Pregnancy causes many changes occur to the body. Despite the obvious changes in the womb itself, a number of other more subtle changes occur. One area that can be definitely affected by pregnancy are the feet. The feet are a pair of highly complicated structures that have a very important role in how we move. Despite being located at the end of the body, many conditions that affect the core of the body will have some affect on the feet. The numerous physiological changes that occur during pregnancy to prepare the way for carrying and delivering a child eventually trickle down to the feet.
Edema
The most common foot problem that occurs during pregnancy is swelling, or edema. The legs and feet can become enlarged with fluid retention, making shoes difficult to fit, and in some cases causing pain. The body must increase the volume of blood circulating around in the blood vessels in order to supply enough nutrients to the fetus to help it grow. This increased volume of blood can potentially overtax the system of blood vessels called veins and lymph channels, which return blood and fluid from the legs back to the heart. Additionally, fetal position can also effect the ability of the veins in the abdomen to allow leg blood to easily return to the heart. The veins eventually may also become varicose, which is simply an engorgement of veins seen superficially in the skin. In order to reduce edema, several techniques can be used at home to good effect. Elevation and avoiding standing for long periods of time is very helpful in reducing the fluid retention, and walking for short periods can help leg muscles pump fluid out of the legs and feet. If one must drive or ride in a car for a long trip, frequent stops with brief leg exercises can reduce fluid retention. Increasing water consumption and decreasing sodium in foods and certain beverages (like sports drinks) will also help the body rid itself of certain amounts of excess fluid. Cold leg soaks can also be helpful, as long as the time spent in the cold water is limited. Altering one's body position can also help to improve the effectiveness of fluid return to the heart. This includes avoiding sitting cross-legged, which can compress certain superficial veins, as well as resting on one's left side to decrease pressure to deeper veins. One must also consider increasing their shoe size temporarily to account for bigger feet and ankles. It should be noted that swelling to the face, around the eyes, or a sudden onset of swelling should be reported immediately to one's obstetrician, as it can be a sign of a more serious condition called preeclampsia.
Flat Feet
Another common foot problem seen in pregnancy is flat feet. This condition is seen later in pregnancy due to hormones which begin to relax the body's ligaments to prepare the birth canal for delivery. The pelvic bones need to become more flexible to allow this to happen, and the ligaments that hold the bones together must loosen. The hormones that allow this to occur will also effect foot ligaments as the hormones travel the body in the blood stream to get to the pelvis in the first place. As the foot ligaments loosen (and there are a lot of them), the structure of the foot become less rigid and some flattening of the arch occurs. Many people already have flat feet, and this can extend some what more in those individuals. Generally, this excess flattening does not cause much harm, and is not usually persistent after the pregnancy period is over. However, the feet can become more fatigued due to the decreased structural rigidity, and one's feet can be uncomfortable after standing for awhile. When this occurs, and as one's weight increases as the fetus grows, there is always the potential to develop a condition called plantar fasciitis. This condition develops when a band of tissue in the arch of the foot called the plantar fascia becomes strained due to increased flattening of the feet, and will develop chronic inflammation. It can persist beyond pregnancy and requires medical treatment for full relief. Unfortunately, many of the medical techniques used to cure this condition are not allowed during pregnancy, but there are many therapy and support techniques that can relieve the pain. In general, flat feet during pregnancy can be supported with stiffer-soled shoes (motion controlled athletic shoes are the best), along with a quality over-the-counter arch insert. If issues persist after pregnancy, a prescription orthotic insert may be of more help.
Toenail Changes
Pregnant women may also notice changes to their toenails. Due to the overall increase in circulation needed to feed the fetus, toenails can grow faster than normal. In addition to increased growth, changes in texture and structure may occur as activity at the nail root (cells which grow nail called the nail matrix) alters in response to the increased blood flow and pressure from any fluid retention in the toe. Additionally, pressure from tighter shoes due to the foot swelling can alter the nail growth pattern. These changes can include brittleness to outgrowing nail tissue, grooves in the outgrowing nail plate, as well as lines visible in the section of new nail outgrowth. Generally, these changes resolve as pregnancy ends and the abnormal nail grows completely out. No treatment is needed beyond normal nail care, unless the changes persist months after delivery.
Cramps
One final foot problem experienced during pregnancy is leg and foot cramps. There can be numerous reasons why these develop. It may not be entirely understood why pregnant women are more prone to developing cramps. General causes can include changes in calcium levels (which regulate skeletal muscle contractions), muscle overuse fatigue, or pressure on vital nerves and blood vessels by the fetus which can result in abnormal nerve stimulus or nutrient circulation to the muscle tissue of the legs and feet. This condition is treated like any other cramping situation, which includes stretching and exercise (walking) to stimulate normal muscle function, as well as a warm bath to relax fatigued muscles and promote normal muscle chemistry.
As one can see, pregnancy can have an effect on other areas of the body beyond the womb. Most are temporary and minor, with symptoms resolving shortly after delivery. However, certain kinds of swelling and any significant foot and leg pain needs to be reported to one's obstetrician, and may require a foot care specialist for full treatment.
