What causes heel pain in the morning?
Not being able to walk to the bathroom in the morning when you hop out of bed is not only annoying, for those of us that suffer from heel pain, it can be very debilitating!
Heel pain that is worse in the morning is a sign of Plantar Fasciitis, an injury to the fascia tissue and tendons that run from your heel bone to the ball of your foot.
This damage, which is tearing of the tissue nearest to the heel bone, is usually caused by one of the following things:
- Wearing shoes that are not supporting your feet properly.
- Wearing inappropriate shoes (eg, high heels).
- Physical exertion, such as running or sports (especially where you have not done so before).
- Tight muscles in your legs and hips or poor posture (which makes you walk differently to compensate).
Luckily, these are all problems that you can fix!
Those first steps in the morning need not be painful if you can follow these simple tips and ideas. Plus, it would help to see a doctor or even better, a podiatrist so that you can get correctly diagnosed.
Don’t ignore Plantar Fasciitis – it rarely goes away on its own or without some intervention. The longer you leave your treatment, the longer the recovery time will be.
So, why do my heels only hurt first thing?
When you sleep, your muscles and tendons relax, and some of them begin to contract or shorten slightly.
Once you wake up and step out of bed, the fascia immediately has to bear your weight and stretches out. However, if it is damaged at all, the pain of this early morning stretch can be immediate.
Where the tissues are already torn and inflamed, they have pulled apart again, ripping any repair work they have achieved overnight. You are reopening the wound which causes your pain.
You may have noticed that after a while, the pain is not so intense or goes away after you start to walk more; also very common for Plantar Fasciitis sufferers.
Your tissues are still broken and torn where they join the heel bone, but you are getting used to the pain. After a few hours, you might feel like you are back to normal but the process will repeat itself over and over if you do not take action to fix the problem.
What can you do to help stop this pain?
There are many ways to start to address this problem, and I have broken it down into some simple sections.
Resting and recuperation
Rest is the most obvious way to help fix your painful heels. Staying off of your feet as much as you can to allow them to repair themselves.
You can also try applying some ice to the sole of your foot, massaging the area with your thumbs or a massage ball or foam roller or some people have found that using compression socks (running socks are perfect for this) can give some support and relief too.
Get better shoes!
I should have put this as the primary way to address Plantar Fasciitis and morning heel pain, but resting can be useful, especially if you are experiencing the pain for the first time.
My foot pain problems started when I persisted in wearing old shoes that had lost their shape and support. I was only walking in them, but it was enough to cause me to have Plantar Fasciitis, which I have been managing for over ten years.
Your shoes need to have an excellent supportive mid-sole area with adequate arch support (the required amount will differ for each person). The sole also needs to be rigid if possible, which will help ensure that your feet are not twisting or slipping to one side or the other (this is called pronation and supination and can cause problems for your ankles too).
Running or gym shoes are great for addressing heel pain in the majority of people. They are designed to give the best support and comfort, and I would recommend people buy these sorts of shoes to help.
Read our article on the best shoes for plantar fasciitis sufferers.
Do your stretches!
Heel pain in the morning that is caused by Plantar Fasciitis is worse if you have tight calf muscles.
If the muscles are tight, this causes tension down the back of your leg, down where your Achilles tendon is and around the heel.
Any extra pulling in this area can make your heel pain worse as it reduces your mobility and pulls muscles in the wrong direction.
Just doing some simple stretches on the stairs a few times a day can work wonders for people who suffer heel pain.
Use the gadgets.
Because heel pain is so common, there are lots of products available that can help reduce the tension on your foot or help stretch the fascia tissue.
Orthotics and insoles.
If you can’t find any supportive shoes or running shoes you like, try buying a pair of orthotic insoles.
These can be purchased over the counter in lots of shops or online and are easy to fit. They slip inside your shoe and will provide extra support for your feet where they need it.
They can sometimes be hard to fit, and you may have to try a few different manufacturers before you get the one that works best, but they are relatively inexpensive compared to a custom pair made by a podiatrist.
Using a night splint is also popular to help treat morning heel pain.
These boot-like devices are worn overnight and are designed to keep your foot stretched up at an angle so that the fascia is not allowed to contract. So when you step out of bed, you are not tearing the tissues again – they have stretched out all night and won’t hurt so much.
Some people find these very cumbersome to wear and not very comfortable either.
You can get a version which looks like a sock, with a velcro strap that pulls your toes up to the right angle which might be less annoying.
How to start using these gadgets.
As with any treatment where you are making changes to the way your body works, it is best to introduce these sorts of gadgets slowly over time. For example, when I started wearing new orthotics, my legs ached for weeks until I got used to using them.
I started by only wearing them for a few hours at a time and increasing the duration over a few weeks.
Many people buy orthotic insoles, wear them for the day and then throw them in the bin after their legs, feet or ankles start to become painful. You need to give yourself time to adjust.
The best advice I can give…
Firstly, look at your shoes – are they doing you any harm? They might be fashionable, but if they are not comfortable, you may be causing yourself some serious problems.
Secondly, book an appointment to see a podiatrist who will examine you properly, look at the way you stand and walk and make suggestions. It could be that you don’t need new shoes, it could be that you are walking incorrectly or putting pressure on one leg more than the other.
Podiatrists are trained to look at the bigger picture for the causes of your foot pain.
Thirdly, make sure you rest when your feet hurt. Give the running or sports a break for a while or take up a lower impact sport such as swimming (or dominoes!).
Having heel pain in the morning is not something I would wish on anyone else, so please take steps to address the issue and don’t think it will just go away on its own.