Pregnancy places a considerable amount of changes on the body to allow for the normal development of the baby. Foot and leg pain is a common complaint from pregnant woman and is often over looked. Several changes to the human body during pregnancy affect the lower limb specifically and these include:
1. Weight gain: Increased body weight during pregnancy will ultimately increase the forces which travel through the foot, ankle, knees and hips during the gait cycle.
2. Ligament laxity: This is caused from naturally produced hormones which prepare the body for labour however means that the joints within the feet and ankles are less stable. In some women, this allows the arches of the feet to drop or “pronate” more than usual.
3. Alteration to spinal alignment: During pregnancy, an increase in lumbar lordosis occurs in the lower back, causing forward displacement of centre of mass. This will ultimately influence changes in stance such as the width of stance and forces in the feet and knees.
4. Dilation of the lower limb veins: Thigh veins tend to dilate during gestation, causing swelling and fluid retention in the legs. This is caused by hormone induced sodium retention which is a natural process during pregnancy. Edema can worsen if the enlarged uterus intermittently compresses the inferior vena cava during recumbency. This compression will obstruct the outflow of both femoral veins in the legs and increase fluid retention in the legs and ankles.
These changes can alter the normal gait pattern of the mother to be and can lead to lower back and limb pain. Pain or discomfort can be avoided by adopting appropriate preventative strategies such as the following:
- Wear seamless socks to prevent restricted circulation.
- Wearing appropriate supportive footwear to prevent injury from altered joint mechanics. Avoid wearing high heel shoes during pregnancy due to increased risk of falls.
- Elevating feet daily above heart level. This eliminates gravitational pull of fluid into the legs and assists with venous outflow.
- Keep hydrated by drinking plenty of water to reduce fluid retention.
- Exercise regularly for general health and to avoid excessive weight gain.