‘I’m A Podiatrist—Here’s What Causes Your Morning Heel Pain’

I swear, nothing makes me feel more like ‘Oscar the Grouch’ than when I wake up in the morning to heel pain. Yes, I normally shuffle to the kitchen for coffee with a less-than-cheery demeanor. But adding morning heel pain to the mix is a recipe for a bad day. I never realized there was a reason this was happening until a running injury landed me in a podiatrist’s office. The great news is that my morning heel pain had solutions (the same can’t be said for my morning attitude).

My heel pain is plantar fasciitis, a condition where the plantar fascia—or the thick connective tissue that runs along the bottom of your foot—becomes inflamed and tender from overuse. Usually, when you flex your foot and move around, your plantar fascia stretches and contracts to support you. Tension and stress are a normal part of walking and running, but sometimes the pressure is strong enough to make small tears in the fascia which can cause inflammation, according to the Mayo Clinic. The fascia presses against nerves in your heel, and you feel major discomfort.

Even though plantar fasciitis is an overuse injury caused by repetitive strain from activities like sports, running, or standing for extended periods, according to William Spielfogel, MD, is a board-certified podiatrist, you might not feel it directly after an intense workout. “[It’s] most noticeable in the morning,” Jeff Brannigan, program director at New York’s Stretch*d previously told Well+Good. “This makes it hard to take those first few steps out of bed due to a sharp painful sensation at the bottom of the foot.”

Why it’s worse in the morning

When you sleep at night, the body relaxes, and the fascia contracts and shortens for six to 10 hours, says Pamela Mehta MD, a board-certified orthopedic surgeon and owner of Resilience Orthopedics and advisor to the Good Feet Store in San Jose, California. Although it naturally stretches and bends with your foot, it needs some warming up in the morning (especially cold mornings). So when you wake up and take your first steps, your plantar fascia isn’t ready to hold your body weight—and it lets you know it, Dr. Metha explains.

You can prevent or alleviate worsened plantar fasciitis symptoms in the morning by stretching and warming up your foot before getting out of bed. Try slowly pointing your toe towards the end of the bed and then flexing your foot to a 90º angle, Dr. Mehta says. You can also massage the fascia gently with your hands, offering it some warmth and circulation.

By stretching and massaging the plantar fascia before taking your first steps, you can get your fascia warmed up and prepare it to support your foot.

Shoe choice is important too

Outside of stretches and in-bed massages, you can support your plantar fascia by wearing the right shoes. One way to keep your feet happy is to make sure you have the appropriate arch support in your shoes, says Dr. Spielfogel. Arch support is important because it can support optimal performance in your sport, reduce risk of injury, and decrease the likelihood of pain.

People with high arches need shoes that offer a significant amount of cushion, especially in the heel area. This is because high arched feet don’t always offer enough shock absorption on their own. Additionally, people with low arches can benefit from shoes with firmer arch support so that the little arch they have is supported and preserved, Dr. Mehta says. This helps with foot placement and gait, which is important for preventing injury as well.

And if pain persists, Dr. Mehta recommends seeking treatment. This condition gets worse if it is ignored or “pushed through” while you continue activities (like running). Consult your doctor about treatment options or even physical therapy techniques.

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