If you are pregnant in Singapore wear good shoes

Dear Ladies,

I would like to speak out about clinical conundrums that I'm experiencing in vaster amounts than ever before in my clinics.

Post pregnancy foot and ankle pain; pain that starts as heel pain (commonly plantar fasciitis) and fast becomes a nerve impingement, ligament strain or tendon overuse. These can result in new mothers unable to walk comfortably the weeks to months after giving birth. This is agonizing and depressing for the new mothers, but not just that, it is heart-wrenching for lower limb specialists such as myself.

To treat a lady post pregnancy takes alot of patience from both parties.

Firstly my side must reduce the pain (immobilization, ultrasound, orthotics, footwear, strapping etc) and follow up with strengthening. While the mothers hormones are still present for allowing generalized laxity this treatment plan becomes a real struggle. Therefore, I am writing this to urge all mothers to be, please take care of your feet especially during pregnancy.

1. Pick appropriate footwear. Flat ballerina shoes may be comfortable but your arches will collapse with the lack of support, straining your knees and adding a chain reaction of muskuloskeletal aches into the pot. Wear shoes with ample cushioning on the base to absorb the added shock from the floor, laces or velcro to ensure your smaller muscles do not over use or curl your toes when you walk (reduces falls risk) and ensure the shoe is not super soft (your feet are not soft and they do need structure). Honestly speaking; the ideal is to wear sports shoes as they support and expand during pregnancy. Arch support slippers with velcro strapping are also available.

2. If you develop heel pain at any stage of pre or post pregnancy, rest, elevate the foot and apply an ice pack to the area. This works to reduce inflammation, ice baths and soaking the feet won't work (too superficial), it needs to be an ice pack.

3. Post pregnancy the hormones still allow flexibility in your ligaments, this continues for up to a year. Your feet are at higher chance of collapsing. If you do develop pain and it is not subsiding after 3 days, please quickly see someone. These cases can be reduced by wearing the right shoes and follow specific advice regarding your lifestyle and bio-mechanics.

I am writing this as my patient has been heart ache for me for the last 3 months, I wouldn't be surprised if she was on this forum also, even after ultrasound, insoles, shoes, therapy and shockwave she is not resolved. Your pain is also our pain. Thank you.