Tara Mina, CPed, always starts an expectant mom on a Brannock Device.
“You can be sure her size has probably changed already,” the ABC-certified pedorthist and Pedorthic Footcare Association (PFA) board member, said.
Mina, who lives near Fort Myers, Fla., speaks from experience. After giving birth to two sons, she went from a 7½ to a 9 shoe.
Changing body, changing feet
“If you are pregnant, be prepared to throw away all of your shoes,” she warned with a grin. “I had to throw out 24 pairs, including the shoes I wear when I ride my bike.”
Pregnancy ultimately kept Mina off her bike and away from work at Southwest Florida Ankle and Foot Specialists in Alva where she was the staff pedorthist. But the hiatus gave her time to pen “Pregnancy & Pedorthics” for Current Pedorthics, the PFA magazine. Her story is part first-person experience with pregnancy and part guide for fellow practitioners.
Mina began with the basics.
“As a pedorthist, you need to recognize how much a pregnant woman’s body has changed. Her weight will put more pressure on her feet, especially her arches.”
Image: Mina T.
Foot and leg swelling also can be an issue. “I recommend wearing compression stockings even before you need them to get through the day – starting in the second trimester. And put them on first thing in the morning.” She added, “Compression stockings are also great late in the day when you swell the most, especially if you a chasing another kid around the house.”
More than a shoe size
She said pregnancy can affect more than shoe size.
“The shape of your feet can change, temporarily or permanently,” she said.
In addition, blood flow increases in a pregnant woman. “That can add pressure on tissue and cause occasional numbness in the feet.”
During the third trimester, hormonal releases create more laxity in joints and ligaments, she said. “As a result, feet become more flexible. The loading factor increases and shock absorption decreases.”
Balance decreases as the expectant mother’s tummy grows. “Her center of gravity changes, so stable shoes are also a must.”
Roominess in footwear does not necessarily equal stability, Mina cautioned.
“When I got pregnant the first time, I did what a lot of women do. I slipped on some comfortable Crocs. That was a big mistake – an unsupportive and unforgiving choice.”
If mom wants happy feet during pregnancy, she should consider a combination of compression hosiery, soft, accommodative orthotics and extra depth shoes with extra firm counters, according to Mina.
She is a fan of athletic shoes with sufficient depth to accommodate orthoses. “I had to take out my rigid [orthoses] and go with something more flexible because of my weight gain.”
Communication is key
Expectant mothers, like all clients, can provide pedorthists with the information they need for matching feet with the proper footwear. Quiz them at the fitting stool like you would any other client, Mina said.
“If she is experiencing swelling in her lower extremities, ask her if she has foot pain. Ask her if she has seen a podiatrist or has been diagnosed with a foot pathology.”
In her article, she quoted Ted Rolling, CO, CPed, from Omaha, Neb., who told her that pregnancy seemed to trigger to conditions such as posterior tibial tendonitis, Achilles tendonitis, plantar fasciitis, corns, plantar calluses and MTP synovitis.
Pedorthists need to realize that they can play an important role in an expectant mother’s health care, Mina said. Questions pedorthists might pose to their expectant patients include:
• Have you seen a podiatrist?
• Have you ever been diagnosed with a foot pathology?
• How many hours a day are you on your feet?
• How active are you during the day?
• Are your old inserts hurting you now that your feet have changed size and shape?
“Do not forget — everything she does takes a toll on her feet,” Mina said.
“And most importantly, as a practitioner, you need to realize that you can play an important role on an expectant mother’s health care team. You can provide mom the tools to keep her on her feet before and after the baby comes.”
For more information:
Mina T. Pedorthic Footcare Association. 2014; May/June. Available at: http://c.ymcdn.com/sites/www.pedorthics.org/resource/resmgr/CP_Articles/PFA_Mag_May-Jun_2014_Pregnan.pdf