By Dr Sayeeda Zain Afshan
Pregnancy comes with a lot of physical and physiological changes in the body, that is the reason why pregnant women feel a lot of pain and discomfort. Certain pains and discomforts need to be resolved so that you can be as comfortable as possible throughout your pregnancy.
One such discomfort is foot pain which is also called as plantar fasciitis.
What is plantar fasciitis?
Weight gain is normal as the pregnancy progresses. This healthy weight gain modifies the stance (position of the legs while standing) to support the body. Causing pronation of the foot (flattening of the arch of the foot so that it touches the ground, causing the step to roll inwards).
This gives an extra strain to the elastic-like structure in the bottom of the foot called Plantar fascia (which runs from heel bone to the base of toes) leading to small tears and inflammation of the fascia. This is then diagnosed as plantar fasciitis.
How do you differentiate between plantar fasciitis and foot pain?
A person with plantar fasciitis presents with:
Sharp, stabbing pain.
Localised to the inner aspect of the heel.
Occurs when arising out of the bed in the morning or from a chair after sitting for a long period.
By evening, the pain might turn into a dull ache.
What can be done to relieve this plantar fasciitis pain?
Plantar fasciitis is a self-limiting condition which usually improves within one year regardless of the treatment.
Rest: Avoiding prolonged periods of standing. There are certain movements which can trigger the pain in the foot, so during the initial days, aggravating movement should be avoided.
Postural corrections: Plantar fasciitis comes with severe pain which can be reduced to an extent by correction of posture so that the body weight is distributed equally throughout the foot by avoiding trick movement happening at the foot.
Stretching and strengthening, self myofascial release: Stretching and strengthening of the gastrocnemius/soleus/plantar fascia.
Icing: Though icing the feet is not a long-term solution for plantar fasciitis, it can provide quick relief in the short term by numbing the heels and helping to reduce inflammation. Icing for 15-20 minutes can help reduce the pain and inflammation associated with plantar fasciitis and other injuries to the foot.
Physical therapy modalities: Ultrasound therapy can help reduce the inflammation in the acute stages which can prevent worsening of the condition.
Dry needling and taping: Minimal invasive non-surgical treatment using needles is shown to be effective in reducing the Plantar pain. Taping: For an entire week, tape is placed on the gastrocnemius and the plantar fascia. According to a systematic review, Low Dye and calcaneal taping are the most commonly used taping techniques; however, they are likely to only offer around a week of pain reduction. A combination of stretching and tapping is more effective than taping alone.
Orthotic foot support/footwear: Footwear that supports the arches of the foot.
Night splinting: Night splints maintain ankle dorsiflexion and toe extension, allowing for a constant stretch on the plantar fascia.
How can physiotherapy help in plantar fasciitis?
As many treatment methods are contraindicated during pregnancy it is better to have expert advice before starting any treatment on your own. A physical therapist will assess your posture and guide you with certain exercises which are safe to be performed during pregnancy and go ahead with the other treatment procedures if required.
Ratio of postpartum women suffering from plantar fasciitis:
More than 2 percent of women suffer from plantar fasciitis, which is 2.5 times higher when compared to men.
What happens if plantar fasciitis is not treated?
If left untreated, plantar fasciitis can result in chronic heel and arch pain and scar tissue.
Pain may cause change in the gait (walking pattern), which can further lead to complications in the hip, knee and ankles. The human body is a kinetic chain, which is why if one joint gets affected it is most likely for the other joint in the kinetic chain of the lower extremities to be affected too.
Hence, it is important not to ignore this condition and get it properly evaluated.
(The writer is Executive Physiotherapist, Cloudnine Group of Hospitals, Bengaluru.)
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