Any kind of foot pain is uncomfortable and can easily make you miserable as it disrupts everyday life. But heel pain, in particular, can be sudden and excruciating, especially first thing in the morning.
So, why do I have heel pain when I wake up? What causes this specific pain at this particular time?
In this article, we will have a look at a few different foot conditions that could be causing heel pain. We will also offer advice on treating your pain and when you should see a doctor.
Let’s have a look at heel pain and some possible reasons.
Why Does Heel Pain Occur in the Morning?
Our feet carry weight all day as we go about our life. But when we go to sleep at night, we often fall asleep with our feet in a “pointed toe” position.
While this allows some of the soft tissues to relax, the plantar fascia contracts and shortens slightly.
When you wake up and place weight on the foot, this causes the thick, fibrous band of tissue to stretch suddenly, which pulls and causes pain in the heel.
With that being said, the location of the pain in the heel can help you identify the cause of the pain.
What Are Possible Causes of Heel Pain?
1. Plantar Fasciitis
The plantar fascia is a thick band of fibrous tissue that runs from the heel of your foot to the base of your toes.
This one singular band of tissue plays a vital role in your foot. It forms part of the soft arch in your foot, acts as a shock absorber, distributes weight evenly, and propels you forward.
When it becomes overused or is placed under repetitive tension, it will become irritated and inflamed. This causes pain where it attaches to the heel bone, the plantar calcaneus.
Plantar fasciitis is most commonly caused by repetitive strain that’s placed on the ligament, which is caused by a number of factors.
These include: wearing shoes that don’t provide the right support for your arch type, spending long hours standing, or walking on hard surfaces.
You can also develop plantar fasciitis if you’re doing a sharp burst of activity, have increased the intensity of your training routine, or if you’re walking or running long distances.
Tight calf muscles or Achilles tendons can increase the stress that’s placed on the plantar fascia, which can cause plantar fasciitis.
You may be at a higher risk of developing plantar fasciitis if you have high arches, flat feet, or overpronate.
If you’re overweight this will place your feet under consistent and excessive stress, and this will increase your chances of developing plantar fasciitis.
The pain of plantar fasciitis increases gradually and is often felt under the heel or in the arch of the foot. You’ll notice the pain when you get out of bed in the morning as the blood supply to your feet is reduced while you sleep.
After a few minutes of walking around, the pain will go away, but it may return with continued walking or activity. When you rest your feet, the pain will go away. But you may notice that over time, it takes longer to go away when you stop your activity.
You could also experience referred pain in the ankle if the inflamed plantar fascia is putting pressure or has irritated a nerve in the foot.
Try to rest your feet as much as possible and elevate them while you’re lying or sitting down.
If you do a lot of high-impact activities, like running, HIIT workouts, or activities that involve jumping, you may want to switch to low-impact activities for a while. This will give your plantar fascia time to heal.
Use a tennis ball to massage the bottom of your foot, by rolling it across your arch. You can apply as much pressure as you are comfortable with. This will help to alleviate the pain and provide relief from the symptoms.
Stretching your foot throughout the day or before you stand up can also help to reduce heel pain.
To help reduce the swelling and alleviate the pain, you can take anti-inflammatory medication.
If left untreated, the plantar fascia can partially tear away from the heel bone, which can lead to a heel spur.
2. Heel Spurs
Heel spurs are calcium deposits that cause small bony growths. They can develop on the back of or under the heel.
When there are small tears, either to the plantar fascia or Achilles tendon, our body will try and repair the damage through fibroblastic activity. This will then release osteoblasts, which are cells that develop bone.
With repeated strains to the foot muscles and ligaments, tearing of the membrane that covers the heel bone, and stretching of the plantar fascia, these calcium deposits build up over time and cause heel spurs.
If the plantar fascia has partially torn away from the heel bone, then you’ll develop a heel spur underneath the heel bone—on the sole. This will cause localized tenderness and the heel pain will increase when you step down on it.
If your heel spur was caused by Achilles tendonitis, then you’ll experience an increase in pain when you push off the ball of your foot.
When inflammation develops around the soft tissue where the heel spurs have formed, this can cause pain.
You may feel a sharp, stabbing pain in your heel when you stand up in the morning as if you’ve stepped onto a sharp object. The pain can then turn into a dull ache that you’ll feel in your heel for the rest of the day.
You may also notice swelling at the front of your heel. There could be tenderness in the bottom of your heel that makes walking barefoot difficult.
Wearing supportive, cushioned shoes can help to reduce the pressure that’s placed on the foot, which will alleviate pain.
You can also try using shoe inserts or orthotic devices that are designed to reduce the pressure on plantar spurs. To help reduce the stress on the Achilles tendon, you could try using heel lifts.
Your doctor may recommend that you wear night splints to help keep the plantar fascia elongated throughout the night. This will help prevent you from experiencing pain in your heel when you first get out of bed in the morning.
To help reduce the pain and swelling, you can roll your foot over a frozen water bottle for 20 minutes, several times a day.
Foot exercises and stretches can help to relax tight muscles in the calves and feet. This can help improve your range of motion and strengthen the muscles in the foot.
Your doctor may recommend some exercises or they may refer you to a physical therapist. The physical therapist may tape or strap the muscles and tendons. This will give your feet time to rest and promote healing.
To reduce inflammation and alleviate pain, you can take over-the-counter medications such as aspirin or ibuprofen.
3. Achilles Tendonitis
Achilles tendonitis is a painful condition that develops from microtears in the tendon, which cause inflammation and irritation.
It’s often caused by overuse of the tendon during high-impact activities, like running, or activities that require you to stop and start suddenly, like tennis or soccer.
You can develop Achilles tendonitis if you have suddenly increased the intensity of your activity, if there’s an increase in walking or running distance, or if you didn’t warm up properly before an activity.
If you’re wearing worn-out shoes, shoes that don’t provide adequate support for your foot structure, or that fit poorly it will increase the strain that’s placed on the Achilles.
Women who often wear high heel shoes are at a higher risk of developing Achilles tendonitis. The Achilles will begin to shorten over time, as the height of the heels doesn’t allow the tendon to fully extend.
You are at a higher risk of developing Achilles tendonitis if you’re overweight, have flat feet, or overpronate. These all put the Achilles under constant stress, which can cause irritation and inflammation.
As we get older, the Achilles will weaken and this can make you more prone to Achilles tendonitis or tendon ruptures.
With Achilles tendonitis, you’ll feel pain in the back of the heel and along the Achilles. It may feel worse in the morning, as there will be stiffness along with the pain. You will notice swelling on the back of your heel that gets worse throughout the day with activity.
Unlike plantar fasciitis, you’ll experience pain and discomfort the whole day, which can feel worse as you go about your daily activities.
The pain can be more severe the day after you’ve exercised or if you’ve had to walk or climb stairs a lot during your daily activities.
Give your Achilles time to heal by reducing activities that place it under pressure, or stop activities that cause pain. If your training routine is high-impact, then switch to low-impact activities like swimming, biking, or using an elliptical.
This will help you remain active and maintain your fitness levels without putting stress on the Achilles.
Make sure that you include gentle calf stretching into your daily routine, and once the Achilles has healed, include strengthening exercises.
Try using heel lifts, as this will increase the height of heel, which will reduce the load, strain, and stretch on the Achilles.
To help reduce the pain and inflammation, ice the area for 20 minutes, 3 to 4 times a day.
4. Stress Fracture
A stress fracture can develop on the heel from overuse causing microtrauma in the bone. But you can also develop a stress fracture if you’re training with the incorrect form or if you’re participating in intense sports.
An injury to the foot, like twisting your ankle, or taking part in activities that place repeated stress on the heel for a long time can cause a stress fracture to develop.
There are also medical conditions that weaken the bones, like osteoporosis, diabetes, or vitamin D deficiency, which could put you at a higher risk.
With a stress fracture, the generalized pain in the heel develops over a few days or weeks. The pain will increase and will get worse the longer you’re on your feet.
You may find that the pain gets better when you rest your foot, but that there is a constant point of pain in one spot on the heel.
There will be swelling and redness in the heel area, which is also painful to the touch. You may experience constant pain as you go through your daily activities and while you rest.
If you believe your heel pain could be caused by a stress fracture, you should make an appointment to see your doctor. If left untreated, the fracture could get worse, heal improperly, and could lead to other conditions such as arthritis.
Your doctor will recommend that you stop any activities that could cause further injury or pain.
Depending on the severity of your stress fracture, you may need to wear a cast or boot to prevent the bones from moving.
If you have a mild fracture, you’ll need to rest your foot and avoid activities that could cause pain or further injuries. Apply ice to the affected area for 20 minutes, 3 to 4 times a day, as this will help to reduce the inflammation and alleviate pain.
Make sure to keep your foot elevated above your heart level when you’re lying or sitting down, as this will also reduce the swelling.
3 Easy Steps You Can Do to Ease Heel Pain
1. Do Circles or Write The Alphabet
Before you get out of bed in the morning, do the following exercise to stretch the muscles and tendons in the foot. You’ll do this for one minute on each foot, focusing on one foot at a time.
Swing your legs out of bed and let them hang over the edge. Then, with your right foot, gently point your toe and draw 5 circles in the air. Then imagine your big toe is a pen and write the letters of the alphabet.
Once you’ve completed the alphabet, repeat the exercise on your left foot.
2. Use a Ball
To stimulate the blood flow to the feet and to elongate the plantar fascia before your feet hit the ground, you’re going to massage them with a ball.
While sitting in bed, place a tennis ball or a lacrosse ball underneath your foot. Use your leg to apply comfortable pressure, and then roll your foot over the ball from heel to toe.
You can roll the ball in small circles from the heel of the foot to the arch.
Massage with the ball for 1 minute on each foot.
3. Foam Roll Your Feet With a Bottle Of Frozen Water
To help reduce the inflammation and alleviate the pain, fill a 600 ml bottle with water, and put it in the freezer.
Once the bottle is frozen, place the bottle on a towel, and roll your foot—heel to toes—over it. As you roll the bottle back towards your heel, point your big toe downwards. This will help to stretch the top of your foot.
You’ll use the weight of your leg to apply comfortable pressure, but be mindful not to push down too hard.
You can do this several times a day for 10 to 15 minutes at a time.
How to Prevent Heel Pain in the Morning
There are a few steps you can take to prevent heel pain from ruining your mornings.
First, make sure that you maintain a healthy weight. Being overweight places unnecessary and constant pressure on the feet, which can make heel pain worse.
You can reduce and maintain your weight by following a healthy, whole food diet, and incorporating exercise into every day.
To protect and support your feet properly, you should make sure you’re wearing the right shoes for your foot type. If you overpronate you will need to wear a stability shoe.
Avoid wearing high-heeled shoes, as these place pressure on the forefoot and can cause foot conditions that lead to heel pain. Also, replace your shoes when they start to show wear and tear. For running shoes, this is every 300 to 500 miles.
If you usually do high-impact exercise like running or sports like basketball, try to switch to low-impact activities instead, or alternate between them. You can still get an excellent cardiovascular and muscular workout from activities like swimming and cycling.
If you continue to run, you may want to look at your running technique and work on improving it so that you strike more with the midfoot than the heel. This will reduce the jarring impact on the heel.
You can also incorporate strength training into your workout routine. Focus on strengthening the legs, especially the calf muscles, which will support the Achilles tendon better and reduce the chances of foot conditions that could cause heel pain.