During pregnancy, every expectant woman expects the quintessential baby bump, the first flutters of movement, and perhaps a few midnight cravings. Along with these wonders may come a few unexpected surprises. Achilles tendon pain during pregnancy is one of these uncommon side effects. The question is, why does heel pain happen for expectant mothers? Is there anything families need to be concerned about if the mother has Achilles tendon pain while pregnant?
Why am I experiencing Achilles tendon pain during early pregnancy?
Many women experience joint and muscle problems during their lives, and women who like to run might notice more issues in areas like the knee and ankle. Interestingly, about half of all pregnant women complain of back pain and pain around the hips to the point where they sometimes have to consult a doctor.
What’s causing all this? Let’s get down to the body’s physiology and why pregnant women experience Achilles tendon pain.
The physiological mechanisms by which these hormonal changes affect the Achilles tendon involve various cellular and molecular pathways. Hormones such as estrogen, progesterone, testosterone, relaxin, and sex hormone-binding globulin (SHBG) have been shown to affect ligament laxity during pregnancy and lactation.
For instance, estrogen and relaxin can alter the expression of genes involved in collagen synthesis and cross-linking, leading to changes in tendon stiffness and laxity. Progesterone’s role in relaxing smooth muscles could also affect the tendon’s mechanical properties. SHBG’s regulation of sex hormone levels can impact the balance of collagen synthesis and degradation, influencing tendon stiffness and laxity.
Let’s find out more about these hormonal changes in specifics:
Estrogen and Relaxin
Estrogen and relaxin are two key hormones that play significant roles in the changes that occur in the Achilles tendon during pregnancy. Estrogen levels increase significantly during the third trimester of pregnancy, leading to increased collagen synthesis and reduced collagen cross-linking and mechanical function. This hormonal change can decrease tendon stiffness and potentially increase tendon laxity.
Relaxin, on the other hand, is responsible for relaxing spinal and pelvic ligaments and joints to facilitate childbirth. Relaxin has been shown to increase the laxity of the pubic ligaments. Similarly, in the Achilles tendon, relaxin could potentially contribute to increased laxity by altering the mechanical properties of the tendon.
Progesterone
Progesterone levels also increase significantly during pregnancy, particularly in the first trimester. While its direct impact on the Achilles tendon is less well-studied compared to estrogen and relaxin, progesterone’s role in relaxing smooth muscles during pregnancy could potentially affect the tendon’s mechanical properties. This relaxation could lead to increased tendon laxity, which could be addressed through Clinical Pilates strengthening exercises.
Sex Hormone-Binding Globulin (SHBG)
SHBG is a protein that binds to sex hormones like estrogen and testosterone, regulating their levels in the body. During pregnancy, SHBG levels increase, which can affect the levels of these hormones and their impact on the Achilles tendon.
For example, increased SHBG levels could reduce estrogen and testosterone levels, potentially leading to decreased collagen synthesis and tendon stiffness.
This hormonal shift could be addressed through adjunctive treatments like INDIBA radiofrequency that promote tissue healing and increase blood flow to the tendon. This adjunctive treatment aims to support tissue integrity and accelerate recovery, which can be particularly useful given the hormonal and physiological stresses on tendons during pregnancy.
Benefits of physical therapy to help strengthen the Achilles tendon for pregnant athletes
Physical therapists can prescribe specific exercises to maintain the tensile strength and muscle function of the Achilles tendon and calf muscles. This includes calf raises, leg presses, and proprioceptive drills to support the feet despite increased ligament laxity.
Physical therapists may work on correcting any gait abnormalities, improving balance, and reducing stress on the Achilles tendon during activities. Stretching exercises for the calf muscles and ankle joints can improve flexibility and range of motion. This is especially important during pregnancy, as hormones affect ligament laxity, making flexibility and range of motion crucial.
By combining these targeted physical therapy interventions and adjunctive treatments, pregnant athletes can maintain Achilles tendon strength and overall musculoskeletal health during pregnancy and postpartum despite the hormonal changes affecting ligament laxity.
Abdominal and gluteal strengthening can help athletes regain core and gluteal muscle strength to stabilise the pelvic. This can help reduce stress on the Achilles tendon and other ligaments affected by pregnancy hormones.
Complementary therapies help Achilles tendon pain during pregnancy
Different modalities and physical therapy techniques can help address the physiological changes in the Achilles tendon during pregnancy due to hormonal fluctuations.
To promote tissue healing, INDIBA radiofrequency and shockwave therapy can stimulate cellular processes that promote tissue healing and repair. This is crucial for addressing the changes in tendon stiffness and laxity caused by hormonal fluctuations. Dry needling and other modalities can help increase blood flow to the tendon and can help deliver oxygen and nutrients necessary for cellular processes, aiding tissue healing and repair.
The adjunctive treatments mentioned can be used to address the physiological changes that occur in the Achilles tendon during pregnancy due to hormonal fluctuations. These modalities can promote tissue healing, increase blood flow, and reduce pain in the tendon, which is crucial for maintaining tendon health and function during pregnancy and lactation.
To learn more about how Achilles tendon pain during pregnancy can be managed, contact HelloPhysio today.
