Pregnancy Feet Pain: What can you do?

Foot and heel pain in pregnancy can be a really hard condition.  As women gain weight, feet changes and changes in the pelvis can really make foot problems an issue.  Let’s talk about how to keep our feet healthy as we navigate pregnancy.

But first, how do I know all of this? Hi — I’m Hilary — The Pregnancy Nurse 👩‍⚕️. I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. 🩺​ I have seen a LOT of women with foot pain in pregnancy, as well as my own plantar fasciitis experience to draw from, so let’s get your feet feeling better!

Changes in Feet in Pregnant Women

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You might be wondering why your FEET have issues when you are growing a baby.  But, as your entire body has to shift and change in an expectant mother.  The pregnancy hormones have an effect on your whole body.  But, today we’re going to specifically talk feet. 

Keep in mind that pregnant women experience a changing center of gravity that will affect all areas of your body including your back, neck and even feet.  As your bump grows, your body has to adjust to keep you upright.

A woman’s body goes through a lot of changes as they progress into their third trimester.  Let’s talk about some of the common causes of heel pain or sore feet.  Please note, if you have severe pain I think it is worth a call into your regular doctor (your OB doesn’t know much about feet).

Swelling of the Feet

It is very normal to have some swelling or fluid retention during pregnancy. Your blood volume dramatically increases to feed both your body and the baby’s.  This puts some extra fluid into your tissues. So, swelling is very normal, which can change your foot size.  FYI,  It is no longer considered an indicator of PIH — as we’ve learned that some swelling is normal.

This can, however, change your shoe size, especially in the third trimester. Don’t keep wearing the smaller shoes.  During pregnancy I often only have one or two pair towards the end that feel comfortable.  Just wear those out.  The good news is that your feet should go back to their previous size afterwards.

If you’re on your feet for a long time each day, you may want to talk to your provider about some compression socks to help this and any lower extremity water retention, you may also find that limiting salt intake helps.

Pro Tip: While you might think it’s best to limit fluids because of swelling, it’s actually important to drink plenty of water so you body can flush all that extra swelling out!

Natural Weight Gain

Of course, as you grow a baby you are going to gain weight.  Weight gain happens from the baby, the amniotic fluid, the extra blood volume plus the placenta.  Is is also not unusual to have some overall extra weight gain due to hormonal issues and changes in eating patterns.  This additional body weight can create flat feet in pregnant patients.  Maintaining a healthy weight can help your feet as well.

Arch of the foot

Because of the swelling, and the added weight you may have some changes in the arch of your foot — giving you flat feet or other foot conditions.  If you’re going to be on your feet for long periods of time, make sure to wear shoes that provide your arch extra support. I love this brand.

If you’re the easy explanation as to WHY your feet hurt, I think you’ll love The Online Prenatal Class for Couples — tons of information to help simplify pregnancy and birth.

Foot Pain in Pregnancy

Beyond these issues there can be actual structural issues that happen with you feet during pregnancy.

Plantar Fasciitis in the Pregnant Woman

Plantar Fasciitis (inflammation of the plantar fascia) is caused when the Planta Facia is stretched in weird ways. While the plantar facia is just in your foot area, it is attached to other ligaments and tendons that stretch up through your pelvis. You can learn more about it here. I also have a whole post on heel pain during pregnancy.

Most often that pain is felt near your heel.  That can mean the back of your foot, directly under your heel, or as the heel extends into the arch.  It can feel achy, tight stabbing or sharp pains — all of those are common plantar fasciitis complaints.

I had this problem BAD in my last pregnancy, and it took me a long time to figure out why.

For most people the plantar fasciitis happens due to something in the foot.  Not wearing enough good arch support in your shoes, or the wrong type of shoes.

Mine, however, was due to pregnancy.  As hormonal changes made my pelvis relax (which can also call symphysis pubis separation, which I also had — I just never realized the two were related) my pelvis shifted how the plantar facia was being stretched into my legs.

When I realized that I had to stretch out the backs of my thighs more with stretching (talk to your doctor about some good stretches for you) it really started to help.  I also started wearing a pelvic girdle and it helped as well.

And yes, this was arch pain.  Which is why I didn’t even think my pelvis was involved.  But since that facia is all connected it really does make sense.  It wasn’t due to my arch height at all.

In each pregnancy my pelvis problems got worse, and hence the plantar fasciitis got worse.

Also, because I worked as a nurse — all the really hard surfaces I was always walking on were putting extreme stress on my feet — nurses VERY often get plantar fasciitis.  So, be mindful of where you’re walking as it might be making your painful feet worse.  There are pads that can be placed under you if you stand on a hard surface for a long period of time (like cashiers).

Home Treatment Options for Plantar Fasciitis

Remember that this involves your entire lower extremities, so while it can be tempting to think that an ankle surgeon can help (because that’s where it hurts) it’s much more than that.  The best way is usually stretching daily — possibly even morning and night. I have a whole post on ankle pain in pregnancy too.

I did, in fact, visit a foot doctor (podiatrist) but he just gave me exercises and I think I would have spent my time better with a physical therapist.

But, here are my best tips for helping your heel pain during pregnancy:

Wear comfortable shoes

Making sure that you’re not wearing shoes that hurt in the first place.  Stop placing your foot health (because it can have longer term effects) above wearing the cute shoes!  Comfortable footwear will also be important as you begin your life as a busy mom — so some new shoes might be in order!

Wear supportive shoes

A lot of pregnant women love flip flips — but they may not provide the support in your arch that you need.  There are a lot of great, supportive flip flops out there – -so just keep that in mind as well.  Get shoes with great shock absorption as well.  It will really help your feet not take as much trauma each time you step.

You may also find that footwear with appropriate arch support helps (or inserts — I like these).

Pain Relief

If it’s really hurting, you can check with your provider if there is any pain relief options that could help.  After pregnancy I used some essential oils for my plantar fasciitis, but I wouldn’t recommend them during pregnancy (but talk with your provider)

Physical Therapy

If all of this seems over your provider’s head, maybe ask for a physical therapy consult.  They are trained to consider your pelvis and how it is affecting your feet — and can help you start some stretching and exercises that can help.  I found that stretching my calf muscles was VERY helpful!

Pro Tip: Calf pain (especially if redness, or heat is also there) can be a blood clot — so be watchful of that if you have leg pain.

Elevating Your Feet

Elevating your feet, especially if swollen can help take pressure off of your aching feet.  It is a great time to get your kicks counts done too.  I normally just put a few extra pillows at the end of the couch for my feet.

This is extra important at the end of the day — so don’t feel like feet propped up time is wasted.

Foot Massage

Thes can sometimes feel great for pregnant women, but sometimes the stretching in the foot area can be really painful.  Might be worth a try as well!  Massage can get improved blood flow to the area which can help when combined with stretching.

Custom Orthotics

If your insurance allows it, you could have custom orthotics made at a podiatrist.  Or, you can buy a pair on Amazon (which is what I do now).  It helps any shoe give you more support and fit better.  Super handy.  Also, I found that wearing shoes with a higher heel helped that fascia not stretch as much. High heels actually helped mine (although some find it makes it worse).

Ice Packs

Some people find that ice packs help their heel pain.  I kept a frozen water bottle that I would roll under my arches to help out. For generalized food pain many people find that cool water helps.

Other Common Foot Complaints in Pregnancy

Heel Spurs

Heel spurs are caused when a little growth comes off the heel bone and can rub against shoes etc.  Most often, women notice these as their feet are swollen and favorite shoes just aren’t fitting as well PLUS a small heel spur.  Pregnancy wouldn’t cause an increase in heel spurs as far as I know.

Many expectant mothers think that plantar fasciitis is a heel spur, when it is not.

Varicose Veins

This is a very common issue in pregnancy.  It happens when blood vessels have extra blood volume (think of a very full hose) plus the added pressure of the baby weight on the lower abdomen.  It makes those veins pop out.  They can be tingly, itchy or sometimes painful.  

The good news is that they will likely go back to normal after you have your baby.  Talk with your provider if they are painful.  There are things you can do including compressession hose that can help them.

Although most common in the lower legs, varicose veins can happen anywhere in your body (including your lady bits) — so talk with your doctor about how to help those too (belly straps might help).

Pro Tip: Varicose veins don’t typically limit blood circulation — you’re still getting circulation to that area, and you will still have return of that blood to your heart, it just takes more time (and may cause some swelling due to that).

Leg Cramps

Charlie horses in both your calves or the ball of your foot can often be an issue for pregnant women.  However, this is due to electrolytes more than structural changes.  Often, women find some extra calcium or bananas help (but talk with your provider before you make big changes).

Ingrown Toenails

Because my swelling was so severe in my feet during my last pregnancy (it often gets worse with each pregnancy) I got an ingrown toenail where the nail dug into my skin as the foot expanded.  It was easily fixed after baby (and most often they go away). Most people’s ingrown nails resolve themselves and don’t need help, fyi.

The Best Ways To Help Heel & Foot Pain in Pregnancy

So, in conclusion — make sure you’re:

1. Wearing supportive shoes that fit well
2. Talk to your doctor about if compression stockings will help
3. Stretching your body especially your lower extremities to make sure that as your pelvis changes, that your body is handling it alright.

Pregnancy CAN be super confusing, but I am ready and waiting to walk you through it in my Online Prenatal Class for Couples. I can’t wait to help you navigate the hospital for your confident, collaborative hospital birth.

Want to do a vibe check before diving into the whole thing with me? — check out my free labor pro tips. It’s your first step toward getting in the driver’s seat of your birth.