Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Why Pregnancy Is So Hard on the Feet

Foot problems are nearly universal during pregnancy — up to 75% of pregnant women experience significant foot pain at some point. The feet are subjected to a perfect storm of physical changes during pregnancy:

• Weight gain (25–35 lbs average): Each additional pound adds 3–4 lbs of force to the feet with each step
• Relaxin hormone: A hormone produced during pregnancy that loosens ligaments to allow pelvic expansion — unfortunately it loosens foot ligaments too, causing arch flattening and overpronation
• Fluid retention: Progesterone causes sodium and water retention; feet swell noticeably, especially in the third trimester
• Center of gravity shift: As the belly grows, the pelvis tilts and the foot pronates to compensate, increasing plantar fascia and arch strain
• Reduced mobility: Decreased ability to exercise and stretch, contributing to tight calf muscles

At Balance Foot & Ankle in Howell and Bloomfield Township, MI, we see many pregnant patients and provide safe, evidence-based treatment tailored to the specific constraints of pregnancy.

Most Common Foot Problems During Pregnancy

Plantar Fasciitis and Arch Pain

The most common foot complaint in pregnancy. Relaxin-induced ligament laxity allows the arch to flatten, increasing tension on the plantar fascia. Symptoms: classic morning heel pain and arch pain throughout the day.

Foot and Ankle Edema

Swelling of the feet and ankles (physiologic edema) affects up to 80% of pregnant women, typically in the third trimester. Usually bilateral and resolves with elevation and delivery.

Concerning edema: Sudden onset, unilateral, or associated with hypertension and protein in urine may indicate preeclampsia — contact your OB immediately.

Metatarsalgia

Increased forefoot loading and weight gain stress the metatarsal heads, causing ball-of-foot pain.

Flat Foot Development

The arches permanently flatten in some women during pregnancy due to relaxin effects. Post-partum evaluation and orthotics may be warranted if flat foot persists and is symptomatic.

Leg Cramps and Calf Pain

Nocturnal leg cramps are extremely common in the second and third trimester, caused by electrolyte changes, vascular compression, and fatigue.

Safe Treatment Options During Pregnancy

Orthotics and Footwear (Safest — First Line)

Supportive footwear and orthotics address the biomechanical cause without any systemic effect:

• Quality arch support insoles (PowerStep Pinnacle, PowerStep Pinnacle) as OTC first step
• Custom orthotics if OTC insoles are insufficient — appropriate throughout pregnancy
• Supportive athletic shoes with firm midsole and motion control features
• Avoid flat shoes, flip flops, and heels throughout pregnancy

Stretching (Safe Throughout Pregnancy)

• Plantar fascia stretch: seated, pull toes back 30 seconds × 3, several times daily
• Calf stretch (seated): towel around ball of foot with straight knee, 30 seconds × 3
• Gentle ankle circles to improve circulation

Compression Socks (Ideal for Edema)

15–20 mmHg graduated compression socks are safe and highly effective for pregnancy edema. Put on before getting out of bed in the morning. Many OBs recommend them routinely from the second trimester onward for edema prevention.

Ice Therapy (Safe)

Ice packs on the heel and arch for 15 minutes after activity is safe throughout pregnancy. Avoid heat applications (ice is preferred).

Night Splints (Safe)

Wearing a dorsiflexion night splint maintains the plantar fascia in a stretched position overnight — safe and effective for pregnancy-related plantar fasciitis.

Medications (Use With Caution)

• Acetaminophen (Tylenol): Generally considered safe in the first and second trimesters for pain relief; discuss with OB
• Oral NSAIDs (ibuprofen): Avoid after 20 weeks due to risk of premature ductus arteriosus closure; discuss with OB for short-term use earlier in pregnancy
• Topical NSAIDs (diclofenac gel): Very limited systemic absorption; considered low-risk with caution after first trimester; discuss with OB

Corticosteroid Injections (Use Cautiously)

For severe plantar fasciitis refractory to conservative care, targeted corticosteroid injection is occasionally considered during pregnancy. The amount of steroid used is very small and local; risk is low, but we typically exhaust conservative options first and always coordinate with the patient’s OB.

Reducing Foot Swelling During Pregnancy

• Elevation: Feet above heart level 30–45 minutes several times daily
• Compression socks: Applied in the morning before swelling begins
• Cool foot soaks: Reduce discomfort and mild swelling
• Reduce sodium intake: Less than 2,000 mg daily
• Stay hydrated: Counterintuitively, adequate hydration reduces fluid retention
• Short walks: Activate the calf muscle pump; better than prolonged sitting or standing

Postpartum Foot Evaluation

If arch pain, flat feet, or edema persist more than 6–8 weeks postpartum, a podiatric evaluation is warranted. Some women develop permanent arch flattening after pregnancy. Early treatment with custom orthotics can prevent progressive deformity and long-term joint damage.

Ready to Get Relief? Book an Appointment Today.

Board-certified podiatrists Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients daily at our Howell and Bloomfield Township, MI offices.

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📞 (810) 206-1402

When to See a Podiatrist for Pregnancy-Related Foot Pain

If pregnancy-related foot swelling, arch collapse, or heel pain is affecting your mobility, a podiatrist can provide safe treatment options that accommodate your pregnancy. At Balance Foot & Ankle, we offer pregnancy-safe foot evaluations and orthotic fitting at our Howell and Bloomfield Hills offices.

Learn About Our Foot Pain Treatment Options | Book Your Appointment | Call (810) 206-1402

Clinical References

1. Segal NA, et al. Pregnancy leads to lasting changes in foot structure. Am J Phys Med Rehabil. 2013;92(3):232-240.
2. Ponnapula P, Boberg JS. Lower extremity changes experienced during pregnancy. J Foot Ankle Surg. 2010;49(5):452-458.
3. Vullo VJ, et al. Review of the relationship between pregnancy and musculoskeletal conditions. Women Health. 1996;25(4):77-96.