by Alap Shah, MD
Why are my ankles and toes so swollen?
Pregnancy triggers many different changes in a woman’s body. Perhaps you have noticed that your belly isn’t the only thing getting bigger right now. Your feet are particularly vulnerable to swelling during pregnancy. Your growing uterus puts pressure on your pelvic veins and on your vena cava (a large vein on the right side of your body that receives blood from your lower limbs and carries it back to the heart). This pressure slows down circulation and causes blood to pool in your legs, forcing fluid from your veins into the tissue of your feet and ankles. This pressure is relieved when you lie on your side. And since the vena cava is on the right side of your body, left-sided rest works the best.
When should I be concerned about swelling?
A certain amount of swelling is normal during pregnancy. You may also have some mild swelling in your hands. However, call your doctor if you notice swelling in your face, puffiness around your eyes, more than slight swelling of your hands or excessive swelling of your feet or ankles. This could be a sign of preeclampsia, a serious condition. Also call your doctor if you notice that one leg is more swollen than the other, especially if you have pain in your calf.
Why do my feet hurt so much?
Due to the natural weight gain during pregnancy, a woman’s center of gravity is completely altered. You have more blood circulating in your body, which causes a new weight-bearing stance and added pressure to the knees and feet. This pressure can lead to pain at the heel, arch, or the ball of the foot. Many women may also experience leg cramping and varicose veins.
Another common foot problem associated with weight gain during pregnancy is over-pronation, also referred to as flat feet. This is caused when a person’s arch flattens out upon weight bear- ing and their feet roll inward when walking, often creating extreme stress or inflammation on the plantar fascia (the fibrous band of tissue that runs from the heel to the forefoot). This condition can make walking very painful, increasing strain on the feet, calves and/or back.
Treatment & Prevention
There are effective ways to treat both swelling and over-pronation during pregnancy. Over-pronation can be treated conservatively with “readymade” orthotics, designed with appropriate arch support and medial rearfoot posting. Proper fitting footwear is also very important. Choose comfortable footwear that provides extra support and shock absorption.
For swelling, try to put your feet up whenever possible. Take breaks from sitting or standing by stretching your legs out. Take a short walk every so often to keep your blood circulating. Ask your physician for prescribed maternity support stockings. Surprisingly, drinking plenty of water will allow for an adequate balance of water retention. Be sure to wear comfortable socks and shoes that accommodate the swelling. Don’t wear socks or stockings with tight bands around your ankles or calves. Finally, exercise regularly, especially by walking, swimming or riding an exercise bike. Along with a well balanced diet, this will assure good health for you and the baby.
As a final note, try not to let these symptoms get you down. Although the sight of your swollen ankles will probably add to you feelings of ungainliness, these are temporary conditions that will pass soon after you give birth.
Dr. Shah has been a physician with Foot and Ankle of West Georgia and Foot and Ankle Surgery Center LLC for four years. He maintains a general and surgical podiatric practice locally, specializing in diabetes and diabetic wound care and is a certified wound care specialist.
