Medically Reviewed | Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle, Michigan
Quick Answer:
Quick Answer: Pregnancy causes significant foot and ankle changes: weight gain increases plantar fascial stress, the hormone relaxin loosens ligaments causing arch flattening, and fluid retention produces edema and nerve compression. Dr. Biernacki provides safe, pregnancy-appropriate treatment including custom orthotics, supportive footwear guidance, compression socks, and non-medication-based interventions for heel pain, arch pain, and edema in pregnant patients.
Treatment at Balance Foot & Ankle: EPAT Shockwave for Heel Pain →
Why Pregnancy Changes Your Feet
Pregnancy produces four significant foot-changing mechanisms. First, weight gain — an average of 25–35 pounds — dramatically increases load on the plantar fascia and arch with every step. Second, relaxin — a hormone produced during pregnancy — loosens the ligaments throughout the body, including the foot, causing arch flattening and heel valgus that often persist after delivery. Third, edema from increased circulating volume and vascular pressure produces foot and ankle swelling that compresses the tarsal tunnel and irritates foot nerves. Fourth, altered gait from the growing abdomen shifts the center of gravity, changing foot strike patterns and increasing forefoot loading.
Plantar Fasciitis During Pregnancy
Pregnancy-associated plantar fasciitis produces the classic morning heel pain that worsens with weight gain and arch flattening from relaxin. Treatment during pregnancy is modified to avoid cortisone injections (limited evidence for fetal safety, though risk is likely very low) and NSAIDs (avoid in third trimester). Dr. Biernacki treats pregnant patients with custom orthotics to support the newly flattened arch, specific stretching protocols safe during all trimesters, arch taping (Kinesio tape or Low-Dye strapping), night splints, and supportive footwear recommendations.
Edema and Nerve Compression
Pregnancy edema of the feet and ankles can compress the posterior tibial nerve in the tarsal tunnel, producing numbness, burning, and tingling on the bottom of the foot — symptoms that overlap with plantar fasciitis but require different treatment. Graduated compression stockings (20–30 mmHg, knee-high) reduce edema significantly when worn throughout the day. Elevation, hydration, and sodium reduction are standard recommendations. Dr. Biernacki distinguishes tarsal tunnel compression from plantar fasciitis with clinical examination and when necessary, diagnostic ultrasound.
Foot Size Changes and Post-Delivery Care
Many women experience permanent shoe size increases (0.5–1 full size) after pregnancy due to relaxin-induced ligament laxity and arch flattening. Post-delivery, custom orthotics provide ongoing arch support for the new foot structure, reducing the risk of chronic plantar fasciitis and arch pain. Dr. Biernacki often schedules a post-delivery follow-up to update orthotic prescriptions to the post-pregnancy foot, which may differ meaningfully from the pre-pregnancy structure.
Dr. Tom's Product Recommendations
Physix Gear Compression Socks — 20-30 mmHg
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Medical-grade 20-30 mmHg graduated compression socks for pregnancy edema, swollen feet, and tarsal tunnel nerve compression. Dr. Biernacki’s top recommendation for edema management in pregnant patients.
Dr. Tom says: “Dr. Biernacki recommended these compression socks for my pregnancy foot swelling. Wore them every day from the second trimester — made a huge difference in comfort.”
Pregnancy edema, foot swelling, tarsal tunnel compression symptoms
Patients with peripheral artery disease (check with OB before compression socks)
Disclosure: We earn a commission at no extra cost to you.
Vionic Tide II Supportive Sandal
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Supportive sandal with deep heel cup and arch support — podiatrist-designed for plantar fasciitis relief. Recommended for pregnant patients who need arch support in open footwear as feet swell.
Dr. Tom says: “My feet swelled too much for regular shoes during the third trimester. Dr. Biernacki recommended Vionics and they were the only thing comfortable and supportive enough.”
Pregnancy arch support, swollen feet needing open footwear, plantar fasciitis
Post-delivery return to regular footwear with orthotics
Disclosure: We earn a commission at no extra cost to you.
✅ Pros / Benefits
- Pregnancy-safe treatment protocols — no cortisone, NSAIDs avoided in third trimester
- Compression stocking recommendations for edema and tarsal tunnel compression
- Post-delivery orthotic update for permanent arch changes
- Arch taping and night splint options for non-medication treatment
❌ Cons / Risks
- Cortisone injection avoided during pregnancy — alternative measures required for severe cases
- Some edema is physiological and resolves post-delivery without treatment
Dr. Tom Biernacki’s Recommendation
Pregnancy foot pain is very real and very undertreated — OBs are appropriately focused on the bigger picture and foot pain often falls through the cracks. We can do a lot safely during pregnancy: orthotics, taping, compression, splinting. Most pregnant patients get significant relief very quickly once they come in.
— Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle
Frequently Asked Questions
Is it safe to get foot orthotics during pregnancy?
Yes — custom orthotics are completely safe during pregnancy. They involve no medication or injection and provide mechanical support. Dr. Biernacki fabricates them from a foot impression with no X-ray required.
When does pregnancy foot swelling typically peak?
Edema typically peaks in the third trimester, especially in warm weather. Compression socks worn from early in the day, elevation when seated, and adequate hydration help manage it throughout the later trimesters.
Will my feet return to normal after delivery?
Partially — edema resolves within a few weeks post-delivery. However, arch flattening from relaxin is often permanent. Many women permanently go up 0.5–1 shoe size after pregnancy and benefit from custom orthotics to support the new arch structure.
Can Dr. Biernacki treat ingrown toenails during pregnancy?
Yes — ingrown toenail treatment (including local anesthesia and partial nail avulsion) is safe during pregnancy. The local anesthetic used (lidocaine) is classified as safe for use during pregnancy.
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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
Frequently Asked Questions
Can I see a podiatrist for heel pain without a referral?
How long does plantar fasciitis take to heal?
Should I walk on my heel if it hurts?
What does a podiatrist do for heel pain?
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
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