Pregnancy and the Feet
Pregnancy is seen by most as a time of anticipation and joy, but it can take a toll on a woman’s body. Even the feet can be affected. Researchers report more than half of all pregnant women have foot complaints.
According to Adriana Karpati, D.P.M., Podiatrist in Grapevine, TX one of the most commonly encountered foot problems in pregnancy is plantar fasciitis (heel pain). As the woman nears the last trimester, production of a hormone, called relaxin, causes the ligaments to loosen in preparation for movement of the baby through the birth canal. This process also loosens the ligaments in the foot. The extra weight during pregnancy compounds the problem, and may cause the arch to flatten and the foot to roll inward while walking. This puts stress on the fascia, or connective tissue that runs from the front of the foot to the heel. The fascia becomes inflamed, leading to heel pain. The pain is worse when first getting out of bed in the morning or after sitting for long periods of time.
Foot swelling is also very common in pregnancy. It occurs due to extra blood volume to support the fetus and pooling of fluid in the lower body. Swelling can be worse after standing for extended periods or during warmer weather. The increase in foot size also makes wearing some shoes more uncomfortable.
Many pregnant women complain of foot cramps (the cramps can also occur in the legs). These become more common during the second and third trimester. The cramps can be caused by an increase in blood volume, relaxation of the blood vessels (which slows circulation) and compression of the veins in the pelvis from the added weight (affecting circulation in the feet). Foot cramps are common at night, but can also occur during the day.
Karpati says pregnant women may also develop ingrown toenails. This is usually caused when the swollen feet are stuffed inside shoes that are too tight. She says pregnant women are used to getting bigger maternity clothes to match their growing girth. However, many patients don’t think about changing their shoe size. The foot can get flatter and wider, growing in length by an extra half inch.
Treating and Preventing Pregnancy-related Foot Problems
Karpati says it’s important for a pregnant woman to take care of her feet as well as the rest of her body. Many foot problems can be relieved or prevented by wearing properly sized shoes. Since the feet tend to swell and enlarge, a new pair of comfortable shoes may be needed. Make sure to get shoes that have a good arch support. Orthotics can also help support the arch. If shoes in general are uncomfortable, try wearing slippers around the house. Avoid going barefoot, which doesn’t give any support to the feet and can increase risk of foot injury.
To reduce swelling, take frequent breaks from standing. Sit down and prop up the feet for at least 30 minutes a day. Don’t cross the legs (this impedes the ability of blood to flow back up to the heart) and avoid wearing pants with constricting ankle cuffs or tight ankle jewelry. It’s also important to watch salt intake, which can contribute to fluid retention and swelling, get regular exercise and eat a healthy diet.
For both heel pain and leg/foot cramps, Karpati recommends stretching. A splint may be worn at night to keep the ankle and foot at a right angle and reduce risk of cramps while sleeping.
Women with ingrown toenails may get some relief by soaking the foot in warm water for the nail to soften. For very small ingrown nails, it may be possible to cut the nail at an angle and peel off the excess nail on the side. For larger or deeper ingrown nails, or if the nail is very red, sore or has any drainage, see a podiatrist for treatment.
Karpati says many pregnancy-related foot problems resolve after the baby is born and the woman gets back to a normal weight and routine. However, sometimes the feet may still be larger, requiring a larger shoe size than that worn needed before pregnancy.
American College of Foot and Ankle Surgeons, http://www.foothealthfacts.org
American Orthopaedic Foot and Ankle Society, http://www.aofas.org
American Podiatric Medical Association, http://www.apma.org
Karadag-Saygi, E., et al., “Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy,” Foot and Ankle International, February 2010, Vol. 31, No. 2, pp. 153-157.
Ponnapula, P., and J. Boberg, “Lower Extremity Changes Experienced During Pregnancy,” Journal of Foot and Ankle Surgery, September-October 2010, Vol. 49, No. 5, pp. 452-458.