While morning sickness, fatigue, and back pain are frequent complaints during pregnancy, leg and foot problems are just as common, particularly during the last trimester. You can try preventing these pains by alternating circulation-boosting exercise with the proper amount of rest (prop those feet and legs up!). But if those aches have already begun, rest assured that they’ll probably disappear after delivery. In the meantime, here's the scoop on what's causing foot and leg pain during pregnancy, and what you can do about it.
Raised hormone levels cause women to retain water during pregnancy, leading to swelling and bloating (also known as edema). Your body needs this extra fluid to carry nutrients and oxygen to your baby, explains David S. Levine, MD, an orthopedist at the Hospital for Special Surgery in New York City. Although swelling isn’t usually cause for concern, consult your doctor if you notice swelling of your face and hands along with blurred vision, severe or constant headaches, and weight gain of more than a pound a day. These can be signs of preeclampsia, a serious medical condition characterized by high blood pressure.
Typically, fluid retention is most pronounced in your feet, ankles, and calves because your growing uterus puts pressure on the veins that carry blood back from your lower body. This partially blocks blood flow, keeping fluid in your legs and feet. Blood vessels are also smallest in your foot and ankle, adds Dr. Levine, so your body has difficulty accommodating the extra fluid pouring in there.
You might notice a little swelling when you've exercised, been standing or walking a while, you're particularly tired, or you've been eating a lot of salty foods or drinking caffeinated beverages. Gravity can make excess fluids pool in our hands and feet, which is why standing and walking make your hands and feet feel heavy. Salty foods make a lot of people retain fluids and caffeine makes us dehydrated.
Jane Anderson, a podiatrist at the Food and Ankle Center in Durham, North Carolina, offers some ideas to prevent and relieve swelling during pregnancy:
Elevate your feet as often as you can. Try to raise your legs 6 to 12 inches above your heart for 15 to 20 minutes to help the blood flow back to your heart and lungs.
Sleep on your side, not your back. This relieves pressure on the vena cava, the largest vein leading to the heart. Otherwise, the pressure slows the blood returning from your lower body.
Consume a lot of fluids. Dehydration worsens swelling. Water keeps the kidneys from thinking you're going to be chronically dehydrated and helps flush salt out.
Drink less caffeine. Even though caffeine makes you pee and that's how you eliminate excess fluids, it also causes dehydration.
Watch the salt. Not too much, not too little. Keep your salt intake just right. Almost no one in America is at risk for consuming too little salt (sodium). Instead, we're more likely to get way too much. Read your food labels and minimize your sodium intake.
Monitor your weight. Women of normal weight should gain 25 to 35 pounds during pregnancy. Excessive weight gain exacerbates swelling and can lead to other problems.
Improve the circulation in your ankles with rotation exercises. Try sitting, with one leg raised. Rotate your ankle 10 times to the right, then to the left. Switch legs. Repeat 10 times.
Ice your ankles. With your feet up, apply ice to the inside of your ankles for 15 to 20 minutes every half hour to an hour.
Some pregnant women can't escape leg cramps. These painful muscle contractions (also called charley horses) usually occur in the calf – and often at night, when legs and feet are tired. It’s believed they’re caused by calcium deficiency and excess phosphorous (found in diet sodas and processed meats), says Enid Leikin, MD, an ob-gyn at Westchester Medical Center in Valhalla, New York. To relieve the cramps, Dr. Leikin suggests eating more dairy products or asking your doctor about calcium supplements. Women who get leg cramps may also have a potassium deficiency, and some expectant mothers report that snacking on potassium-rich bananas or dried apricots nips those cramps in the bud.
Besides dietary changes, you can prevent leg cramps by revving up your circulation; try taking a 15- to 20-minute walk in the evening. Also avoid standing or sitting in one position for too long, since this can cause fluid to accumulate, making your legs feel heavy or full of pressure.
If you find yourself in the middle of a leg cramp, ease the pain by resting your calf on a hot-water bottle or flexing your foot to stretch the calf. The best solution is walking, but if it's the middle of the night and you don't feel like getting out of bed, try grasping your foot with both hands and gently pressing your thumbs into the arch, pushing toward your toes.
As if tired, aching legs aren't enough, about 20 percent of women develop varicose veins – which look blue, swollen, and ropelike – during pregnancy. Pregnant women have up to 40 percent more blood in their circulatory system, and this extra blood increases the amount of pressure on the veins walls, causing veins to stretch so their valves don't close properly. Faulty valves allow blood to pool in the veins, and they often become varicose. You're more likely to get varicose veins if you gain excess weight, stand for long periods during the day, or if your mother had them (they're hereditary).
With varicose veins, many women complain of aching in the legs, as well as heaviness, fatigue, and pressure. Although these symptoms usually subside after pregnancy, they tend to worsen with each new baby.
As with other leg problems, increasing circulation can help relieve discomfort – and even prevent varicose veins in the first place. Ronald Dee, MD, a vein specialist in Stamford, Connecticut, recommends taking a walk every day or doing other low-impact exercises such as swimming or bicycling. If you can't exercise, try sitting in a rocking chair several times a day; use your legs to gently rock back and forth to encourage better blood flow.
The gentle pressure of stockings can relieve aching during pregnancy, too. Put them on before you get out of bed so blood doesn't have a chance to pool at your ankles. Also ask your doctor about prescription-strength hose. Once you've had the baby, you may choose laser therapy or surgery to remove the veins.
Not only is swelling uncomfortable, it may prevent your usual heels or boots from fitting properly. In fact, it's not unusual for an expectant mom to go up a half to a full size in shoes, says Dr. Anderson. The hormone relaxin (released primarily during the third trimester to relax your pelvic ligaments for childbirth) also flattens and lengthens foot ligaments.
Since your center of gravity is constantly shifting as you gain weight, you’ll need comfortable shoes that balance you (so say goodbye to high heels!) Instead, choose footwear with a broad-based one- to two-inch stacked heel. For a dressy or office shoe, try an Aerosoles style with a crepe sole for shock absorption. If you're looking for a walking or athletic shoe, buy a running sneaker, which also offers more shock absorption. Those struggling with width can buy men's shoes in an equivalent size – they're cut wider.
Here are some more shoe-buying tips from Dr. Anderson:
Shop late in the day. Feet tend to swell as the day goes on.
Be sure shoes fit before you leave the store. It's a myth that you can "break them in."
Choose shoes with a square or round toe. Avoid pointy-toed shoes.
Buy boots with room in the calf area, because your calves may swell. Also choose a boot with a side zipper; they're easier to get on and off than a pull-on style.
Replace worn heels often. Uneven heels can throw you off balance.