Research shows that pregnancy can negatively impact foot health. One study showed that 50% of pregnant women reported issues in the feet, including unsteady gait, swelling, and increased foot width. While some foot issues disappear after you have your baby, others can create permanent changes in the structure of your feet. Many care providers will tell expecting mothers that foot problems regularly occur during pregnancy and are part of having a baby. Rather than brush off these symptoms as a side effect of pregnancy, let’s examine the causes of foot issues and the evidence-based methods to prevent or relieve these problems.
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Your feet are complex structures. Each foot has 26 bones (28 if you count sesamoids), 30 joints, more than 100 muscles, tendons, and ligaments, and around 200,000 nerve endings. Of course, we use our feet to stand and walk. We may not appreciate everything they do, like allowing us to make complex movements, play sports, absorb shock, or simply balance. If you have ever injured your foot, you know firsthand how debilitating it can be not to have your feet healthy and able to do their job.
Pregnancy Impacts Your Feet
Research shows that pregnancy imposes a negative impact on foot health. This study outlines many of the issues that can arise in your feet during pregnancy and calls for better patient education and management of foot health. Many care providers will tell expecting mothers that foot problems regularly occur during pregnancy. One study showed that 50% of pregnant women reported issues in the feet, including unsteady gait, swelling, and increased foot width. Rather than brush off these symptoms as a side effect of pregnancy, let’s examine the causes of foot issues and discuss the evidence-based methods to prevent or relieve these problems.
Pregnancy Changes that Impact Your Feet
Let’s start with some of the symptoms you could experience during pregnancy that can impact your feet.
A significant role of your feet is to support the weight of your body. Weight gain during pregnancy is inevitable. The American College of Obstetricians and Gynecologists recommends that you gain between 25-35 pounds during your pregnancy, assuming you start your pregnancy at a healthy weight. Even with these guidelines, most pregnant women are not gaining weight within the suggested ranges. One study that examined over 18,000 pregnancies found that just 25.8% of women gained weight within the recommended ranges, with 21.3% gaining less and 52.9% gaining above. Maintaining a healthy weight before, during, and after pregnancy can decrease the strain on your feet.
Your doctor or midwife will monitor your weight as a metric of your health during pregnancy. Your energy is better focused on healthy habits than the number on the scale. Any steps towards overall improving your health by eating well, physical activity, and prioritizing basics like sleep and hydration will positively impact your weight in the long run. See this episode for more information on healthy weight gain during pregnancy.
Your Center of Gravity Shifts
Most of the weight you gain during pregnancy is in your belly. As your pregnancy progresses, your growing belly shifts your center of gravity forward. This can change how you walk and distribute pressure across your feet.
Relaxin is a hormone that relaxes your ligaments. This is necessary and will help when you are in labor and giving birth. The downside is that relaxin doesn’t only concentrate its effects on your pelvis and hips before birth. This hormone can affect your entire body throughout your whole pregnancy.
You have 30 ligaments in each foot that can be affected by relaxin. The longest of these is the plantar fascia that runs from your toes to your heel and forms the arch of your foot. Relaxing these ligaments, especially in your plantar fascia, can permanently change your foot’s shape and structure. Relaxin can contribute to your arch collapsing and overpronation. This can lead to your feet increasing a shoe size, developing bunions, and stress and inflammation on the tissue that runs along the bottom of your feet. It’s natural for your feet to flatten during pregnancy, but too much flattening can cause foot pain and increased strain on your knees, legs, and back.
Loss of Arch and Over-Pronation
A study that examined arch height changes postpartum found that pregnancy can lead to lasting changes in foot structure. 61% had an increase in foot length, and 71% had a drop in their arch height. 22% of women reported an increase in shoe size.
A decrease in the arches of your feet causes your feet to flatten out, resulting in overpronation. When you put weight on your foot, your feet roll inwards because your arch isn’t there to help support your foot. This problem can create stress and inflammation on the tissue that runs along the bottom of your feet, called your plantar fascia. That inflammation can morph into plantar fasciitis, which can be painful. Over time over-pronation can lead to pain as strain increases on your feet, legs, and back. Over-pronation can be so severe that even walking becomes painful.
While you have limited to no control over your weight gain or hormone levels during pregnancy, you can opt for footwear with arch support to try and prevent overpronation and relieve some of the effects if your arches have started to flatten out.
Researchers in a study that identified lasting changes in foot structure during pregnancy suggest the need to assess whether using inexpensive, well-tolerated, and widely available arch-supporting orthoses during pregnancy could potentially protect the long-term musculoskeletal health of women.
The American College of Obstetricians and Gynecologists recommends wearing supportive shoes to prevent or ease back pain during pregnancy. ACOG states you should wear low-heeled (but not flat) shoes with good arch support, such as walking or athletic shoes.
One way to ensure your shoes have good arch support is to use insoles. Insoles slide right into your flats, boots, or athletic shoes and instantly make any pair of shoes more comfortable. In addition to helping preserve your arch, research demonstrates that wearing insoles can help with lower back pain. I highly recommend the insoles from Mommy Steps. Save 20% off with the code FEET.
Quality of Life
Quality of life is the degree to which an individual is healthy, comfortable, and able to participate in or enjoy life events. One study examined pregnant women’s foot health and the impact on their quality of life. The research revealed that pregnant women present lower scores on the dimensions related to the quality of life related to foot health than the non-pregnant control group. Not only can foot pain impact your quality of life, but other factors like footwear options and your ability to comfortably participate in social activities can also take a toll.
As your arches gradually collapse, the metatarsal bone can shift outward and create a bunion. This is a misalignment of a bone in your foot that creates a bony bump at the joint of the base of your big toe. This shifts your big toe to point towards your other toes rather than straight ahead. There is also something called a bunionnette that can develop at the joint of your little toe on the outside of your foot. A bunion can range from mildly uncomfortable to very painful. Plus, this changes the shape of your foot, which may make it difficult to fit into some shoes.
In the best case scenario, you prevent bunions in the first place. The key to prevention is to wear footwear that will help maintain the integrity of your arch and keep your arch from collapsing and shifting your metatarsal bone outward. Wearing insoles with arch support can assist by adding additional arch support to athletic shoes or creating arch support in flats.
If you have a bunion or are developing one, you need to wear comfortable shoes or use insoles with arch support. This can prevent your bunion from worsening and provide some relief by distributing pressure more evenly as you walk. You can try soaking your feet in a warm bath or ice them. As a last resort, surgery can be an option.
Another issue that can affect your feet is edema. Several physical changes can contribute to edema (swelling) during pregnancy. You have 45% more blood and fluids in your body. Your growing uterus puts pressure on the blood vessels in your pelvis and legs. This pressure can slow down circulation and cause blood to pool in your legs, ankles, and feet. Plus, elevated hormones during pregnancy can make the walls of your veins softer, which makes them not work as effectively. Swelling can also cause numbness, tingling, or your legs and feet being achy. Heat exposure and higher sodium levels can exacerbate swelling.
Thankfully, many interventions can help prevent or relieve swelling. The easiest way to reduce swelling in your feet and ankles is to elevate your feet as often as possible. Ideally, your feet are above your heart. This elevation helps the fluid pooling in your lower extremities move toward your pelvis.
From an evidence standpoint, elevating your feet is just as good, if not better, than water immersion to reduce swelling. If you combine exercise with water immersion, you may have better results. One study found that exercise in a pool helped reduce swelling. There is evidence that foot massage can have a beneficial effect on swelling.
Compression stockings that generate variations in pressure as they go up your leg may help. It may seem counterintuitive, but staying hydrated will help your body retain less fluid. If you are dehydrated, your body wants to hang on to as much liquid as possible, which can contribute to edema.
See this episode to learn more about why swelling happens, how to prevent and treat it, and when you should call your doctor or midwife.
Walking and Movement
A study found that changes in pregnancy and your feet can also affect your gait. While factors like decreased walking speed sound harmless, this can cause greater rotation of the sacroiliac joint, which connects your hip bones to your sacrum. Ultimately, this can cause musculoskeletal pain and discomfort. The primary symptoms in this study were ankle edema, reported by 80% of participants, and an increase in foot width, reported by 78%. A decrease or collapse of your arch will cause your feet to be wider. This is yet another reason to support and protect your arch during pregnancy.
Taking Care of Your Feet
Your feet work very hard to support your weight and movements. In addition to taking steps to take care of them, like wearing supportive shoes or insoles to protect your arch, consider giving your feet some love. Give yourself permission to relax with your feet elevated. Ask your partner for a foot massage, or give yourself one. Enjoy a foot soak. Treat yourself to a pedicure at home, at a nail salon, or at a spa. All the hard work your feet are doing is a perfect excuse for pampering and a little self-foot-care.
Talking to Your Doctor or Midwife
If you are experiencing any issues with your feet or have questions, please talk to your doctor or midwife. While many pregnancy-related symptoms may get brushed off as temporary, please advocate if you are concerned about long-term changes to the structure of your feet. You may also consider seeing a podiatrist who specializes in foot health.
Thank you to the amazing companies that have supported this episode.
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