Prenatal Practice: Feet Relief

A pregnant body is a marvel to behold. I know because as I type this, a baby is growing at an incredible speed inside my belly, and my body is adjusting as quickly as it can. Just seven months ago, our baby was a fertilized egg burrowing itself into my uterine lining. Today it is kicking my ribs. Since implantation, everything has changed—from the placement of my organs, to the width of my rib cage, to how I place my feet on the earth. And it could not be more exciting! 

The number of changes a pregnant body undergoes in a short amount of time, along with the body’s resilience in adapting, is nothing short of miraculous. For example, the uterus expands 500 to 1,000 times its original size over the course of pregnancy (generally 40 weeks), and it takes only six weeks to shrink back down to its original size! Of course, other body parts take a little longer to return to their pre-pregnancy form, and some—like the feet—may never do so. A pregnant person’s feet often grow or change shape during the pregnancy, and 60 to 70 percent of the time, the changes are permanent.

The Amazing Human Foot 

The human foot is one of the more complex structures of the body. It is made up of 28 bones, 30 joints, and more than 100 tendons and muscles. The bones of the forefoot are organized in neat rows, from the arches to the tips of the toes. The bones in the heel region of the foot are strategically stacked atop one another and connected to the lower shinbones. The foot has three arches, which provide elasticity when moving, stability when standing, and shock absorption for carrying the weight of the body. The medial arch, on the inner side of the foot, is the most noticeable of the three arches, and also the highest. The lateral arch, on the outer side of the foot, is less distinctive, but still very important. And finally there’s the transverse arch, which spans the center of the foot horizontally. 

Because the feet are our foundation, anything going on there reverberates up the body, which is why it is so important to keep our feet happy and healthy during the important transitional time of pregnancy.

Our feet are not only our primary mode of movement, but also a major way we interact and connect with the world. They literally ground us. The body is a complex machine with many interworking parts, and each part affects the others. Because the feet are our foundation, anything going on there reverberates up the body, which is why it is so important to keep our feet happy and healthy during the important transitional time of pregnancy.

Foot Changes in Pregnancy

We know that feet often enlarge in pregnancy, but they don’t actually grow the same way they did when we were children. Instead, it seems that rather than the bones growing larger, the surrounding soft tissue structures of the feet change shape.

During pregnancy, the hormone relaxin is secreted, which loosens the connective tissue in the body in preparation for the changes needed as the baby grows and the body gives birth. It is easy to understand why the pelvis needs to adapt its shape, but unfortunately, relaxin cannot differentiate between the foot and the pelvis. So the entire body becomes loose-jointed, leading to instability throughout.

Next, weight gain during pregnancy—specifically the baby belly, affects the distribution of body weight on the feet. During pregnancy, it’s common to arch the lower back to accommodate a growing uterus. This changes our gait and standing posture. Weight gain by itself won’t cause significant changes, but combined with loosening joints, it can increase the risk of soft tissue injury. 

The most notable structural change in the foot during pregnancy is collapsing of the arches—especially the medial arch—which may then cause a widening or lengthening of the foot. These changes, which can be permanent, often lead to other issues.

Plantar fasciitis, which is linked to collapsed arches, is a common pregnancy-related foot issue. It expresses itself as heel pain or soreness on the bottom of the foot. According to the podiatry website Podantics, it can be caused by increased pressure resulting from flattening of the arches and “inflammation of the plantar fascia (the tissue along the bottom of the foot that connects the heel bone to the toes).” Symptoms are often worse in the morning after inactivity, as the plantar fascia lining the bottom of the foot tightens during sleep (whereas it stretches and loosens up during the day). Though plantar fasciitis may continue after the pregnancy, it can be managed or even resolved.

Of course, edema, or swelling, which usually occurs toward the third trimester, also plays a part in enlarging the foot. A pregnant body produces twice the blood and fluids of a not-pregnant body. The increase in fluids, while uncomfortable, is not permanent but may last for a short while after the pregnancy. Keep in mind that swelling elsewhere could be an indication of a more serious issue, such as preeclampsia. Always check with your doctor to make sure your symptoms are within the normal range. 

Finding Foot Relief

Because a lot of factors contribute to foot growth during pregnancy, there is much we can do to slow and perhaps prevent it. The best medicine is movement! Here are some ways to stretch and strengthen your feet during pregnancy:

Tiptoe balance standing at the wall

This exercise helps to improve foot flexibility and strengthen the ankles and calves. It is also a great way to challenge your balance, which can become particularly precarious around the second trimester. 

Stand sideways next to a wall with your feet hip-width apart. On an inhale, lift up onto the balls of your feet. As you lift your heels, try to distribute your weight evenly across the balls of your feet. Keep your inner ankles drawing upward, which will help activate your inner arches. On an exhale, imagine keeping your arches and ankles lifting as you lower your feet to the floor. Repeat 20 times. 

Downward dog with heels up the wall

While high heels may not be the ideal shoe during pregnancy, high-heeled downward facing dog is an amazing way to open the arches of the feet.

Begin on hands and knees with your toes touching the wall. Curl your toes under and bring your heels against the wall. Make sure you are on the balls of your feet. (Think high heels rather than a ballerina’s pointe shoes.) Lift your knees and reach your hips up and back, coming into downward facing dog. Lift your inner ankles and inner arches, pressing into all four corners of the feet at the same time—the pinky-toe side of your foot, your outer heels, big-toe mound, and inner heel. As the wrists can become sensitive in pregnancy, hold only a few breaths before returning to hands and knees, and then repeat once again. (Another option for alleviating wrist discomfort is placing your hands on blocks.)

Downward dog calf stretch with toe lifts

Not every foot issue is based in the foot itself. When there is instability somewhere in the body, the surrounding muscles will often tighten up to compensate. For example, tight calves are commonly linked to heel pain and plantar fasciitis. 

Start on hands and knees with your hands slightly in front of your shoulders. Curl your toes under, lift your knees, and on an exhale, come into downward facing dog. On an inhale, rise up onto the mounds of all ten toes. As you exhale, bend your right knee, lowering your left heel toward the floor while also lifting all of your left toes away from the floor. This will lift your arches. On an inhale, rise up onto all ten toe mounds again. On an exhale, bend your left knee, lowering your right heel toward the floor while lifting your right toes. Inhale back up onto all ten toe mounds and repeat two more times on each side for a total of three rounds. 

Toe squat

We can be quick to blame our changing body for causing the aches and pains of pregnancy. But sometimes it’s not about our body—it’s about our shoes! Most shoes lack sufficient insole support, which contributes to flattened arches. This pose is a tonic for feet that have been wearing nonsupportive shoes. 

Have two blocks nearby. From hands and knees, bring your legs together, curl your toes under, and start to walk your hands back until you are sitting up on your heels. Aim to have weight on all ten toes and keep your inner ankles drawing in toward each other. Take deep breaths. You may want to place your hands on blocks in front of you to lessen the intensity.

If you’d like to increase the intensity, try walking your hands behind your body and lean slightly into them.

Remain for 10 full breaths. To come out, walk your hands forward again and untuck your toes. It may feel good to tap the tops of the feet after this movement. 

Kneeling top foot stretch

We have spent quite a bit of time targeting the inner arches, because collapsing arches is such a common complaint during pregnancy. However, it is just as important to stretch the top part of the foot.

Sit on your heels with your toes pointed. Place your hands on the floor out to the sides on either side of your buttocks and begin tipping your weight back so that your knees and shins lift away from the floor. This counterbalance will open the tops of the feet, ankles, and shins. Work to have all ten toenails pressing into the ground and your ankles tracking with your middle toes and knees. The farther back you walk your hands, the higher the knees will lift and the greater the stretch. Bend your elbows a bit to leverage the knees higher. Remain for 20 full breaths. Then lower your knees and slowly walk your hands from the back of the mat to the outside of your hips. 

Lunge on top of foot 

The shin muscles (such as the tibialis anterior) are responsible for flexing the foot, and they are used in every step we take. Just as we need them to be strong, we need them supple too. Also, pointing the feet strengthens the arches and calves.

Start in a low lunge with your hands on two blocks. Depending on how far along you are in your pregnancy, you can either place your hands on either side of your front foot or both hands (and your belly) on the inside of the front foot. Come onto the top of your back foot, pointing your toes. If your knees are sensitive, place a blanket under the back knee. On an inhale, press strongly into the top of your back foot so that your shin and knee lift away from the floor. Hug your outer ankle in toward the midline of your mat by pressing more weight into the mound just beneath your big toe. Remain here, or try bringing your hands into prayer position, hovering with your torso tilted over your front thigh. 

Hold for 10 breaths. To come out of the pose, place your hands on the blocks and lower your back knee. Pass through hands and knees before switching sides. 

Butterfly pose with inner arch massage

Who doesn’t love a good foot rub? With this pose, you don’t have to wait until a loved one returns home in order to get one. Foot massages can improve circulation, alleviate swelling, and reduce inflammation. 

 Sit on your mat with legs out in front of you. Bend your knees and let them fall open to the sides as you bring the soles of your feet together a comfortable distance from your pelvis and easily within your reach. For the first few breaths, press the outer edges of your feet together, using your hands to separate your feet. Place your thumbs into your medial arches and press firmly. Following the guidelines of acupressure, begin to massage your arches upward from the inner heel toward the big-toe mound, using lotion if desired. Stay as long as you like. When you are ready to come out, use your hands to bring your knees together, then stretch your legs out in front of you.

Maintaining healthy feet throughout pregnancy is not just possible, it is important. Dedicating a little extra time each day to foot care will help ensure that your feet are strong and supple when it comes time to chase after your little one. And it may even prevent permanent growth, allowing you to keep your favorite shoes.

Photography: Kyle Rebar