Just an FYI

  • Foot pain during pregnancy can be difficult. There is increased body weight gain, increased joint laxity by release of Relaxin, and additional edema in the foot and ankle that often makes it painful to wear normal shoes that fit a few weeks prior. A lot of women will switch to flip flops to accommodate the greater foot size and changing the amount of support that they were accustomed to during normal daily activities.
  • It’s been suggested that rates of PF are in higher during pregnancy and the first line of defense is often the podiatrist or MD prescribing custom orthotics instead of Physical Therapy. Pregnancy lasts only so long (although I’m sure too long for some) and the hope is the foot pain will clear after delivery. This is a bummer as increased foot size and adding an orthotic likely won’t fit in normal shoes.
  • Weight bearing during pregnancy changes to more pressure in the 5th metatarsal. For those that use orthotics prior to pregnancy be aware for too much arch support and further putting pressure onto the lateral foot.

Original article here: Changes in foot plantar pressure in pregnant women.
Elsayed E1,2, Devreux I1, Embaby H3, Alsayed A1, Alshehri M1.

Abstract
BACKGROUND:

During pregnancy, the body undergoes many hormonal and anatomical changes causing several medical problems as the musculoskeletal system problems.

OBJECTIVE:
To investigate the plantar pressure distribution during pregnancy.

SUBJECTS:
Twenty two pregnant and non-pregnant females were selected from the King Abdulaziz University in Jeddah.

METHODS:
All females were evaluated by inspection regarding their deformities of the spine, pelvis, lower extremities and feet. Pain was assessed by the Visual Analog Scale (VAS), and the weight and height were recorded using a calibrated weighing scale. Finally, the plantar pressure distribution was examined by a Global Postural Analysis device (GPA).

RESULTS:
The results revealed significant asymmetry of weight bearing in the study group (pregnant) compared to the control group (non-pregnant) (p> 0.05). In addition, there was a significant increase in pain intensity in the study group (p= 0.02). On the other hand, the results showed a non-significant difference between study and control groups regarding the three points of pressure (calcaneus, 1st metatarasal and 5th metatarsal) (p> 0.05). Moreover, there was a significant direct relationship between the month of pregnancy and increased weight bearing on the 5th metatarsal in the study group (p= 0.04).

CONCLUSIONS:
There is an effect of pregnancy on plantar pressure distribution as well as weight symmetry which should be considered when designing an antenatal program.

 

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KEYWORDS:
Pregnancy; global postural analysis; musculoskeletal Disorders; pain; plantar pressure distribution

original article here: Plantar pressure and foot pain in the last trimester of pregnancy.

By: Karadag-Saygi E1, Unlu-Ozkan F, Basgul A.

Abstract
BACKGROUND:

Back and foot pain are common complaints during pregnancy. Progression of symptoms is seen especially in the third trimester as the center of gravity (COP) is altered due to weight gain. The aim of the study was to evaluate plantar pressure changes and postural balance differences of pregnant women.

MATERIAL AND METHODS:
Thirty-five last trimester pregnant women with complaints of foot pain were included. The control group consisted of 35 non-pregnant women who were age and body mass index (BMI) matched volunteers. All selected cases were overweight. Foot pain in pregnancy was measured by Visual analogue scale (VAS). Percentages of pressure on forefoot and hindfoot were measured using static pedobarography and peak pressures at forefoot, midfoot and hindfoot were measured using dynamic pedobarography. As a measurement of balance, COP sway length and width were also analyzed.

RESULTS:
Compared to overweight individuals, pregnant patients had higher forefoot pressure on the right side with standing and walking. Also, significant increases in contact times under the forefoot and longer floor contact times were found. VAS scores were correlated with forefoot contact times during walking. Although the sway length from COP was higher than controls, no significant correlation was found in sway length and weight gain.

CONCLUSION:
These data suggest that forefoot pressures increase in the last trimester of pregnancy during standing and walking. There is prominent increased postural sway in anterior-posterior direction in this period.

CLINICAL RELEVANCE:

We believe that based on the observed pressure changes, foot pain in pregnancy due to changes in body mass and distribution may be relieved by exercise and shoewear modifications.

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