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  • Writer's pictureDaniel Selin

Leg pain during pregnancy

Pregnancy, foot pain, leg cramps, foot widening, loosening of ligaments, insoles, physical therapy

From the beginning of pregnancy, the body begins to prepare itself for the upcoming challenge, the birth of a new life. During pregnancy, the total amount of blood increases, breathing becomes more frequent, and ligaments loosen. These changes enable the embryo to develop and prepare the body for childbirth. However, these changes also bring new forms of stress and altered movement patterns, which can result in joint pain and stiffness for many expectant mothers as the pregnancy progresses. Feet are particularly affected due to the large amount of stress placed on them and weakened support.


During pregnancy, a woman's body secretes more of a hormone called relaxin, which as its name suggests, relaxes the joints and ligaments. This allows the baby to fit through the birth canal by softening the pubic bone and surrounding ligaments. However, the hormone's effect is not limited to the pelvic area, but rather the entire body, including the feet. This, combined with weight gain, changes in posture, and altered movement patterns, leads to changes in the foot structure and loading.


These changes cause the transverse and longitudinal arch structures of the feet to loosen, with weight shifting towards the front of the foot, resulting in a wider and longer foot, sometimes even up to two shoe sizes! These changes are often permanent and cause ankle and foot pain for many during and after pregnancy.


The position of the back, pelvis, knees, and hips also changes. This can cause back and leg pain during pregnancy. Weight gain and abdominal growth cause a shift in the center of gravity, resulting in a change in posture in the pelvis. The pelvis tilts forward, the lumbar curve increases, the hips and knees rotate inward, the arches of the feet collapse, and the weight shifts towards the balls of the feet. As a result, the small facet joints in the lower back become more compressed, the pelvis becomes less stable, and the movement patterns of the hips and knees change. This can lead to numbness or pain in the toes due to nerve compression or deformities such as hammer toes or bunions. Pain in the sole and heel of the foot is also common during pregnancy, often due to plantar fasciitis. Many also experience swelling and fatigue in their legs, which is related to weakened venous circulation as the growing belly presses on the veins.

 

Prevention and care

Swelling and associated leg fatigue during pregnancy can be alleviated by brisk walking, cycling, or swimming, depending on how far along the pregnancy is. The goal is to increase muscle activity in the lower limbs and activate the muscle pump system. This improves venous blood flow, allowing the fluid causing swelling to move more efficiently and reducing the likelihood of swelling. Additionally, it's a good idea to elevate the legs for about fifteen minutes each evening, which helps gravity aid venous blood flow. Clothing and compression stockings also seem to play a significant role in reducing swelling by increasing external pressure on tissues, preventing the accumulation of fluid. Therefore, the use of compression stockings and compression garments can reduce existing swelling and prevent future swelling.


We cannot, nor do we want to, change weight gain or the production of the relaxin hormone during pregnancy. However, with the right exercises, shoe choices, and individual support, we can reduce the negative effects of these factors.


Taking breaks to stretch and doing short walks is recommended, as prolonged sitting or standing weakens blood circulation in the lower limbs and increases swelling.


Localized training can also reduce foot pain during pregnancy. This involves targeted strength training to assist the stretched ligaments. This training can be done throughout the pregnancy. It's particularly important to maintain the muscles that raise and maintain the arches of the feet and strengthen the lower limbs as a whole, as well as the muscles that support and control the pelvis and lower back, such as the buttocks, back, and abdominal muscles. It's also worth maintaining and practicing good posture and movement control because the changes that occur in the body can change the positions and patterns of movement of the limbs. An experienced physiotherapist can develop an individualized program that meets your specific needs.

 

Can support insoles help with foot pain during pregnancy?

A functional yet surprisingly underutilized way to reduce foot pain during pregnancy is to have customized insoles made to support the foot structures during pregnancy. This reduces stress on the joints, minimizes ligament stretching, and avoids major changes in the alignment of the lower limbs.


By supporting the foot structures, the collapse of foot arches and the related enlargement of the foot, rotation of the knees and hips, tilting of the pelvis forward, increased lumbar lordosis, and related joint pains can be reduced. Supporting the foot also affects the load on the pelvis and spine. At the same time, insoles distribute the forces on the foot, avoiding peak loading that easily leads to overuse and pain. Insoles can help relieve foot pain during pregnancy quite quickly, especially when they are used early enough.


It is advisable to have the insoles made early enough, at the latest during weight gain, so that the feet get the support they need before changes have already occurred. It is much more difficult to reverse changes that have already occurred than to be proactive. Footwear selection can also affect foot health during pregnancy. The shoe sole should have sufficient cushioning, be flat but flexible, and the shoe should be adjustable so that it can be worn even if the foot swells. High heels should be avoided but they are not entirely forbidden.


Overall, customized insoles can be a highly effective and often underutilized solution for alleviating pregnancy-related foot pain. To ensure the best possible outcomes, it's important to consult with a physiotherapist who can assess your unique needs and create a personalized plan for the duration of your pregnancy. Don't let foot pain put a damper on this exciting time in your life – take steps to address the issue and enjoy a more comfortable pregnancy with the help of individualized insoles.

 

Self care

  1. Exercise regularly: Regular low-impact exercise such as walking, swimming or prenatal yoga can help reduce leg pain during pregnancy.

  2. Wear comfortable shoes: Avoid wearing high heels or shoes with little support, which can worsen leg pain.

  3. Take breaks and elevate your legs: Try to take frequent breaks throughout the day to elevate your legs and reduce swelling.

  4. Stay hydrated: Drinking plenty of water can help keep your body hydrated and reduce leg cramps.

  5. Practice good sleep habits: Sleep on your side with a pillow between your knees to help alleviate leg pain.

  6. Use compression stockings: Compression stockings can help improve circulation and reduce swelling in the legs.

  7. Massage and stretch: Gentle massage and stretching exercises can help reduce tension and improve blood flow in the legs.

Remember to always consult with your healthcare provider before starting any new exercise routine or treatment during pregnancy.

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