Question
QUESTION: Dear Doctor, I've been having problems with my feet since I gave birth to my daughter back in February. About 6 weeks after she was born I started having pain on top of the outer side of my left foot and on the top of the foot where the foot joins the leg. It hurts every time I stand up after a period of resting. About 4 weeks ago I started hurting at the bottom of my foot, at the end of the heel where the arch starts. It feels a bit like plantar fasciitis (I used to suffer from this in the past but it was cleared up by custom made orthotics) but it doesn't necessarily hurt after period of rest but constantly when I am standing up or walking or anytime my weight is on the foot. Sometimes the pain wears off after walking for a while and sometimes it doesn't. I have been told that the hormone relaxin probably caused the problems on top of my foot but I am unsure about this foot pain at the bottom. I got custom made prescription orthotics but these were made before I got the pain at the bottom of the foot. I am wondering if I should go back to my podiatrist and ask them to adjust the orthotics (they were already adjusted once). They have quite high arches and I have been wearing them for 2 weeks now and they feel a bit more comfortable now but I have the pain at the bottom of my foot every day. Any idea what this could be? I was also wondering how long does it take for the relaxin hormone to completely dissapear? And once it's gone, will my foot problems get better? Apologies about all these questions, I cannot ask my podiatrist as she is on vacation for 2 weeks. Many thanks for your help.

ANSWER: Hi Katarina,

Your foot will certainly change from the hormone relaxin.  Relaxin causes the ligaments and fibrous structures of the foot and ankle to loosen.  This is typically not reversible and allows permanent changes to the foot structure.  You will likely need your orthotics adjusted or new ones made.  You foot structure will likely be more flexible now.  The relaxin is likely out of your body but the effects will remain.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com

DISCLAIMER:
This information is offered as free advice and as general information. It may not be applicable to the specific questioner and his/her problem.  It is not based on actual knowledge of the questioner or his/her medical history and it cannot and should not be relied upon as definitive medical opinion or advice.  Reliable medical opinion and advice can only be obtained through hands-on physical contact and exam of the patient to establish an accurate diagnosis and treatment plan.  No doctor/patient relationship is created or established here and may not be inferred through answers on this site.  The questioner and other readers must consult his/her own doctor before proceeding or implementing any suggestions contained within this document and answers on this site.  The questioner is only to act upon his/her own doctor抯 orders and recommendations. By reading this posting which follows, the reader fully understands and confirms that he/she holds harmless this writer. If this is not fully agreeable to you, the reader, and/or you have not attained the age of 18 years, you hereby are advised to read no further.

---------- FOLLOW-UP ----------

QUESTION: Dear Dr Katz,

Many thanks for your reply. I have been wearing my new custom made orthotics since 01Aug but have seen little improvement. The orthotics were made by using 3D optical laser foot scanner so I assume they should be pretty accurate. I had them adjusted twice now and I may need to speak to my podiatrist again. They have high arches and it took me a while to get used to them. I had X-ray of my feet done to look for arthritis but all is looking fine. I was wondering if you could give me some advice here. Is it possible that all these problems were caused just by the relaxin hormone? You mentioned in your previous reply that the effects will remain - what do you mean by that? Does it mean that I will have this pain till the rest of my life (I am 33 yrs old!) or is it likely to get better as long as I wear the orthotics constantly? I have been wearing nothing but trainers with orthotics in them for the past few months and still feel no improvement. Is there anything else I should be doing, do you think MRI would be beneficial and should I ask to be referred to an orthopeadic surgeon? Last time I saw my doctor I was told that it is not common after pregnancy and I am just unlucky - not really the answer I was looking for! Any advice you could give me would be greatly appreciated. Many thanks in advance.

Answer
Hi Katarina,

You should get relief with the orthotic devices over time.  Some people have a hard time adjusting to the devices.  However, it is possible that the orthotic devices made for you need further adjustment or are not an appropriate material for you.  I would make sure that your doctor continues to work with you on getting corrected.  In addition, you may need to consider an anti-inflammatory and possibly physical therapy.  With physical therapy they can help you strengthen the foot and ankle to make up for the ligament weakness.  Don't give up.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
http://www.thetampapodiatrist.com
http://www.tampacryosurgery.com
http://katzpodiatristtampa.blogspot.com
http://painfoot.blogspot.com
http://twitter.com/TampaPodiatrist
http://www.facebook.com/markatz?ref=name#/profile.php?id=100000260088035&ref=nam

DISCLAIMER:
This information is offered as free advice and as general information. It may not be applicable to the specific questioner and his/her problem.  It is not based on actual knowledge of the questioner or his/her medical history and it cannot and should not be relied upon as definitive medical opinion or advice.  Reliable medical opinion and advice can only be obtained through hands-on physical contact and exam of the patient to establish an accurate diagnosis and treatment plan.  No doctor/patient relationship is created or established here and may not be inferred through answers on this site.  The questioner and other readers must consult his/her own doctor before proceeding or implementing any suggestions contained within this document and answers on this site.  The questioner is only to act upon his/her own doctor抯 orders and recommendations. By reading this posting which follows, the reader fully understands and confirms that he/she holds harmless this writer. If this is not fully agreeable to you, the reader, and/or you have not attained the age of 18 years, you hereby are advised to read no further.