It’s a story we’ve heard over and over (and over) again.
We ask our patient to describe their pain to us. What are your symptoms like? And we get a variation on this story.
“Well, doctor, in the morning I cringe just thinking about putting my foot down on the floor after getting out of bed. It hurts so bad!”
“Any other times?” we ask.
“Well, now that you mention it, I went to see that new superhero movie last week and my heels hurt so bad when I finally got up out of my seat.”
“Where is the pain located most of the time?”
“The bottom of my foot. Right under the heel.”
Now, asking a few questions isn’t the same thing as making a full examination. And since a lot of different types of injuries can cause heel pain, we’ll take our time and be careful about our diagnosis.
But when we hear stories like this, the odds are very high that our patient has a condition called plantar fasciitis. Although several different symptoms are possible, that “early morning” stabbing heel pain is its most common and distinguishing feature.
So Why Do My Heels Hurt in the Morning?
Let’s assume your diagnosis is, in fact, plantar fasciitis. Here’s what’s going on.
In order to do this properly, we’re going to have to start from the beginning. Bear with us.
The Ballad of the Plantar Fascia
Basically, at the very bottom of each foot there is a long, tough, flexible band of connective tissue called the plantar fascia. You can think of this is being like a ligament or tendon in terms of its function or composition. In fact, all three types of tissues are primarily made from collagen and very similar to one another, with the main difference being their primary anatomical function:
- Tendons connect muscles to bones.
- Ligaments connect bones to other bones.
- Fascia surround muscles, organs, and other structures to separate them from the skin, attach them to a wide area of the body that they need to act upon, and provide support and stability.
In particular, the plantar fascia—which stretches all the way from the bases of your toes to the front of your heel—has a pretty complicated and tough job. This singular band of tissue has a huge role to play in supporting your arch, evenly spreading the weight of your steps over as much time and area as possible, and even propelling you forward.
It flexes like a bowstring, dampening and storing energy when bearing weight. This, ideally, prevents those impact forces from being too stressful or causing too much damage to any one particular muscle, bone, or part of the foot. Then, when you push off, that stored energy gets released like a spring, making your locomotion more efficient.
Pretty neat, huh? We think so.
But here’s the problem. Your plantar fascia is not invincible. And if it gets overstretched and overstressed without enough time to repair itself, it starts to break down, leading to pain and inflammation.
(More information about the most common underlying causes of this breakdown can be found later in this blog, so stay with us!)
The most common location for this pain and inflammation just so happens to be at the underside of the heel, right where the plantar fascia connects with the heel bone.
But Why Does It Hurt in the Morning Specifically?
So let’s return to the original question.
If you’ve got a painful, broken down plantar fascia, shouldn’t it just hurt all the time—whenever you’re using it? What’s with the spike in discomfort when getting up after a break?
Essentially, the answer has to do with what’s happening to the tissue when you’re not bearing weight. When you’re sleeping or taking a breather, the inflamed plantar fascia contracts and shortens slightly. Think of it like a muscle or joint that feels a little stiff until you’ve had a chance to warm up a bit.
Unfortunately, once you put weight on that foot again, the sudden force load comes as something of a shock to your plantar fascia. That initial re-stretching and re-aggravation of the damaged tissue can be quite painful. Give it a few minutes, though, and your discomfort will start to recede (though probably not totally go away).
Incidentally, this is why night splints are commonly recommended for plantar fasciitis sufferers. The splints keep the fascia in an elongated position during the night, so that its better prepared to handle that initial morning shock.
How Did I Get Here?
We touched on it briefly above, but let’s get into more specifics.
The “big picture” cause of most cases of plantar fasciitis is overuse. Simply put, your plantar fascia has to bear too much weight too often over too long a time without enough of a chance to rest and recover. Sooner or later, it’s going to break down.
But what specific activities or choices can lead to that kind of breakdown? There are lots of possibilities, but here are some of the most common risk factors:
- Tough jobs. Tons of us spend most of the day on our feet. If you work in healthcare, construction, education, logistics, or any of a couple dozen other fields, you know what we’re talking about. It’s even worse if the surfaces underfoot tend to be cement, tile, or other hard and flat materials without much give.
- Bad shoes. The right pair of shoes can really make or break it for your heel pain. A supportive pair with good cushioning and support will give your arch (and by extension plantar fascia) a little extra assist with every step you take throughout the day. Bad shoes leave the plantar fascia to fend for itself—with sometimes disastrous results.
- Active hobbies. No, we’re not saying you need to give up running or playing basketball. But it’s undeniable that certain activities—especially of the “running and jumping” variety—can seriously stress out your heels. If you like being active, wearing the right shoes and following a sensible training protocol becomes even more important.
- Foot structure. Unfortunately, for some of us genetic inheritance is on the list of culprits. If you were born with—or subsequently developed—an inefficient foot structure such as a flat foot, high arch, or gait abnormality, your basic way of walking might be putting more strain than usual on your plantar fascia.
- It’s no secret that obesity has become more prevalent in our society in the last few decades—and our home state of Oklahoma has the third worst adult obesity rate in the nation, at more than 36 percent. Since the impact force on your plantar fascia can actually be equivalent to a couple of times your own body weight, carrying a few extra points can really put a lot of excess strain on the plantar fascia.
Now, as you might imagine, the fundamental cause of your plantar fasciitis makes a major difference in terms of how best to treat and prevent it.
For one person, for example, the best remedy might include a new a pair of shoes and a squishy mat at their workstation. For another, custom orthotics are going to be a major piece of the puzzle. Athletes and workers, meanwhile, might especially be interested in some of our advanced therapies, such as shockwave, to accelerate the tissue healing process.
When you hobble into the Foot & Ankle Center of Oklahoma, we’ll be sure to get to the bottom of what’s troubling you and leading to your morning heel pain. That way, we can offer you the absolute best possible treatment plan—one that not only perfectly addresses the cause of your plantar fasciitis, but also makes sense within the context of your lifestyle.
So stop suffering from morning heel pain! The team at Foot & Ankle Center of Oklahoma provides effective treatments for people just like you literally every day. You can enjoy that relief, too.
To schedule an appointment with us in Oklahoma City—or at our new clinic in Moore!—just give us a call at (405) 418-2676. You can also request an appointment online.
Heel pain in the morning might be because of a condition like plantar fasciitis or Achilles tendinitis. It may also be due to an injury like a stress fracture. Heel pain can sometimes be treated with at-home remedies like ice and rest.What does it mean when your heels hurt in the morning? ›
Why is heel pain worse in the morning? The way people rest their feet in bed causes the plantar fascia ligament to tighten during sleep. This is the same reason you're likely to experience heel pain after sitting for a while. The good news is the rest is probably helping your foot heal.How can I stop my heels and ankles hurting? ›
- resting your heel – avoiding walking long distances and standing for long periods.
- regular stretching – stretching your calf muscles and plantar fascia.
- pain relief – using an icepack on the affected heel and taking painkillers, such as non-steroidal anti-inflammatory drugs (NSAIDs)
As you sleep, the plantar fascia remains still rather than stretching and relaxing as it would if you were awake and moving. Because it doesn't get to stretch, it slowly constricts and becomes tighter. This can make walking in the morning quite painful until the ligament has a chance to loosen up from being active.Does plantar fasciitis ever go away? ›
Most people who have plantar fasciitis recover in several months with conservative treatment, such as icing the painful area, stretching, and modifying or avoiding activities that cause pain.How do I get rid of morning heel pain? ›
Pain relievers such as ibuprofen and naproxen also can ease heel pain and inflammation. Icing the heel is important, as well as rest and elevating the foot. “The most effective treatment for plantar fasciitis includes calf and Achilles stretching, plantar fascia stretching, and a night splint or a night sock,” Dr.What are 2 symptoms of plantar fasciitis? ›
- Pain on the bottom of the foot near the heel.
- Pain with the first few steps after getting out of bed in the morning, or after a long period of rest, such as after a long car ride. ...
- Greater pain after (not during) exercise or activity.
Calcaneal Stress Fracture
Acute heel pain caused by calcaneal stress fractures can closely resemble the symptoms usually associated with plantar fasciitis. The history may reveal a recent abrupt increase in daily exercise or other activities.
Vitamin C, vitamin B-3, and vitamin E deficiencies may contribute to dry, cracked heels. However, these vitamin deficiencies are rare in developed countries. Other conditions like athlete's foot or eczema may also lead to cracked heels. Walking around barefoot and the natural aging process can be factors, too.What are the 3 causes of plantar fasciitis? ›
Plantar fasciitis can be caused by a number of factors, including type of shoes, foot structure, overuse and types of walking surfaces.
Non-urgent advice: See a GP if: heel pain is severe or stopping you doing normal activities. the pain is getting worse or keeps coming back. the pain has not improved after treating it at home for 2 weeks.When I get up from sitting I can hardly walk? ›
It can be due to reduced blood flow, tight muscles and ligaments, fluid pooled in the body's lower extremities, or pins and needles sensations in the feet.Why do my feet and ankles hurt when I wake up and walk? ›
The Four Most Common Causes of Morning Foot Pain:
Plantar Fasciitis. Achilles tendinitis. Arthritis. Hypothyroidism.
Your feet hurt more in the morning because it's a return of pressure and stress being placed on them. After being off of your feet all night, your feet usually aren't experiencing any pain. When you wake up, all the pain and pressure comes back.What is the best anti inflammatory for plantar fasciitis? ›
Plantar fasciitis pain responds well to ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). These can ease any pain, swelling, and inflammation.Can a chiropractor fix plantar fasciitis? ›
Chiropractic care is a very effective treatment for plantar fasciitis as well as the pain that is caused by the condition. Chiropractic for plantar fasciitis involves a very precise technique that involves adjustments to the feet and ankles as well as spinal alignment.Why does my heel hurt when I get out of bed? ›
Heel pain in the morning might be because of a condition like plantar fasciitis or Achilles tendinitis. It may also be due to an injury like a stress fracture. Heel pain can sometimes be treated with at-home remedies like ice and rest.Is walking good for plantar fasciitis? ›
Walking around after lying or sitting for a time may ease plantar fasciitis symptoms as the ligament stretches out. However, the pain will gradually worsen throughout the day making you very uncomfortable and affecting normal daily activities.What is the best sleeping position for plantar fasciitis? ›
Most people sleep with their feet pointed down, which relaxes the plantar fascia during the night and causes early morning pain when you suddenly stand up and stretch it. Night splints work by stretching your foot arches and calves while you sleep.Can vitamin D cured my plantar fasciitis? ›
There seems to be evidence suggesting that Vitamin D, along with magnesium, is helpful in the treatment of Plantar fasciitis. However, it is best to use it as an adjunct to other treatment methods like exercises and orthotics. This is because vitamin D alone cannot cure plantar fasciitis.
Patients suffering from plantar fasciitis typically have pain directly beneath the heel bone where the plantar fascia attaches. In the case of Baxter's neuritis, the pain on examination is higher on the foot and more to the inside, rather than the bottom—where the nerve is actually inflamed or entrapped.Who is most likely to get plantar fasciitis? ›
Both men and women can have plantar fasciitis, though it's more common in active men between the ages of 40 and 70. You may be more likely to get plantar fasciitis if you: Have foot arch problems such as flat feet and/or high arches. Run long distances or on uneven surfaces.What can a podiatrist do for plantar fasciitis? ›
Other methods a podiatrist may use to reduce pain and treat plantar fasciitis include physical therapy, night splints that gently stretch the plantar fascia, orthotics that correct can help distribute weight more evenly, steroids to reduce inflammation and pain, and shock wave therapy that initiates the body's healing ...Can a xray show plantar fasciitis? ›
Although plantar fasciitis does not show up on x-rays, your doctor needs to make sure you don't have a fracture or another condition that's causing the pain. Once you have a positive plantar fasciitis diagnosis, there are numerous treatment options to relieve your pain and discomfort.How can you test for plantar fasciitis at home? ›
Sit in a chair, bend your knee and bring your affected foot up to rest on the opposite knee. Using your thumb, press firmly down throughout the heel area of your foot. If you experience significant amounts of pain, or “hot spots”, then you most likely have plantar fasciitis.Is heel pain related to liver? ›
Liver disease can cause pain and swelling in the feet. When the liver isn't working right, excess fluid builds up in the lower extremities leading to edema. Peripheral neuropathy in the feet (numbness, weakness and pain caused by nerve damage) has also been associated with chronic liver disease.Which vitamin is good for heel pain? ›
Don't forget to add vitamin C. So many foot problems, including tendinitis and plantar fasciitis, develop because of inflammation. Fortunately, vitamin C can help fight that inflammation. So look for foods rich in this helpful vitamin, including oranges, kiwis, strawberries, tomatoes, kale and spinach.Does heel pain Mean diabetes? ›
Can Diabetes Make My Feet Hurt? While the danger of numbness and loss of sensation from peripheral neuropathy is the biggest threat to diabetes sufferers, feet with sensation (that can feel pain!) are no picnic either. Diabetes can contribute to painful feet, especially heel pain from plantar fasciitis.Is plantar fasciitis a form of arthritis? ›
Plantar Fasciitis is a condition of the foot that is closely associated with rheumatoid arthritis. This may surprise some people who suffer from one or both conditions. Yet nearly a quarter of people in the U.S. suffer from foot pain, and these types of conditions only get worse with age.How do you stop my feet from hurting when I wake up? ›
Most people afflicted with plantar fascia can improve their condition with conservative methods. Before you get out of bed in the morning, try massaging your foot and stretch the plantar fascia. You can roll your foot over a golf ball or massage it with your hand. Icing the painful area is also helpful.
The abnormal buildup of fluid in the body is called edema. Edema is commonly seen in the feet and ankles, because of the effect of gravity, swelling is particularly noticeable in these locations. Common causes of edema are prolonged standing, prolonged sitting, pregnancy, being overweight, and increase in age.