Why Do My Heels Hurt When I Wake Up in the Morning?

There is nothing quite as frustrating as waking up feeling rested, only to take your first few steps and feel a sharp, stabbing pain in your heels. For many people, morning heel pain is a daily occurrence that can affect everything from your morning routine to your ability to stay active. The good news is that it is common, treatable, and often preventable.

At My Family Podiatry, this is one of the most frequent complaints we see. Patients ask, “Why do my heels hurt when I wake up?” The answer usually lies in a few key conditions, most commonly plantar fasciitis and Achilles tendinopathy. However, there are other potential causes that may need to be considered.

This guide will help you understand what is really happening, what you can try at home, and when it is time to seek professional help.

Morning Heel Pain Causes

1. Plantar Fasciitis

Plantar fasciitis is the most common cause of heel pain under your foot first thing in the morning. The plantar fascia is a thick band of tissue that connects your heel to the ball of your foot. It supports your arch and absorbs shock during walking and running.

When this tissue becomes inflamed or overloaded, it can become painful, particularly after rest. During sleep, the fascia tightens slightly. As soon as you put weight on it again, it stretches abruptly. That stretch is what causes the familiar sharp or burning pain under the heel.

This pain often settles after a few minutes of walking as the fascia warms up and becomes stretchier but may return after sitting or resting throughout the day.

2. Achilles Tendinopathy

The Achilles tendon connects your calf muscles to your heel. Like the plantar fascia, it can become irritated or degenerate over time, especially with excessive load or poor biomechanics.

Morning pain from Achilles tendinopathy is usually felt at the back of the heel rather than underneath. It may feel like a deep ache, tightness, or stiffness that improves slightly as you start moving.

This condition is common in runners, active individuals, and those who have recently changed their exercise routine or footwear.

3. Other Possible Causes

While plantar fasciitis and Achilles tendinopathy make up the majority of cases, other causes of morning heel pain may include:

• Baxter’s nerve entrapment (nerve irritation near the heel)

• Calcaneal stress fractures

• Fat pad atrophy (reduced cushioning under the heel)

• Inflammatory conditions, such as rheumatoid arthritis

These are less common but are important to consider if your symptoms do not match the usual patterns or are not improving with rest.

At-Home Heel Pain Treatments

If your morning heel pain is relatively new or mild, there are several simple strategies you can try at home. These methods often help reduce symptoms and prevent worsening of the condition.

1. Calf and Plantar Fascia Stretching

Tight calves and plantar fascia tissue contribute to morning heel pain. Stretching can improve flexibility and reduce strain on the heel.

• Plantar fascia stretch: Sit in bed, cross one foot over your knee, and gently pull your toes back toward your shin. Hold for 20 to 30 seconds and repeat several times before standing.

• Calf stretch: Stand facing a wall, step one foot back, and press the heel into the ground until you feel a stretch. Hold for 30 seconds and repeat on both legs.

2. Ice or Frozen Bottle Rolling

Use a frozen water bottle or massage ball under your foot for 5 to 10 minutes. This can reduce pain and help with symptoms of plantar fasciitis.

3. Footwear Changes

Avoid walking barefoot, especially on hard surfaces like tiles or timber floors. Wear cushioned, supportive footwear around the house.

• Choose shoes that support your foot and provide some cushioning

• Replace worn-out shoes, particularly running or walking shoes

4. Over-the-Counter Insoles or Heel Cushions

You may get short-term relief from arch supports or gel heel cups. These reduce pressure on the heel while you wait for assessment.

Make sure they fit your existing shoes properly. These are temporary options and do not replace proper diagnosis and treatment.

5. Self-Massage or Trigger Ball Work

Roll a massage ball or trigger ball under your arch and around your calf for a few minutes in the morning and evening. This helps release some muscle tension and may help with symptoms.

If you have been trying these strategies consistently for more than two to three weeks and your pain has not improved, it is time to seek help. Morning heel pain that persists needs a professional assessment to determine the underlying cause and create a treatment plan.

Professional Treatment Options

At My Family Podiatry, we provide tailored, evidence-based treatment for heel pain. Our approach looks beyond inflammation to address the mechanical causes of the problem.

1. Biomechanical Assessment

We assess the way you walk and stand, looking for imbalances or inefficient movement patterns. Many cases of heel pain are linked to how you load the foot with each step.

2. Footwear and Gait Analysis

Your footwear plays a large role in both causing and treating heel pain. We will review what you wear at work, during sport, and at home, and advise on what will best support your recovery.

3. In-Clinic Ultrasound or Imaging Referrals

We can use diagnostic ultrasound in the clinic to assess your plantar fascia or Achilles tendon. If needed, we refer for further imaging such as X-rays or MRI to rule out more complex issues like stress fractures.

4. Custom Foot Orthotics

We offer custom orthotics when needed to offload pressure, correct foot alignment, and reduce tissue strain. These are particularly helpful in patients with flat feet, high arches, or chronic overuse injuries.

5. Shockwave Therapy (Radial and Focused)

We are proud to offer Dolorclast EMS radial and focused shockwave therapy, which allows us to treat different layers of tissue with precision.

If you have tried shockwave therapy elsewhere without success, the difference in treatment mode may be the missing piece. Our technology provides targeted energy to reduce pain and stimulate tissue healing, even in long-standing cases.

6. Exercise Prescription

We provide personalised strengthening and loading programs. These may include:

• Eccentric heel drops for Achilles rehabilitation

• Progressive loading for plantar fascia strength

• Balance and gait retraining for long-term prevention

When to Seek Help

You should book a podiatry consultation if:

• Your heel pain has lasted more than two to three weeks

• The pain is interfering with your walking, exercise, or work

• You have tried stretching and footwear changes without relief

• The pain is worsening or becoming more frequent

Early intervention helps prevent chronic pain and supports faster recovery.

Next Steps

Morning heel pain is common, but it is not normal. Whether it is caused by plantar fasciitis, Achilles tendinopathy, or something else, we can help you find lasting relief.

At My Family Podiatry, we combine clinical assessment with leading technologies like focused and radial Dolorclast EMS shockwave therapy, along with supportive, hands-on care that puts your recovery first.

If you have had morning heel pain for more than a few weeks or if home treatments are not working, click the button below to book your appointment today.

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