Pregnant women experience many changes throughout their body and their feet are no exception. Towards the end of the second and throughout the third trimester, there are hormonal, postural and anatomical changes that can lead to foot discomfort. The most common complaints that The Foot Practice team see during pregnancy are ingrown toenails, callouses, cracked heels, swelling and generalised foot and ankle pain.

Altered Biomechanics

The gradual weight gain experienced by expecting mums can have an impact on the biomechanics of the feet as the centre of gravity shifts as pregnancy progresses. Furthermore, During pregnancy, there is an increased level of the hormone relaxin in the body, which is needed to loosen the ligaments of the birth canal and pelvis, in preparation for child birth. This hormone also causes an increased laxity in the ligaments of the feet , which may cause flattening of the arch of the foot and/or excessive rotation of the ankles. With increased weight and altered biomechanics comes increased forces that are placed on the feet, knees, hips and back. It is common to experience conditions such as metatarsalgia, bursitis, neuroma, plantar fasciitis, tibialis posterior tendonitis or increased corn and callus formation as a result of these biomechanical changes.

Of course the type of foot wear you decide to wear will hugely impact your foot health during pregnancy. Although not always appropriate, athletic footwear is the best choice for pregnant women, especially if most of the day is spent walking or standing. Shoes may also need to be purchased slightly larger, to accommodate foot changes. Alternatively supportive slippers or sandals with arch support are now available for those who simply don’t want to wear such restricted shoes in Singapore’s hot humid climate.

Where footwear alone does not help then foot orthoses may be beneficial during pregnancy, as they improve foot function during walking and redistribute load away from pressure areas. They support the medial longitudinal arch of the foot, which can reduce loading through the plantar foot structures. Padding can be added to the orthoses, to more specifically alter foot loading patterns for pregnant women.

Swelling And Cramping

Swelling in the feet, otherwise referred to as oedema, normally occurs in the latter part of pregnancy due to a number of changes that occur within the body. Increased blood volume, extra pressure on the blood vessels in the legs and pelvis and increased water retention all have an effect. Cramping is usually caused by altered calcium levels, muscle fatigue and increased pressure on nerves and blood vessels. It is usually swelling and altered foot shape that puts pregnant woman at more risk of developing ingrown toenails, especially if footwear is too tight.

To help minimize the swelling there are some little changes you can incorporate in to the day. For example; Legs should be elevated at the end of the day, take regular breaks during the day to sit down with feet up, simple Calf and foot exercises can reduce fluid retention in the feet, ankles and lower legs. For symptomatic relief of cramping daily massage and lower leg exercises are recommended. Of course always have your feet measured and be sure to wear a bigger shoe to accommodate any swelling.

It is important to see a podiatrist who will assess and provide professional advice if you are experiencing any foot problems that may be related to your pregnancy. At The Foot Practice we can perform an in depth biomechanical assessment and gait analysis or we are happy to help even if it is simple advice on footwear. If you simply find cutting your nails too difficult then we can do your nail cutting for you.

Peter Barker, Podiatrist

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