Why Do My Heels Hurt In The Morning?

Waking up with heel pain can turn the simplest task of getting out of bed into a challenging ordeal. This pain, often described as a sharp or stabbing sensation, can make those first few steps in the morning particularly uncomfortable. While the pain may subside after walking around, it often returns after periods of rest or inactivity. If you’ve experienced this, you’re not alone. Morning heel pain is a common complaint, and understanding its causes and management strategies can help you find relief and prevent it from interfering with your daily life.

A Common Culprit: Plantar Fasciitis*

A condition that affects the plantar fascia—a thick band of tissue that runs along the bottom of your foot, connecting your heel to your toes. The plantar fascia provides support to the arch of your foot and absorbs shock during activities like walking or running.

Key word: SUPPORT.

When the plantar fascia becomes irritated or painful, it’s often because you have started to rely more or even solely on your plantar fascia for arch/foot support. Meaning, the smaller muscles of your foot (intrinsic muscles) are not performing their job because either they are too weak or placed inside of shoes where they cannot perform. Ultimately, when the smaller muscles of the foot cannot perform their job of controlling foot motion, the foot relies more heavily on dense connective tissue, aka the plantar fascia. 

During rest, such as when you sleep, the tissue tightens. Upon waking and placing weight on your foot, the sudden stretching of the plantar fascia can cause sharp pain at the heel. This pain may improve as the tissue warms up with movement but can recur throughout the day, especially after periods of inactivity.

Other Potential Causes of Morning Heel Pain

While plantar fasciitis is the most common cause, other conditions could also be responsible for your heel pain:

1. Heel Spurs

   - Bony growths on the underside of the heel, known as heel spurs, can develop due to chronic stress on the plantar fascia. Though they don’t always cause pain, they can exacerbate discomfort in some cases.

2. Achilles Tendinitis

   - Inflammation of the Achilles tendon, which connects the calf muscles to the heel, can cause pain at the back of the heel. This condition often results from overuse or tight calf muscles.

3. Bursitis

   - The bursae are fluid-filled sacs that cushion the heel. Inflammation of these sacs (bursitis) can lead to heel pain, particularly after prolonged standing or repetitive activities.

4. Tarsal Tunnel Syndrome

   - This condition involves compression of the posterior tibial nerve near the ankle, leading to pain, tingling, or numbness in the heel and foot.

5. Stress Fractures

   - Small cracks in the heel bone from repetitive stress or overuse can cause localized pain that worsens with activity.

6. Arthritis

   - Conditions like rheumatoid arthritis or osteoarthritis can affect the heel joints, leading to stiffness and discomfort, especially after rest.

How to Manage Morning Heel Pain

Managing heel pain effectively requires addressing both the symptoms and the underlying causes. Here are the best strategies to relieve and prevent morning heel pain:

1. Stretching and Strengthening Exercises

Keeping the plantar fascia, calf muscles, and Achilles tendon flexible and strong can alleviate pain and prevent recurrence. Try these exercises:

- Plantar Fascia Stretch: Sit down and pull your toes toward you using a towel or your hands. Hold for 20–30 seconds and repeat 2–3 times.

- Calf Stretch: Stand facing a wall with one foot forward and the other extended back. Keep the back leg straight and press your heel into the floor as you lean forward. Hold for 20–30 seconds and repeat 2–3 times on each side.

-Banded small toes press downs: Start seated with a resistance band anchored under toes 2-5 only. Pulling up on the band creating resistance for toes to press down against. Perform 20-30 reps.

2. Wide Toe Box Shoes

Wearing shoes with a wide toe box is crucial for managing heel pain. 

4. Orthotic Inserts

Over-the-counter (and custom, but they are $$$) orthotic inserts can provide additional arch support and cushioning for your heels which has been shown to be effective at managing pain in the short-term. 

5. Massage and Self-Myofascial Release

Using a tennis ball, massage roller, or your hands, apply gentle pressure to the arch and heel of your foot. This helps loosen tight tissues and improve blood flow.

6. Gradual Activity Modification

If your pain is caused by overuse or repetitive activities, consider reducing or modifying your activity level. Gradually increase your activity to avoid overloading your feet.

Like so many things, some of these may work for you, some may not. What’s important is you explore different options when you address your heel pain. Find what works for you and stick with it.

Keep moving forward babes!

Xoxo

Lindz