Pregnancy and Feet

Leg and foot pain is experienced by many women during pregnancy, especially during the last trimester.  The most common issues associated with leg and foot pain include plantar fasciitis (heel or arch pain), swelling, varicose veins and cramping.

 

Plantar fasciitis or  HEEL PAIN during pregnancy

Pregnant women often experience heel and arch pain, which is known as plantar fasciitis. Plantar fasciitis occurs when there is extra strain put on the plantar fascia.  This is a band of connective tissue that runs long ways across the bottom your foot. This becomes more common during pregnancy due to two main factors.  Firstly, the release of a substance called ligament relaxing hormone and also the weight gain that is an inevitable part of pregnancy.

 

Towards the end of pregnancy a hormone called ligament relaxing hormone is made in order to relax and allow stretch in the ligaments around the pelvis.  This allows the two halves of the pelvis to separate to prepare for child birth. This also has an effect on the ligaments that hold the many bones in the foot together. As this decreases the structural integrity of the foot, the bones are now able to move slightly further apart, allowing the arch to flatten. As the arch flattens the plantar fascia is stretched across a greater distance.  It can become irritated and pull on its attachments to the bone. This causes the pain that is felt in the arch and bottom of the heel bone.

 

The arches of your feet may not return to their previous height after pregnancy if it drops. Wearing an orthotic device during the last half of a pregnancy can both reduce or eliminate foot pain and also be protective of ongoing foot problems after pregnancy. It may reduce the permanent changes to your feet, especially given the effects of multiple pregnancies can compound.

 

Swelling of the feet during pregnancy

Swelling occurs when there is an excess of fluid in the fleshy tissues of your lower leg and foot. As the uterus grows bigger during pregnancy its puts pressure on many of the blood vessels that carry blood from your legs back to your heart. The increased pressure on these veins slows down the flow of blood, causing it to pool.  This puts increased pressure on the blood vessel wall. This causes the clear fluid in the blood called plasma to leak out into the surrounding tissue of the ankles and feet and causes swelling.

As well as this, during pregnancy, raised hormone levels cause the body the keep more of the fluid that the body receives. This extra fluid is most noticeable in the feet, ankles, and calves where it settles towards the lowest points due to gravity.

A combination of the swelling of the feet and the ligament relaxing hormone causing the arches to lower, may cause shoes to feel tight.  Your foot size may increase by half to a full size. It is important to wear properly fitted shoes that offer support and cushioning. It would be wise to make an appointment for assessment if:

• swelling is not symmetrical or
• the feet swell very rapidly or
• if there is pain occurring in the foot, calf or leg. If the painful area is also hot and hard or ‘woody’ to the touch, it may be a sign of a clot in the leg.  This needs to be examined as soon as possible.

Ways to help reduce the impact of swelling during pregnancy include.

• Elevating your feet as often as possible.  Try to lift the feet above the level of the hip to encourage gravity to move the fluid upwards.
• Wear well fitting footwear. Due to ‘expansion’ of your feet in pregnancy, your old shoes may no longer fit.
• The swelling in the feet disperses after the birth of the baby.  The change in length of your foot is often permanent as discussed above.
• Wear socks without seams that are not too tight.  They should not leave a constriction mark where they finish.
• If driving a long distance, take regular breaks involving a stroll to promote circulation.
• Exercise regularly as part of your overall health regimen.
• Keep well hydrated. Drink water in preference to other beverages.
• Avoid excess salt that can cause water retention
• If severe, compression stockings may be required.

Gait changes during Pregnancy

As pregnancy progresses, women can expect some degree of looseness to develop within the joints of the foot and ankle. This can cause or worsen existing instability. Added to this, the unaccustomed weight bourn ‘out-front’ during pregnancy will change the angle of your back and hips and alter your gait and foot function.  The curvature of the back becomes more pronounced and most women will adopt a broader-based gait to maintain balance.

Varicose veins in the legs and feet during pregnancy

Pregnant women have increased fluid retention. As a result of this, the volume of blood circulating around the body is increased. This creates an increase in pressure on the walls of the veins.  It also puts extra pressure on the valves within the veins that work to return blood back to the heart. The extra strain on the valves causes them to not close as efficiently and become faulty, which allows blood to flow back and pool. You are more likely to get varicose veins if you gain too much excess weight or stand for long periods.  Your risk is also increased if you have a hereditary predisposition, for example, if your mother had varicose veins. Some of the symptoms that accompany varicose veins include aching legs, heaviness, fatigue, and pressure. Increasing circulation can help relieve discomfort. This can be done through low impact exercises including swimming or a short walk.  Resting with the legs elevated is more beneficial than sitting with the legs hanging down.  Some commercial products that stimulate fluid to return to the circulatory vessels can be useful in this condition.

 

Leg cramping  during Pregnancy

Leg cramping occurs most commonly in the calves during pregnancy but can also occur in the feet. Cramps in the legs and feet commonly occur at night. The reason as to why cramping occurs is not known for certain but it is thought to be due to the muscles being fatigued at the end of the day or possibly a vitamin and mineral imbalance.  Adequate hydration is important so be sure to keep up your water intake even though the pressure of the baby on the bladder makes it likely that you will need to urinate more often.

 

If you would like to talk about protecting your foot health during pregnancy or if you are experiencing foot and leg pain, call us on 3256 1006 and let us help you today.