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Pregnancy and the Impact on the Lower
Extremity
Dr Kristina L Petrocco-Napuli
1
Objectivesbull Discussion of the pregnant patient and how
this effects the biomechanics of the lower extremity and gait
bull Identify common foot conditions of the pregnant patient
bull Discussion and identification of treatment options associated with pregnancy induced foot pain
2
The Pregnant Patient
bull Important history questions regardless of presenting conditionndash GravidaParandash Which week of pregnancyndash Depending on trimester
bull What are they experiencing Both normal and abnormal (morning sickness edema headaches etc)
bull Are they feeling the baby move Are they kick counting
ndash Nutritionbull What are they eating and are they supplementing
ndash Who is on their birthing team And have they thought about their birthing planbull ObMidwifeDoula
3
Fetal Development
4httpaboutgettingpregnantcomgetpregnantfasthop=galus
Stages of Pregnancy
5
httpwwwlivesciencecom44899-stages-of-pregnancyhtml
Weight Gain During Pregnancy
6
httpmomgirlstalkinsmackcomhealthpregnancy-day-by-day---welcome-to-your-first-trimester-(part-20)aspx
wwwrealmomsfitcom
Changes in Biomechanics During Pregnancy
- Increased anterior pelvic tilt
- Increase lumbar lordosis
- Increased thoracic spine kyphosis
- Increased internally rotated shoulders
- Increased ligamentous laxity
7
httpwwwnpionlineorgarticles2013-march-incorporating-npis-4-points-of-posture-during-pregnancy-and-postpartumhtm
Changing Biomechanics During Pregnancy
8httpwwwchiropracticencinitascompregnancy-chiropractors
Gait Pattern
9
httpmomgirlstalkinsmackcomsecrets_advicehow-to-beautify-for-pregnant-women-at-weekendaspx
ldquopregnant patients had higher
forefoot pressure hellipwith standing and walkinghelliphellipsignificant increases in contact times under the forefoot and longer floor contact times were
foundrdquo
Foot Ankle Int 2010 Feb31(2)153-7Plantar pressure and foot pain in the last trimester of pregnancy
Karadag-Saygi E1 Unlu-Ozkan F Basgul A
10
Most Common MSK Conditions During Pregnancy
bull Lumbopelvic Pain
bull Wrist pain (carpal tunnel like symptoms)
bull Rib Pain
bull Hip Pain
bull FootHeelCalf Pain
11
Common Pregnancy Induced Lower Extremity Complaints
Swelling and Edema
Plantar Fascitis
Metatarsalgia
Foot and Leg Cramps
Varicose Veins
12
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Objectivesbull Discussion of the pregnant patient and how
this effects the biomechanics of the lower extremity and gait
bull Identify common foot conditions of the pregnant patient
bull Discussion and identification of treatment options associated with pregnancy induced foot pain
2
The Pregnant Patient
bull Important history questions regardless of presenting conditionndash GravidaParandash Which week of pregnancyndash Depending on trimester
bull What are they experiencing Both normal and abnormal (morning sickness edema headaches etc)
bull Are they feeling the baby move Are they kick counting
ndash Nutritionbull What are they eating and are they supplementing
ndash Who is on their birthing team And have they thought about their birthing planbull ObMidwifeDoula
3
Fetal Development
4httpaboutgettingpregnantcomgetpregnantfasthop=galus
Stages of Pregnancy
5
httpwwwlivesciencecom44899-stages-of-pregnancyhtml
Weight Gain During Pregnancy
6
httpmomgirlstalkinsmackcomhealthpregnancy-day-by-day---welcome-to-your-first-trimester-(part-20)aspx
wwwrealmomsfitcom
Changes in Biomechanics During Pregnancy
- Increased anterior pelvic tilt
- Increase lumbar lordosis
- Increased thoracic spine kyphosis
- Increased internally rotated shoulders
- Increased ligamentous laxity
7
httpwwwnpionlineorgarticles2013-march-incorporating-npis-4-points-of-posture-during-pregnancy-and-postpartumhtm
Changing Biomechanics During Pregnancy
8httpwwwchiropracticencinitascompregnancy-chiropractors
Gait Pattern
9
httpmomgirlstalkinsmackcomsecrets_advicehow-to-beautify-for-pregnant-women-at-weekendaspx
ldquopregnant patients had higher
forefoot pressure hellipwith standing and walkinghelliphellipsignificant increases in contact times under the forefoot and longer floor contact times were
foundrdquo
Foot Ankle Int 2010 Feb31(2)153-7Plantar pressure and foot pain in the last trimester of pregnancy
Karadag-Saygi E1 Unlu-Ozkan F Basgul A
10
Most Common MSK Conditions During Pregnancy
bull Lumbopelvic Pain
bull Wrist pain (carpal tunnel like symptoms)
bull Rib Pain
bull Hip Pain
bull FootHeelCalf Pain
11
Common Pregnancy Induced Lower Extremity Complaints
Swelling and Edema
Plantar Fascitis
Metatarsalgia
Foot and Leg Cramps
Varicose Veins
12
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
The Pregnant Patient
bull Important history questions regardless of presenting conditionndash GravidaParandash Which week of pregnancyndash Depending on trimester
bull What are they experiencing Both normal and abnormal (morning sickness edema headaches etc)
bull Are they feeling the baby move Are they kick counting
ndash Nutritionbull What are they eating and are they supplementing
ndash Who is on their birthing team And have they thought about their birthing planbull ObMidwifeDoula
3
Fetal Development
4httpaboutgettingpregnantcomgetpregnantfasthop=galus
Stages of Pregnancy
5
httpwwwlivesciencecom44899-stages-of-pregnancyhtml
Weight Gain During Pregnancy
6
httpmomgirlstalkinsmackcomhealthpregnancy-day-by-day---welcome-to-your-first-trimester-(part-20)aspx
wwwrealmomsfitcom
Changes in Biomechanics During Pregnancy
- Increased anterior pelvic tilt
- Increase lumbar lordosis
- Increased thoracic spine kyphosis
- Increased internally rotated shoulders
- Increased ligamentous laxity
7
httpwwwnpionlineorgarticles2013-march-incorporating-npis-4-points-of-posture-during-pregnancy-and-postpartumhtm
Changing Biomechanics During Pregnancy
8httpwwwchiropracticencinitascompregnancy-chiropractors
Gait Pattern
9
httpmomgirlstalkinsmackcomsecrets_advicehow-to-beautify-for-pregnant-women-at-weekendaspx
ldquopregnant patients had higher
forefoot pressure hellipwith standing and walkinghelliphellipsignificant increases in contact times under the forefoot and longer floor contact times were
foundrdquo
Foot Ankle Int 2010 Feb31(2)153-7Plantar pressure and foot pain in the last trimester of pregnancy
Karadag-Saygi E1 Unlu-Ozkan F Basgul A
10
Most Common MSK Conditions During Pregnancy
bull Lumbopelvic Pain
bull Wrist pain (carpal tunnel like symptoms)
bull Rib Pain
bull Hip Pain
bull FootHeelCalf Pain
11
Common Pregnancy Induced Lower Extremity Complaints
Swelling and Edema
Plantar Fascitis
Metatarsalgia
Foot and Leg Cramps
Varicose Veins
12
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Fetal Development
4httpaboutgettingpregnantcomgetpregnantfasthop=galus
Stages of Pregnancy
5
httpwwwlivesciencecom44899-stages-of-pregnancyhtml
Weight Gain During Pregnancy
6
httpmomgirlstalkinsmackcomhealthpregnancy-day-by-day---welcome-to-your-first-trimester-(part-20)aspx
wwwrealmomsfitcom
Changes in Biomechanics During Pregnancy
- Increased anterior pelvic tilt
- Increase lumbar lordosis
- Increased thoracic spine kyphosis
- Increased internally rotated shoulders
- Increased ligamentous laxity
7
httpwwwnpionlineorgarticles2013-march-incorporating-npis-4-points-of-posture-during-pregnancy-and-postpartumhtm
Changing Biomechanics During Pregnancy
8httpwwwchiropracticencinitascompregnancy-chiropractors
Gait Pattern
9
httpmomgirlstalkinsmackcomsecrets_advicehow-to-beautify-for-pregnant-women-at-weekendaspx
ldquopregnant patients had higher
forefoot pressure hellipwith standing and walkinghelliphellipsignificant increases in contact times under the forefoot and longer floor contact times were
foundrdquo
Foot Ankle Int 2010 Feb31(2)153-7Plantar pressure and foot pain in the last trimester of pregnancy
Karadag-Saygi E1 Unlu-Ozkan F Basgul A
10
Most Common MSK Conditions During Pregnancy
bull Lumbopelvic Pain
bull Wrist pain (carpal tunnel like symptoms)
bull Rib Pain
bull Hip Pain
bull FootHeelCalf Pain
11
Common Pregnancy Induced Lower Extremity Complaints
Swelling and Edema
Plantar Fascitis
Metatarsalgia
Foot and Leg Cramps
Varicose Veins
12
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Stages of Pregnancy
5
httpwwwlivesciencecom44899-stages-of-pregnancyhtml
Weight Gain During Pregnancy
6
httpmomgirlstalkinsmackcomhealthpregnancy-day-by-day---welcome-to-your-first-trimester-(part-20)aspx
wwwrealmomsfitcom
Changes in Biomechanics During Pregnancy
- Increased anterior pelvic tilt
- Increase lumbar lordosis
- Increased thoracic spine kyphosis
- Increased internally rotated shoulders
- Increased ligamentous laxity
7
httpwwwnpionlineorgarticles2013-march-incorporating-npis-4-points-of-posture-during-pregnancy-and-postpartumhtm
Changing Biomechanics During Pregnancy
8httpwwwchiropracticencinitascompregnancy-chiropractors
Gait Pattern
9
httpmomgirlstalkinsmackcomsecrets_advicehow-to-beautify-for-pregnant-women-at-weekendaspx
ldquopregnant patients had higher
forefoot pressure hellipwith standing and walkinghelliphellipsignificant increases in contact times under the forefoot and longer floor contact times were
foundrdquo
Foot Ankle Int 2010 Feb31(2)153-7Plantar pressure and foot pain in the last trimester of pregnancy
Karadag-Saygi E1 Unlu-Ozkan F Basgul A
10
Most Common MSK Conditions During Pregnancy
bull Lumbopelvic Pain
bull Wrist pain (carpal tunnel like symptoms)
bull Rib Pain
bull Hip Pain
bull FootHeelCalf Pain
11
Common Pregnancy Induced Lower Extremity Complaints
Swelling and Edema
Plantar Fascitis
Metatarsalgia
Foot and Leg Cramps
Varicose Veins
12
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Weight Gain During Pregnancy
6
httpmomgirlstalkinsmackcomhealthpregnancy-day-by-day---welcome-to-your-first-trimester-(part-20)aspx
wwwrealmomsfitcom
Changes in Biomechanics During Pregnancy
- Increased anterior pelvic tilt
- Increase lumbar lordosis
- Increased thoracic spine kyphosis
- Increased internally rotated shoulders
- Increased ligamentous laxity
7
httpwwwnpionlineorgarticles2013-march-incorporating-npis-4-points-of-posture-during-pregnancy-and-postpartumhtm
Changing Biomechanics During Pregnancy
8httpwwwchiropracticencinitascompregnancy-chiropractors
Gait Pattern
9
httpmomgirlstalkinsmackcomsecrets_advicehow-to-beautify-for-pregnant-women-at-weekendaspx
ldquopregnant patients had higher
forefoot pressure hellipwith standing and walkinghelliphellipsignificant increases in contact times under the forefoot and longer floor contact times were
foundrdquo
Foot Ankle Int 2010 Feb31(2)153-7Plantar pressure and foot pain in the last trimester of pregnancy
Karadag-Saygi E1 Unlu-Ozkan F Basgul A
10
Most Common MSK Conditions During Pregnancy
bull Lumbopelvic Pain
bull Wrist pain (carpal tunnel like symptoms)
bull Rib Pain
bull Hip Pain
bull FootHeelCalf Pain
11
Common Pregnancy Induced Lower Extremity Complaints
Swelling and Edema
Plantar Fascitis
Metatarsalgia
Foot and Leg Cramps
Varicose Veins
12
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Changes in Biomechanics During Pregnancy
- Increased anterior pelvic tilt
- Increase lumbar lordosis
- Increased thoracic spine kyphosis
- Increased internally rotated shoulders
- Increased ligamentous laxity
7
httpwwwnpionlineorgarticles2013-march-incorporating-npis-4-points-of-posture-during-pregnancy-and-postpartumhtm
Changing Biomechanics During Pregnancy
8httpwwwchiropracticencinitascompregnancy-chiropractors
Gait Pattern
9
httpmomgirlstalkinsmackcomsecrets_advicehow-to-beautify-for-pregnant-women-at-weekendaspx
ldquopregnant patients had higher
forefoot pressure hellipwith standing and walkinghelliphellipsignificant increases in contact times under the forefoot and longer floor contact times were
foundrdquo
Foot Ankle Int 2010 Feb31(2)153-7Plantar pressure and foot pain in the last trimester of pregnancy
Karadag-Saygi E1 Unlu-Ozkan F Basgul A
10
Most Common MSK Conditions During Pregnancy
bull Lumbopelvic Pain
bull Wrist pain (carpal tunnel like symptoms)
bull Rib Pain
bull Hip Pain
bull FootHeelCalf Pain
11
Common Pregnancy Induced Lower Extremity Complaints
Swelling and Edema
Plantar Fascitis
Metatarsalgia
Foot and Leg Cramps
Varicose Veins
12
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Changing Biomechanics During Pregnancy
8httpwwwchiropracticencinitascompregnancy-chiropractors
Gait Pattern
9
httpmomgirlstalkinsmackcomsecrets_advicehow-to-beautify-for-pregnant-women-at-weekendaspx
ldquopregnant patients had higher
forefoot pressure hellipwith standing and walkinghelliphellipsignificant increases in contact times under the forefoot and longer floor contact times were
foundrdquo
Foot Ankle Int 2010 Feb31(2)153-7Plantar pressure and foot pain in the last trimester of pregnancy
Karadag-Saygi E1 Unlu-Ozkan F Basgul A
10
Most Common MSK Conditions During Pregnancy
bull Lumbopelvic Pain
bull Wrist pain (carpal tunnel like symptoms)
bull Rib Pain
bull Hip Pain
bull FootHeelCalf Pain
11
Common Pregnancy Induced Lower Extremity Complaints
Swelling and Edema
Plantar Fascitis
Metatarsalgia
Foot and Leg Cramps
Varicose Veins
12
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Gait Pattern
9
httpmomgirlstalkinsmackcomsecrets_advicehow-to-beautify-for-pregnant-women-at-weekendaspx
ldquopregnant patients had higher
forefoot pressure hellipwith standing and walkinghelliphellipsignificant increases in contact times under the forefoot and longer floor contact times were
foundrdquo
Foot Ankle Int 2010 Feb31(2)153-7Plantar pressure and foot pain in the last trimester of pregnancy
Karadag-Saygi E1 Unlu-Ozkan F Basgul A
10
Most Common MSK Conditions During Pregnancy
bull Lumbopelvic Pain
bull Wrist pain (carpal tunnel like symptoms)
bull Rib Pain
bull Hip Pain
bull FootHeelCalf Pain
11
Common Pregnancy Induced Lower Extremity Complaints
Swelling and Edema
Plantar Fascitis
Metatarsalgia
Foot and Leg Cramps
Varicose Veins
12
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
ldquopregnant patients had higher
forefoot pressure hellipwith standing and walkinghelliphellipsignificant increases in contact times under the forefoot and longer floor contact times were
foundrdquo
Foot Ankle Int 2010 Feb31(2)153-7Plantar pressure and foot pain in the last trimester of pregnancy
Karadag-Saygi E1 Unlu-Ozkan F Basgul A
10
Most Common MSK Conditions During Pregnancy
bull Lumbopelvic Pain
bull Wrist pain (carpal tunnel like symptoms)
bull Rib Pain
bull Hip Pain
bull FootHeelCalf Pain
11
Common Pregnancy Induced Lower Extremity Complaints
Swelling and Edema
Plantar Fascitis
Metatarsalgia
Foot and Leg Cramps
Varicose Veins
12
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Most Common MSK Conditions During Pregnancy
bull Lumbopelvic Pain
bull Wrist pain (carpal tunnel like symptoms)
bull Rib Pain
bull Hip Pain
bull FootHeelCalf Pain
11
Common Pregnancy Induced Lower Extremity Complaints
Swelling and Edema
Plantar Fascitis
Metatarsalgia
Foot and Leg Cramps
Varicose Veins
12
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Common Pregnancy Induced Lower Extremity Complaints
Swelling and Edema
Plantar Fascitis
Metatarsalgia
Foot and Leg Cramps
Varicose Veins
12
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
13
Increased Weight Gain
Over Pronation
Increased Foot Pain
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Common Pregnancy Induced Lower Extremity Complaints
bull Swelling and Edemandash Late in pregnancy
ndash Must rule out preeclampsia and DVT if unilateral
bull Plantar Fascitis (10 of general population)ndash Increased weight gain
ndash Inflammation
ndash Relaxin
ndash Footwear
14
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Common Pregnancy Induced Lower Extremity Complaints
bull Metatarsalgia
ndash Pain in the ball of the foot
ndash ldquowalking on pebblesrdquo ldquobruised feelingrdquo
bull Foot and leg cramps
ndash Second through third trimester of pregnancy
ndash Calcium and magnesium
15
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Common Pregnancy Induced Lower Extremity Complaints
bull Varicose Veins
ndash Superficial swollen veins
ndash Sore itchy
ndash Legs can be tired and achy
16
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Considerations in Treatment
bull Taping
bull Instrument assisted soft tissue
bull Manipulation
bull Diet
bull Exercise
17
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Educating Pregnant Patients on Foot Health
bull Control weight gain
bull Avoid high heels
bull Exercise
bull Drink Fluids and avoid salt
bull Elevate feet
bull Shop for shoes late in the day
bull Comfort and support are key
18
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Support
19
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Questions
20
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
Contact Information
Dr Kristina Petrocco-Napulidrkrispnicloudcom
Twitter drkrispn
21
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
References
American Podiatric Medical Associationhttpwwwapmaorgindexcfm
Foti T Davids J and Bagley A A Biomechanical Analysis of Gait During Pregnancy Journal of Bone and Joint Surg Am May82 (5)625 (2000)
Huang T Lin S Hoi C Yui C and Chou Y The Gait Analysis of Pregnant Women Biomedical Engineering Applications Basis and Communications April 1467-70 (2002)
Karadag-Savgi E Unlu O and Basgui A Plantar Pressure and Foot Pain in the Last Trimester of Pregnancy Foot and Ankle Int Feb 31(2)152-157 (2010)
Lisi A Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy A Retrospective Case Series Journal of Midwifery and Womenrsquos Health Vol 51 Issue 1 pages e3-e7 (2006)
Nyska M Sofer D Howard CB Laevi A and Meizner I Plantar Foot Pressures in Pregnant Women Isreal Journal of Medical Science 33(2)139-146 (1997)
Price C Andrejevas V findlow AH Graham-Smith P Jones R Does Flip Flop Style Footwear Modify Ankle Biomechanics and Foot Loading Patterns J Foot and Ankle Res 267(1) (2014)
22
