As we move closer to Mother’s Day, I thought it fitting to dedicate this article to the pregnant moms who are with child. According to a recent article in Glamour magazine, there is a baby boom in Hollywood that includes such stars as Mia Kunis and Ashton Kutcher, Christian Bale and Sibi Blazic, Scarlett Johansson and Romain Dauriac, and Drew Barrymore and Will Kopeman. Like all pregnant moms and expectant fathers, I am sure they too have a lot to think about and do to get ready for the arrival of their new baby. Moms are busy decorating the nursery, making frequent visits to their OBGYN, sending party favors for baby shower gifts, changing diets and thinking about names. Expectant fathers are busy trying to give a little more TLC, making frequent trips to the grocery store to satisfy insatiable cravings and making dry rehearsal runs for the moment they get “the call.”
All these things are essential, but far too little attention is given to mothers' feet, and how to get them fit to carry both her and baby during the pregnancy. 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.
Many of my pregnant patients tell me that their feet are noticeably swelling and ache with pain. Some even tell me their feet feel like they are stretching like a balloon and 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 a false 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 in 5 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) that are too narrow or short ones 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 (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. Here are some tips to minimize over-pronation:
— Straight-Knee Calf Stretch: stand arm’s length away from a wall. 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. Bend your forward leg, but keep you back leg straight. Hold for 10 seconds. Relax and repeat with other leg forward. Repeat exercise for 10 times, three sets a day. Do not arch your back or hunch your shoulders during this exercise.
— Bent-Knee Calf Stretch: stand arm’s length away from a wall. 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. Hold for 10 seconds. Relax and repeat with other leg forward. Repeat exercise for 10 times, three sets a day. Do not arch your back or hunch your shoulders during this exercise.
— 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. Repeat this exercise three times a day. Elevate your ankle above your hip if it is swollen.
— Reverse Calf Raise: After removing your shoes and socks sit with you 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. Repeat with each foot for twenty times. Do three sets a day.
— Standing Calf Raise: Using a sturdy counter for balance, stand and lift on floor so you are supported by the other foot. Rise up on the ball of your foot and toes and onto your heel. Repeat this 30 times on each foot and do three sets a day.
— Exercise: Walking, swimming, or riding an exercise bike is recommended. Water aerobics classes are also excellent because immersion in water may temporarily help reduce swelling, particularly if the water level is up near your shoulders.
— 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 and pending motherhood should be a pleasant, enjoyable experience. 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 Dr. Sigle at (217) 787-2700 for more information or to schedule an appointment or visit myfootandanklecenter.com.