Pregnancy triggers many different changes in a woman’s body. Many women experience different complaints of new aches & pains throughout their pregnancy, particularly in the hips, legs and feet. Foot and ankle pain is commonly seen and helped by podiatrists. While extra weight gain associated with pregnancy is a main reason, there are other factors that cause pain and discomfort too. The good news is that a lot can be done both in the clinic with treatment and at home to feel more comfortable!
There are a few main reasons why pregnant women experience pain in the foot and ankle. Due to the natural weight gain during pregnancy, a woman’s centre of gravity is completely changed. This causes a new weight-bearing stance with added stress to the knees, legs and feet. Another factor is the naturally released hormones that prepares the body for childbirth which also causes relaxation of the ligaments in the hips and feet. Swelling within the feet and ankles causes a pressure type of pain too. Other skin and toenail complaints can occur too.
The most common foot problems that podiatrists see with pregnancy is:
- Over-pronation (flattening of the arch)
- Foot pain
- Calf cramping, development of ingrown toenails
- Hard skin formation
Over-Pronation (Arch Becoming Flatter)
Over-pronation is when the arch will flatten out which can occur when a person will stand for long periods and their feet roll inward when walking. This can create stress or inflammation on the plantar fascia (plantar fasciitis), the fibrous band of tissue that runs from the heel to the forefoot. Pain can be felt in the foot and ankle, the legs, or the arches of the feet.
Symptoms of over pronation can vary from person to person. Some pregnant women will experience heel, arch or ankle pain due to their foot positioning combined with laxity of the ligaments, generally after the first trimester. This can make walking very painful and can increase strain on the feet, calves and back. A combination of weight gain and hormonal changes adds to a change in foot posture.
Management of foot pain from over-pronation:
- Supportive shoes with good arch support and cushioning
- Custom foot orthotics to reduce strain on the feet
- Exercises to work on strength and stability of the core foot muscles
- Shockwave therapy
Oedema or swelling normally occurs in the latter part of pregnancy and results from the extra fluid pooling in the extremities, particularly the legs and feet. It is visible to see the changes and will feel as though the skin is being pulled. High blood pressure as well as blood pressure changes are a risk factor for this. The enlarging uterus from the growing baby puts pressure on the blood vessels in the pelvis and legs causing returning circulation to slow down. Many women will notice that when their feet are swollen, they can become purplish or pale in colour.
Management of swelling in the feet:
- Wearing proper fitting shoes (as shoes that are too narrow or short will constrict circulation)
- Have your feet measured several times throughout your pregnancy as they may change sizes. Often foot size changes permanently following pregnancy
- Wear seamless socks that do not constrict circulation
- Exercise regularly to promote overall health and circulation
- Drink plenty of water to keep the body hydrated
- Eat a well-balanced diet and avoid foods high in salt that can cause water retention
- Avoid too much of any one activity – eg too much standing or sitting
- Avoid standing in one position for long periods of time
- Foot and ankle pain
Getting sore feet anywhere from the arch, heels, ankles can all be an annoying new issue for pregnant women. Plantar fascia pain is commonly felt during pregnancy too. While weight gain can seem to be the most obvious cause of foot pain there are other reasons for this too. Due to the growing baby bump, the change in the centre of gravity also changes the demands on the feet and legs. This results in different and new areas of pressure that were not an issue beforehand. Extra fluid (oedema) and changes to the blood vessels with formation or worsening of varicose veins can all lead to more discomfort around the foot and ankle.
Podiatrists help to assess all foot problems during pregnancy. A lot can be done to treat and improve foot health during this time.
Treatment for foot pain can include:
- Treating pain with foot mobilisation therapy with a foot massage through the muscles
- Using compression stockings
- Providing more arch support by a premade or custom foot orthotic
- Shockwave therapy
- Footwear advice
- Providing nail and skin care
Calf pain and cramping
Discomfort, tightness, cramping and pain in the calf muscles at the back of the leg can be a painful and annoying symptom for pregnant women. There are many different theories around why this is felt. Common reasons include hormonal changes, blood mineral changes or deficiencies, the carrying of extra weight putting increased pressure on calf muscles, and lack of hydration too. Blood flow changes along with excess fluid and flat feet can all play a part in this too.
Please seek medical advice or consult your doctor should you notice redness, intense and ongoing calf pain, with associated swelling and lack of mobility within the calf muscle of either one or both legs. For all other symptoms a podiatrist will be able to manage and treat calf pain.
Treatments for calf cramping can include:
- Massage to the calf muscles
- Shockwave therapy to the muscle belly
- Calf stretches and strengthening
- Wearing supportive and comfortable shoes
- Increasing water intake
- Addressing nerve tension through the hip, hamstring, calf or foot
- Taking supplements such as magnesium and iron
Due to increases in swelling in the feet the shoes can fit more snug and put more pressure on toenails leading to ingrown toenails. Sometimes ingrown nails are self limiting during the pregnancy, but other times they can lead to ongoing pain and infections. Extra weight can also play a role in more pressure through the toes and toenails. Hormonal changes to the nails and skin contribute to the occurrence and stubbornness of nails digging in during pregnancy. Change in foot size with current shoes no longer fitting can cause nails to grow in too – be sure to check the fit of your shoe size if your nails are feeling sore.
Whether it be from morning sickness, the developing baby bump, or purely the difficulty bending to reach the feet, it can be difficult to attend to the feet and skin while being pregnant. With increased weight and the feet working harder than usual it is typical to see either new areas of hard skin under the feet, or extra thick hardness than usual. A lot can be done to help pregnant women feel comfortable Our podiatrists help maintain your toenails and any hard/thick skin so you don’t have to struggle ! Read more about nail and skin care here.
Pregnancy is a special time – you don’t need to persevere with soreness!
Come and see the experts, podiatrists can help you feel a lot more comfortable walking around for the next 9 months!