By John M. Sigle DPM, FACFAS
As an expectant mother, there are many times you may feel the weight of the world is on your shoulders. During pregnancy, the weight of at least one world is actually on your feet. Mom’s feet are her baby’s first stroller, rocker, and swing — their sole vehicle to the outside world. This incredible responsibility of carrying your child is special, exciting, and undoubtedly strenuous, making foot care during pregnancy that much more vital for mothers.
As the natural weight gain increases, the center of gravity changes, adding excessive pressures to the knees, ankles, and feet. Edema (swelling) and over-pronation (flat feet) are the two of the most common foot problems that are overlooked. In order to make the pregnancy period more comfortable, it is important to learn about foot care, and what can be done to relieve aches and pains.
Edema
Many of my pregnant patients tell me that their feet are noticeably swelling and ache with pain. Some even tell me their feet feel as though they are stretching like a balloon and are ready to pop. A certain amount of swelling is normal during pregnancy because more water is retained, and there is a change in blood chemistry causing fluid to shift into the tissue. As the uterus expands, pressure increases in the pelvic veins and large vein (vena cava) on the right side of the body that carries blood from the lower limbs to the heart. As the return of blood from the legs is decelerated, fluid is pushed from the veins into the tissues in the feet and ankles.
Some women also experience swollen feet and a larger shoe size due to the release of a hormone called relaxin. Although the feet appear to be growing, it is really an illusion because the hormone causes the ligaments to become lax and stretched out.
Roughly 75 percent of pregnant women experience edema, especially by the time they reach their third trimester. Edema is considered to be worse during the summer and at the end of the day. Edema is more strenuous for women who are carrying multiples, or for those who have excessive amniotic fluid.
Edema is annoying, to say the least, but it is normal and generally harmless. It is important to pay close attention if there is excessive or sudden swelling to the feet, hands, face, and puffiness around the eyes. Call your doctor promptly if these symptoms are present because it could be a sign of preeclampsia, a pregnancy-induced hypertension that occurs five to 10 percent of the time. Also, contact your doctor immediately if one leg is significantly more swollen than the other or if there is pain in the calf area. These conditions could be a sign of a blood clot.
The good news is that most women’s feet will be fine following childbirth and should return to their normal size. Here are some tips to minimize edema:
- Keep the body hydrated and drink plenty of water to flush your system of excess sodium and other waste products.
- Eat a well-balanced diet with low salt content.
- Elevate your feet and relax.
- Lie on your left side to improve circulation to your lower extremities.
- Avoid long periods of sitting or standing and take breaks if you are on your feet a lot.
- Do not cross your legs or ankles when sitting.
- Take several short walks if you are sitting for any length of time, and elevate your feet when sitting.
- Stay away from uncomfortable shoes (high heels) or shoes that constrict circulation.
- Measure your feet regularly and wear shoes to accommodate changing foot sizes.
- Wear seamless stockings that do not restrict circulation and sock fabrics, such as cotton instead of nylon, that allow your feet to breathe.
- Waist-high maternity support stockings are helpful but should be put on early in the morning.
- Walk regularly and exercise with modification.
- Use proper foot care hygiene by trimming your toenails, removing calluses, and using moisturizer to avoid dry and cracked skin.
- Give yourself a foot massage or ask your partner, family member, or friend to help.
- Take regular foot baths and apply lotion to your feet.
- Use laser therapy on your feet, ankles, and calves to reduce edema and aches and pain.
Over-pronation
Over-pronation (flat feet) is another common problem that occurs during pregnancy as a result of added weight gain. It occurs when a person’s arch flattens out during weight-bearing movement (like walking), causing the feet to turn in abnormally. The dense band of tissue that extends from the heel to the forefoot (plantar fascia) becomes strained and inflamed due to increased flattening of the feet. Walking can become very painful, and women may experience increased discomfort and strain on the feet, calves, and back. Regular exercise and proper footwear are the most helpful ways to minimize over-pronation. Helpful exercises include the following:
- Straight-knee calf stretch — Place the palms of your hands on the wall. Move one foot forward about 12 inches. Keeping toes pointed forward and both heels on the floor, lean toward the wall.
- Bent-knee calf stretch — Place the palms of your hands on the wall. Move one foot forward about 12 inches. Keeping toes pointed forward and both heels on the floor, bend both knees and lean forward.
- Ankle circles — Sit straight-legged on the floor or another firm surface. Rest your calf muscles on a rolled-up bath towel or blanket. Rotate your ankles in each direction for two minutes.
- Reverse calf raise — After removing your shoes and socks, sit with your heel at the edge of a telephone book or block of wood that is at least three inches high. Raise the front of your foot as far as you can, then lower it back down.
- Standing calf raise — Using a sturdy counter for balance, stand and lift one foot so you are supported by the other foot. Rise up on the ball of your foot and toes and back onto your heel.
- Exercise regularly — Walking, swimming, or riding an exercise bike is recommended. Water aerobics classes are also excellent.
Proper footwear
- Select the proper footwear and avoid going barefoot or wearing sandals or flip-flops because they do not provide support for your arch.
- Wear low-heeled shoes that are soft, comfortable, and provide room to move.
- Use ready-made orthotics or custom orthotics to provide arch support and shock absorption.
- Wear seamless socks that do not constrict circulation.
- Use laser therapy on your feet and ankles if you are experiencing plantar fasciitis, tendonitis, achiness, and pain.
Pregnancy should be a pleasant, enjoyable experience, but your feet need to be in good shape to carry you and your baby. Understanding the causes of foot pain and learning easy home remedies can help. Contact the Foot & Ankle Center of Illinois at 217-787-2700 to schedule an appointment, or stop by the Springfield clinic location if you are interested in purchasing specialty foot-care products. The Foot & Ankle Center of Illinois is located in seven convenient locations in Springfield, Decatur, Taylorville, Carlinville, Shelbyville, Sullivan, and Monticello, IL. Visit the patient library at myfootandanklecenter.com to view a short video on Cutting Edge MLS Laser Therapy for reducing edema and pain management and to learn about the benefits of custom orthotics.
Photo credit: Amanda Gardner Photography