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

Why Heel Pain Is So Common During Pregnancy

Plantar fasciitis and heel pain affect a significant proportion of pregnant women — estimates suggest 25-40% experience meaningful foot pain during pregnancy. Several pregnancy-specific factors converge to create this high prevalence: relaxin (the hormone that loosens pelvic ligaments for delivery) also affects plantar fascial and foot ligament stiffness, allowing arch collapse that increases plantar fascial tension. Weight gain (typically 25-35 lbs over pregnancy) proportionally increases tensile load on the plantar fascia. Altered gait mechanics from the growing abdomen and changed center of gravity shift loading patterns. Foot size increases (many women’s feet permanently enlarge with each pregnancy). At Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, we provide pregnancy-safe heel pain treatment that avoids medications and procedures contraindicated in pregnancy.

Safe Treatments During Each Trimester

First trimester: the safest treatment window for most conservative interventions. Stretching is safe throughout pregnancy — the plantar fascia and Achilles stretching protocols (the most important non-pharmacological intervention) can begin immediately. Over-the-counter arch support insoles are safe in the first trimester. Physical therapy without deep tissue techniques is appropriate and effective. Second trimester: orthotics (both OTC and custom) remain appropriate. Night splints maintain the ankle in dorsiflexion during sleep, preventing overnight fascial contracture that causes morning first-step pain. Supportive footwear becomes increasingly important as foot widening accelerates. Ice application for 15 minutes after activity reduces inflammatory symptoms. Third trimester: same treatments apply. As mobility becomes limited, exercise modifications that reduce plantar fascia load (swimming, cycling, seated exercise) become practical alternatives to walking-heavy activity. NSAID avoidance after 20 weeks is standard obstetric guidance.

What to Avoid During Pregnancy

Several standard plantar fasciitis treatments require modification or avoidance in pregnancy. NSAIDs (ibuprofen, naproxen): avoid after 20 weeks — associated with premature closure of the ductus arteriosus and fetal kidney effects. Use acetaminophen as needed for pain within OB-recommended guidelines. Corticosteroid injections: generally avoided during pregnancy — systemic absorption is possible, and evidence for safety in pregnancy is limited. If symptoms are severe enough to consider injection, discuss explicitly with the OB. Any deep tissue technique, acupuncture, or manual therapy: review with the OB before initiating, particularly in the third trimester when certain mechanical manipulations are avoided.

Postpartum Foot Care

Heel pain often persists postpartum or develops de novo after delivery as activity resumes with permanent foot changes from pregnancy. The foot size changes (arch flattening, foot lengthening and widening) from relaxin and weight gain may not fully reverse — many women need to resize footwear permanently after pregnancy. Custom orthotics made postpartum based on the new foot architecture can provide significant relief for persistent plantar fasciitis. Contact Balance Foot & Ankle at (810) 206-1402 for pregnancy-safe heel pain evaluation and treatment throughout your pregnancy and postpartum period.

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Balance Foot & Ankle — Howell & Bloomfield Township, MI

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When to See a Podiatrist for Heel Pain During Pregnancy

Heel pain during pregnancy is extremely common as weight gain, hormonal ligament loosening, and flat foot progression stress the plantar fascia. At Balance Foot & Ankle, Dr. Tom Biernacki provides pregnancy-safe treatments including custom orthotics, supportive taping, and stretching protocols to manage heel pain without medication.

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Clinical References

1. Ponnapula P, Dangeti SG. Changes in foot morphology during pregnancy. The Foot. 2010;20(2-3):64-67.
2. Segal NA, Boyer ER, Teran-Yengle P, et al. Pregnancy leads to lasting changes in foot structure. Am J Phys Med Rehabil. 2013;92(3):232-240.
3. Vullo VJ, Richardson JK, Hurvitz EA. Hip, knee, and foot pain during pregnancy and the postpartum period. J Fam Pract. 1996;43(1):63-68.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

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Dr. Tom Biernacki, DPM

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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.