Does being pregnant take away the swing in your step and replace it with leg cramps? Here’s what you need to know plantar fasciitis in mums – one of the causes of foot pain during pregnancy.
What is plantar fasciitis?
When you are pregnant, some of the advice that most people will tell you is to “Slow down,” “Take it easy,” or “Don’t spend too much time on your feet.” Do you wonder if it ever has something to do with the foot pain we experience during pregnancy?
Pregnancy has been known to bring about many changes in a woman’s body. Unfortunately, some of these changes cause pain and discomfort with the most changes affecting your feet. Plantar Fasciitis, for instance, is one of such common effects.
When the plantar fascia, the chunky loop of connective tissue that extends from your heel to your toes beneath your foot swells or gets irritated, it brings on Plantar Fasciitis. Do you feel increasing pain when climbing the stairs? Or when you stand for extended periods or on your toes?
Chances are you have developed plantar fasciitis, which is somehow responsible for foot pain during pregnancy. To a certain extent, Plantar Fasciitis is more frequent in women than men and more so in pregnant women.
Causes of Plantar Fasciitis in pregnant mums
There are many factors that could cause changes in an expectant mom’s body, but what could be the culprit of foot cramps and pain in pregnancy? The main causes of Plantar Fasciitis in pregnant women are:
a) Loosening and softening of ligaments caused by relaxin
When you get pregnant, there is a hormone known as relaxin that is released from your placenta, your uterus lining and the membranes surrounding the foetus.
Its levels are usually at their highest during the first three months in order to help implant the developing foetus into your uterus’s wall and increase placenta growth.
Throughout your pregnancy, relaxin takes care of you as well through controlling the changes in cardiovascular output, renal system and arterial functioning in your body.
It is however during the third trimester that relaxin softens and relaxes the ligaments on all sides of your hips and pelvis to enhance flexibility.
Much as this will ease labour when the time comes, it gets a bit tricky because it softens your other body ligaments like those of the knees and feet hence reducing your stability, meaning chances of falls and slips increase; and also weakens your foot arch muscles, making the Plantar Fascia more susceptible to injury.
b) Increase in weight
So you have added a few pounds and probably feel alien to your own body. The increase in weight is, of course, necessary for you and your baby’s health. However, it is also another major cause of Plantar Fasciitis in pregnant women.
A study done found that pregnant women in their last two trimesters had higher forefront pressure while standing and walking than overweight women. This increased pressure coupled with loose ligaments strains the Plantar Fascia causing it to swell and tear which is what podiatrists refer to as Plantar Fasciitis.
Commonly referred to as flat feet, overpronation is when the arches of your feet flatten significantly due to the increased weight and also changes your gait as feet roll inwards while you walk.
Podiatrists confirm overpronation as very common in pregnant women and assess that it causes Plantar Fasciitis by extremely stressing and inflaming the Plantar Fascia making it difficult and painful to walk.
Symptoms of Plantar Fasciitis
Most reported symptoms of Plantar Fasciitis include:
- Stabbing pain and stiffness beneath your heel which sometimes occurs in your mid-foot area.
- Pain when taking your first steps after a period of inactivity like sleeping, sitting or driving for long hours. These pains normally ease after walking for a few minutes.
- Pain from applying pressure on certain parts of your foot and zero pain on applying equal pressure on other parts.
- Crippling or great pain after prolonged exercising, standing, walking or other activity.
As some common pregnancy side effects such as nausea and morning sickness tend to subside or lessen as the weeks go by. Plantar fasciitis or leg cramps tend to get worse as the woman’s pregnancy progresses.
Leg pain during pregnancy – how it changes
Image source: iStock
For instance, leg cramps during the first trimester are very minimal. Just a bit of ache and pains that may be brought about by the change in hormone levels and the sluggish feeling brought about by fatigue.
If you’re used to being always “on your toes” then suddenly you have to stop. The lack of exercise could also contribute to leg cramps.
If you were spared from leg pain during the first trimester, then it would most likely develop during the second trimester. When your blood circulation slows down and there’s an increase in blood volume.
Finally, you’ll find that leg cramps during pregnancy in the third trimester is the absolute worst. Because that’s the time that you’ve gained a lot of weight and your muscles get fatigued from the added pressure of carrying your baby in your womb.
You can even experience leg cramps during pregnancy while sleeping if you sleep with your bedding tucked in with your toes pointing downward.
However, don’t worry as it will definitely get better once you have given birth and the weight will be lifted off your belly.
Swollen feet and ankles during pregnancy
Aside from leg cramps, your foot pain may even be accompanied by swollen feet or ankles.
Elevated hormone levels cause pregnant women to retain a lot of water, which can lead to bloating and swelling, also known as oedema. While your body needs this extra fluid to carry nutrients and oxygen to your baby, it can cause worry and discomfort in pregnant women.
Because your growing uterus puts too much pressure on the veins that carry blood in your lower body, fluid retention is more noticeable in your feet, ankles, and calves.
Some of the triggers for oedema in pregnancy include fatigue, exercising, eating salty foods, excessive intake of caffeine, and being on your feet for a long time.
When is it not normal?
While swelling in pregnancy isn’t usually a cause for concern, consult your OB-gynecologist right away if you notice swelling of your hands and face accompanied by blurred vision, severe or constant headaches, and excessive weight gain (more than 1 pound a day) as this can be a warning sign of preeclampsia, or high blood pressure in pregnancy.
Moreover, you should also inform your doctor if you experience severe leg cramps or a lot of pain in your legs when you’re standing or moving around, severe swelling, and the skin in the affected area is warm to the touch, as it may also be a symptom of a blood clot caused by deep vein thrombosis (DVT), which can cause complications to your pregnancy.
How to treat foot pain in pregnancy
Leg cramps and swollen ankles can cause a lot of discomfort in pregnant women. It can affect your disposition as well as your routine and your sleep. But not to worry, mums, because there are a ton of treatment methods that you can try to ease foot pain in pregnancy.
We divided treatment methods into two sections:
The treatment methods can be divided into three sections:
a) Home treatment/DIY remedies
Among the basic do-it-yourself treatments you should try are:
- Take plenty of rest by avoiding any activities that worsen the pain or cause a great impact on your feet like running. As you lie down podiatrists suggest you raise your legs at least 6 inches above your heart for 15 minutes in order to improve blood flow.
- You could also ice your feet daily for about 20 minutes 3 to 4 times either by using an ice pack, ice block or rolling your feet over a cold water bottle. Ensure to consult your obstetrician before using ice.
- Some simple calf and Plantar Fascia stretch 3 to 5 times daily will elongate your heel cord since Plantar Fasciitis is heightened by tight muscles in your feet.
- Focus on buying shoes and slippers that offer arch support and efficient cushioning. This will prevent tiny tears in tissue cells caused by the pressure felt on your heels as you move. Heel pads also provide cushioning.
- Use a night splint to hinder the Plantar Fascia from shortening while you sleep and effectively stop the pain.
b) Non-surgical treatment
- Over-the-counter non-steroidal anti-inflammatory painkillers such as ibuprofen, and paracetamol will relieve pain and reduce swelling. If you experience stomach pains see your doctor for an alternative prescription.
- A steroid injection notably cortisone which is an anti-inflammatory medication will ease your pain by reducing the swelling. Multiple uses could, however, rupture the plantar fascia or shrink your heel’s fat pad elevating your pain.
- Extracorporeal shock wave treatment to try and stimulate the healing process of the damaged tissues. ECWT does not involve a surgical incision and is often tried before considering surgery.
c) Surgical treatment
You should only consider surgery if after 6 months plus of persistent non-surgical treatment fails and pain is restricting your day to day activities. The two surgeries that can be done are:
- Gastrocnemius recession surgery is done to lengthen your calf muscles and increase the ankle’s motion. It is, therefore, appropriate only if you have trouble moving your feet despite months of doing calf stretches. It can be performed with an open incision or an endoscope. Though not common, it could lead to nerve damage.
- Plantar Fascia release is whereby your Plantar Fascia ligament is partially cut to ease tension and remove a large bone spur if noticed. It is recommended if you have normal ankle flexibility but continued pain. Postoperative problems include incomplete pain relief or nerve damage.
Remember Plantar Fasciitis does not end on its own after childbirth so take care of your feet now that you have the time to avoid inconveniences from the condition when your baby comes.
If you are feeling intense pain in your legs when you are pregnant, do not hesitate to consult your gynaecologist to pinpoint what is causing it and provide appropriate treatment.
Updates by Camille Eusebio