel spurs, posterior -tibial tendonitis and bunions. If relief cannot be gained by wearing good footwear then we recommend seeing a podiatrist.
EDEMA
Edema is also called swelling in the feet and often occurs in the latter part of pregnancy. It is caused by the extra blood accumulated during pregnancy. The enlarging uterus puts pressure on the blood vessels in the pelvis and legs causing circulation to slow down and pool in the lower extremities. This can cause the feet and lower legs to look purple and if, as is sometimes the case in pregnancy, extra water is retained in the body this can cause added swelling. If swelling occurs in the face or hands please seek medical assistance immediately.
Edema can be treated a couple of ways. Primarily you should elevate your feet as often as possible. Place your feet on a small stool or chair especially if you have to sit for long periods. If you have to be seated for a long period eg a long drive then stop frequently and walk around for a while to get the circulation going. Wear proper fitting footwear. Footwear that constricts circulation should be avoided such as narrow or small shoes.
Your foot will change shape through out pregnancy and you should measure your foot size several times through pregnancy to make sure that you are wearing the appropriate sized footwear. It is likely that your feet will change size during pregnancy. This is normal. Wear seamless socks that are not too tight for circulation. Exercise regularly throughout your pregnancy. Walking is a great option to promote good health in pregnant women. Drink plenty of water. Eat a well balanced diet. Avoid salty foods as they can contribute to water retention. Check your feet against each other. The swelling should be similar (symmetrical) in both feet. If it is not it may be a sign of a vascular issue and you need to seek medical attention immediately.
TOE PAIN
Ingrown toenails are a common condition in pregnant women. Ill fitting shoes, tight socks and incorrect nail trimming can lead to troublesome toes. Lets face it in the end it can be near on impossible to get near them yourself.
If the skin around your toenails is red, swollen and painful to touch, attention may be required. Trim your nails straight across and always make sure your shoes fit well. Try not to pick or tear at the nails.
Salt water baths can be a great way to relieve a troublesome nail and never try to remove the problem nail at home- this will only exasperate the problem. Book in with your Podiatrist to discuss treatment options. Seeing a Podiatrist for your nail care in the later stages is a good plan to have.
HEELS AND CALLOUS
Cracked heels are often caused by the changes in posture, the way you walk and weight gain. This causes some heels to dry up and get sore. If you suffer from swollen feet it is more likely that you will get dry, cracked heels due to the increased pressure on the padded area under your heel. The extra pressure causes it to expand sideways and can possibly crack. The best treatment is to routinely moisturize your feet every day.
Callous are also caused by the additional stress on the feet during pregnancy. Hard skin can present when an area is overworked.
If the callous or cracked heels become problematic we recommend that you seek treatment by a registered podiatrist to ensure that you don’t get any infections that could impact your health. This is also a good chance to have a relaxing safe treatment at a time when it is difficult to reach your own feet.
We wish you the best with your pregnancy and hope that this information will ensure that you maintain optimal health for you and your bub!
AFTER PREGNANCY
Many of these conditions continue after pregnancy especially if you are breast feeding. It takes some time for the impact of reducing hormone levels and weight loss to allow feet and limbs to recover. If you are concerned please contact your podiatrist.
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