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When Your Heels Hurt in the Morning

HeelsHurtJacquie Eubanks RN BSN

If you hobble about with heel pain when you take your first steps in the morning, you may have developed plantar fasciitis, one of the most common causes of heel pain and stress. Normally, the pain quickly subsides simply by walking, which warms and stretches the tissues. However, intense activity or periods of sitting or standing throughout the day may trigger the pain to return. One thing for certain is that the pain and stiffness will be there again the next morning. Common to long distance runners, the overweight and those who wear shoes without adequate arch support, plantar fasciitis is an inflammation of the plantar fascia, a strong tissue band that runs along the bottom of the foot and stretches from the heel to the mid-foot bones.

The multifunctioning plantar fascia provides arch support, stores potential energy for foot acceleration, and performs as a shock absorption mechanism. Consisting of three distinct areas, known as the medial, central and lateral bands, the central band is the most likely to be affected. Although some argue that the pain is caused by chronic degenerative irritation that can occur with or without inflammation, there’s no question that this condition can be painfully debilitating. While plantar fasciitis can be the result of aging, traumatic injury, or tight Achilles tendons, most cases are caused by overuse stresses, training errors, improper foot wear, sudden weight gain and chronic obesity, as well as a profession that requires standing for long time periods.

The good news is that the condition is often temporary and most cases resolve satisfactorily with nonsurgical treatment. For the highly physically active person with chronic pain, the slow resolution can be frustrating, as similar to ligaments the fascia tissue takes time to heal. A combination of treatments may help to speed recovery, but it can up to a year to return to normal pain free functioning, particularly when activity is not curtailed. If the condition is not resolved it can lead to associated secondary injury to the hip and knee joints. Treatment often includes rest, exercises that stretch the Achilles tendon and the calf muscles and, most importantly, pain and inflammation reduction.

Conservative treatments for the relief of plantar fasciitis include:

– When an injury is involved, rest, ice, compression and elevation is important. If an injury is particularly painful, cold therapy can be applied for 10 minutes every hour for the first 24 – 48 hours. As symptoms ease, an icepack can be applied three times a day. If the pain is caused by repetitive impact, icing for 20 minutes after activity and at the end of the day is recommended.

– Be sure every day shoes have adequate arch support, and rotate your shoes daily. Running shoes wear out quickly, so replace them as often as needed to ensure good arch support and proper cushioning.

– Foot sleeves designed specifically to address plantar fasciitis provide targeted compression to reduce pressure on the fascia to alleviate arch and heel pain, as well as aid recovery.

– Custom made orthotics, arch supports or heel pads inserted in shoes can help prevent further damage and reduce pain by redistributing pressure. They should be worn in both shoes at all times, even if the pain is in one foot.

– Wearing a night splint that holds the foot in a flexed position helps to lengthen the fascia and Achilles tendon while sleeping, often alleviating morning pain and stiffness.

– Exercises that stretch the calf muscles and the Achilles take priority over strengthening when pain is present. Though it’s typical to experience pain in just one foot, healthcare practitioners recommend stretching both sides several times daily.

– Try exercises such as sitting on the floor with the legs straight in front of you. Then reach for the toes and pull them toward you. You can also sit in a chair with one foot crossed over the opposite knee. Then pull the toes back and use your thumb to massage along the fascia.

– Standing calf stretches help to loosen the Achilles to relieve stress on the fascia. To stretch the calf muscles, stand about three feet from a wall and place one leg straight behind you with your toes facing forward. With hands placed on the wall, keep the back knee straight, and the feet flat on the ground. Bend the opposite knee and lean in towards the wall until a good stretch is felt in the calf muscle. Hold for 30 – 60 seconds and repeat several times. Be sure to stretch both calf muscles.

– Rolling each foot on a ball, or a roller designed specifically for stretching underneath the foot, is helpful and can be done while seated.

– Avoid high impact jumping activities like aerobics or volleyball. Limit repetitive activity to every other day and cross train on alternate days. Avoid exercising or walking barefoot on hard surfaces. A low impact sport such as cycling or swimming, which place no direct impact on the heels, are good alternative exercise choices.

– Creams or gels that contain anti-inflammatory or pain-relieving ingredients may also be very helpful.

Professional Supplement Center carries these and other high quality products to aid recovery and help relieve symptoms of plantar fasciitis:

Ligament RestoreLigament Restore by Pure Encapsulations: This product combines ingredients found naturally in tendons, ligaments and joints to help strengthen and support the maintenance and repair process of healthy connective tissues. Gluten and soy free, Non-GMO formulation.


Plantar Fasciitis...Plantar Fasciitis Sleeves by Zensah: These sleeves utilize T-Band Compression™ to help lift and stabilize the area from the Achilles to the plantar fascia, reducing pressure and relieving heel pain. The sleeves provide targeted compression to improve circulation and reduce swelling for faster recovery. Moisture-wicking fabric keeps feet dry, while silver ions provide odor protection. Sold as a pair, these comfortable sleeves may be worn day, night and during activity. Unisex sizes S, M, L. Available in White, Black or Magenta.


Foot RollerFoot Roller by TheraBand®: This simple and effective foot roller provides temporary relief from foot pain associated with plantar fasciitis, heel spurs, tired feet and excessive activity. The ridged design and 1.5” diameter is idea for stretching the plantar fascia and increasing flexibility. Roller may be frozen or chilled prior to use to help reduce inflammation. Compact, lightweight, easy to clean, and slip resistant. Exercise instructions included.


Celadrin Topical...Celadrin® Topical Liposome Lotion by Now Foods: This paraben free lotion provides topical relief for general joint discomfort, soreness and stiffness. Liposome delivery provides superior penetration and absorption of active ingredients in support of increased joint function and balance.


Herbal Heat Roll-OnHerbal Heat Roll-On by Heritage: Intended for external use, this soothing massage liniment provides fast acting, warm, penetrating relief after exercise or strenuous activity. Eco-friendly, cruelty-free herbal formulation.


Topricin Foot...Topricin Foot Therapy Cream by Topricin (Topical Biomedics): This award winning homeopathic foot therapy cream is specifically formulated to effectively address foot and ankle pain. Effective for plantar fasciitis, Achilles tendonitis, heel pain, strains, sprains, bruising, and leg cramps, as well as impact and sports injuries, this soothing treatment addresses swelling and soreness while helping to drain fluid and toxin buildup, improving blood flow to the injured tissue. Made in the USA, without fragrance, petroleum, mineral oil, menthol or capsaicin. Fast absorbing, non-greasy and non-staining formulation.

Plantar Fasciitis. http://www.healthline.com/health/plantar-fasciitis#overview1
Heel and Foot Pain (Plantar Fasciitis). https://patient.info/health/heel-and-foot-pain-plantar-fasciitis
Oh My Aching Feet: Plantar Fasciitis. http://www.empowher.com/plantar-fasciitis/content/oh-my-aching-feet-plantar-fasciitis
Plantar Fasciitis. http://www.sportsinjuryclinic.net/sport-injuries/foot-heel-pain/plantar-fasciitis
Plantar Fasciitis. http://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/diagnosis-treatment/treatment/txc-20268820
Calf Stretches. http://www.stretching-exercises-guide.com/calf-stretches.html
Fullem, Brian W. DPM. The Runner’s Guide to Healthy Feet and Ankles. Skyhorse Publishing, 2016