During pregnancy, some women will get increasingly frustrated with shopping, since the clothes they just bought are too small shortly after they were purchased. Additionally, all of a sudden the shoe size that they have worn their entire adult life no longer fits. Lastly, the feet, ankles and legs seem to be increasing in size, as well as there being the presence of heel pain. There is no doubt that pregnancy can take a toll on the body, but why is an increasing baby bump leading to bigger feet, ankles, legs, and heel pain?
During pregnancy, hormones are constantly changing. Especially toward the end of pregnancy, there are more hormones that are released in order to make the ligaments, specifically of the pelvis, more lax. The ligaments need to be looser and be able to stretch so the baby can exit the birth canal. These hormones, do not just work on the ligaments of the pelvis, but rather all the ligaments of the body including the feet since the hormones are traveling via the blood stream. There are more than 50 ligaments in the foot alone, so when the hormones act on the ligaments, the ligaments become more stretched allowing the bones to slightly move away from each other. This leads to a bigger foot; during pregnancy, the foot may increase anywhere from a half size to one whole size! A quick side note for those patients who are not pregnant, but are noticing that their shoe size is increasing as well; this may be due to one ligament in the foot called the Spring Ligament, which is located on the bottom of the foot. The Spring Ligament is the only ligament in the foot that contains elastic fibers, so it will stretch naturally overtime leading to a slightly larger foot.
Additionally, the baby needs oxygen as well as the mother, so there will be an increase in oxygen carrying blood to reach the baby-this increase in fluid leads to the swelling noted in feet, ankles and legs, which will also increase shoe size. Remember that the feet will have the most swelling since gravity pulls all the fluid down, so this is a normal physiological response.
To decrease the swelling in the feet, ankles and legs:
- Wear prescribed compression stockings
- Elevate the feet
- Drink a lot of water and try to minimize salt intake
- Wear shoes that will accommodate the swelling-too small of shoes will lead to increased discomfort
Lastly, the heel pain experienced during pregnancy is due to the sudden increase in weight. On the bottom of the foot, there is what is called the plantar fascia. The plantar fascia helps to support the arch, but with the sudden increase of weight, the plantar fascia will be stretched and will pull where it attaches to the heel bone resulting in heel pain. This heel pain is called plantar fasciitis. This too can also be experienced in the non-pregnant patient for various reasons. Ways to decrease the pain caused by plantar fasciitis include:
- Give your feet a rest by taking a few minutes to sit during extended periods of activity
- Ice your feet when you are able
- Elevating your feet (will also help to reduce swelling)
- Wear over-the-counter orthotics for additional cushioning and arch support
Since the health of you and your baby are the most important, be diligent about going to your prenatal care appointments, as well as with following the doctor’s recommendations. The side effects stated above will be monitored throughout your pregnancy and will try to be reduced to provide you with more comfort.