Waking Up in the Morning is a Pain to my Foot!

Waking Up in the Morning is a Pain to my Foot!

While a small minority of us spring out of bed once the alarm rings, most of us dread getting out of bed – who’s with me here? It is a pain to get out of bed in the morning, but what’s worse: when the heel touches the ground, it shoots pain from the foot right up your spinal cord into the brain and “OUCH” you go!

Waking up in the morning and experiencing pain in your feet when you take those first steps can be a distressing experience. This often-encountered discomfort is frequently associated with a condition known as plantar fasciitis. Understanding why your feet hurt when you wake up and walk is essential to effectively managing and alleviating this issue.

As mentioned above, the culprit is most likely the plantar fascia. It is a thick fibrous band, shaped like a bowstring, that connects the heel to the ball of the foot. Its primary function is to support the foot arch and provide shock absorption when we walk.

It also has a close relationship with the calf muscles through fascial connections, meaning reduced tissue mobility and muscle extensibility of the calves may play a role in the development of plantar fasciitis or plantar fasiopathy.

Heel pain in the morning during the first few steps?

Well, the culprit is most likely the plantarfascia. It is a thick fibrous band, shaped like a bowstring, that connects the heel to the ball of the foot. Its main function is to support the arch of the foot and provide shock absorption when we walk.

It also has a close relationship with the calf muscles through fascial connections – meaning reduced tissue mobility and muscle extensibility of the calves may also contribute to the onset of plantar fasciitis or plantar fasiopathy.

During sleep, our feet naturally rest in a slightly pointed position, known as plantar flexion. This position keeps the plantar fascia and calf muscles shortened for an extended period.
The intense pain experienced during the first few steps in the morning is often due to the abrupt and forceful stretching of the plantar fascia when we put our body weight on it. This sudden stretch can cause discomfort as the tissue adapts to bearing the load. Similarly, standing after prolonged sitting can also trigger this pain due to the sudden need for the fascia to stretch and support the body’s weight.

Why do my feet hurt when I wake up and walk?

Plantar fasciitis is a common repetitive strain injury. Some factors may increase the risk of developing this condition. They include:Plantar fasciitis is often recognised as a repetitive strain injury that can be influenced by various risk factors. Understanding these factors is crucial in both preventing and managing the condition effectively.

  1. Footwear Choices: The type of shoes you wear plays a significant role. Regularly engaging in activities like running, walking in poorly fitted shoes, or lacking adequate arch support can increase your risk. The proper footwear provides essential support and reduces strain on the plantar fascia.
  2. Types of Physical Activity: Your choice of activity can also contribute. Long-distance runners, ballet dancers, and individuals whose jobs involve standing for extended periods are particularly at risk. Additionally, suddenly increasing activity levels, such as going from minimal exercise to intense workouts or long runs, can shock the feet and lead to problems.
  3. Foot Structure: Both high arches and flat feet are risk factors for plantar fasciitis. These feet classifications can alter the distribution of pressure and stress across the foot, making them more susceptible to overuse injuries. However, having a normal arch doesn’t ultimately spare you from the risk, as the condition is often linked to repetitive stress and strain.
  4. Body Weight: Individuals with a BMI greater than 30kg/m² face a significantly higher risk, up to five times more, than those with a BMI under 25kg/m². Higher body weight increases the load on the foot structures, exacerbating the risk of overuse injuries. Therefore, maintaining a healthy body weight can be beneficial in reducing the likelihood of developing plantar fasciitis.
  5. Calf Muscle Flexibility and Mobility: The condition of the calf muscles, which include the gastrocnemius, soleus, and plantaris, is also a key factor. Tightness in these muscles can directly impact the plantar fascia due to their fascial connections. The calf muscles blend into the Achilles tendon, which continues to the plantar fascia. Limited mobility in these tissues can disrupt the efficient energy transfer along the kinetic chain, potentially leading to persistent or recurrent heel pain.

Factors such as inappropriate footwear, specific physical activities, foot structure, body weight, and the flexibility of calf muscles can increase the likelihood of developing plantar fasciitis. Awareness and proactive measures can help prevent this common yet painful condition.

I’ve been having heel pain in the morning for many years; I even have a heel spur!

A bony growth on the heel bone is called a heel spur. occurring in 10–20% of people. It forms due to the calcification of the plantar fascia, indicating a high-load area where the body deposits calcium to manage stress.

Contrary to common belief, the heel spur itself might not be the direct cause of the pain. Surprisingly, the discomfort often arises from the irritation or inflammation of the plantar fascia or other soft tissues surrounding the heel. There are people out with bony spurs who do not have heel pain! Therefore, it does not indicate the need to remove it surgically. Having the bone spur removed surgically does not guarantee the resolution of your pain.

If the loading pattern stays, the spur will grow back again.

Morning Routine to Alleviate Foot Pain

  1. Flex and Point Your Foot: Begin by flexing your foot, pulling your ankle back until you feel a gentle stretch in your calves. Then, point your toes forward to ease the tension. This up-and-down motion (flex and point) should be repeated around 20 times. This exercise helps loosen tight calf muscles connected to the plantar fascia.
  2. Foot and Toe Stretch: Flex your foot and extend your first toe while sitting. This specific movement targets the plantar fascia.Do this stretch three times, holding it for 30 seconds each time. It’s a great way to gently stretch the plantar fascia before putting weight on your feet.

Postural Adjustments: Once you’re on your feet, consider the following strategies throughout the day to manage your pain:

  • Footwear: Opt for thick-soled slippers at home to cushion your heels. Additionally, silicone heel cushions in your shoes can provide extra support and reduce the impact of ground reaction forces on your heels. Ensuring your footwear offers adequate foot support, especially during physical activities, is crucial.
  • *Taping: This can be a temporary but effective method to offload stress from your arch. It supports and can alleviate some of the strain on the plantar fascia.
  • Targeted Exercises: Strengthening specific muscles can help reduce the load on the plantar fascia. Focus on exercises for the foot intrinsics (the small muscles within the foot) and the tibialis posterior (a muscle in your lower leg). Given the plantar fascia’s connection to the calf muscles, stretching the gastrocnemius and soleus muscles is also beneficial. Regular stretching can improve flexibility and reduce tension in these areas.

What is *taping? How can it help the pain in the foot?

Taping, in managing foot pain related to conditions like plantar fasciitis, involves using adhesive tape to provide support, stability, and offload stress from the affected area, specifically the foot arch.

In the case of plantar fasciitis, taping techniques are often aimed at reducing tension on the plantar fascia, which is the thick band of tissue running along the bottom of the foot. The taping method typically involves applying a specific pattern of adhesive tape to the foot to offer additional support to the arch and heel.

The taping technique used for plantar fasciitis aims to limit excessive movement and stress on the plantar fascia, allowing it to rest and heal more effectively. This approach can also help distribute the load across the foot more evenly, reducing discomfort and pain during movement.

There are various taping methods employed by physiotherapists, each serving a slightly different purpose, such as providing arch support, stabilising the foot, or reducing tension on the plantar fascia.

Ideally, you should check in with a physiotherapist, as delaying heel pain treatment can be painful and affect other joints down the kinetic chain. We can provide advice for footwear and teach you taping techniques to help manage the pain. Different foot types may require a slightly different set of exercises. Here is a snapshot of what else physiotherapy treatment can offer:

 

Why do my feet hurt when i wake up and walk? Visit a physiotherapist in Singapore for a proper diagnosis

Shockwave Therapy

Shockwave therapy is an inventive treatment that uses mechanical energy to target areas of injury specifically. In chronic plantar fasciitis, the root cause of pain is often the scarring and hardening of the plantar fascia. This scarring results from repeated micro-injuries at the same spot on the fascia. Shockwave therapy is particularly effective in these scenarios because it helps to break down and soften these scar tissues.

The therapy works by delivering high-energy sound waves to the affected areas. These waves stimulate the body’s natural healing processes, promoting blood flow and regeneration of the damaged tissue. This non-invasive treatment is becoming increasingly popular for its efficacy in treating persistent plantar fascia pain that hasn’t responded to more conventional therapies.

Standing, Walking, and Postural Correction

Another critical aspect of managing plantar fasciitis involves analysing and correcting your posture during various activities, especially while standing and walking. Often, without realising it, how you stand or walk can strain the plantar fascia excessively, exacerbating the condition.

Biomechanical errors, which refer to the body’s incorrect alignment or movement patterns, can arise from various factors, including lifestyle habits, the type of footwear you use, and ingrained postural habits. For instance, wearing high heels or shoes with insufficient arch support can increase the load on the plantar fascia. Similarly, standing with uneven weight distribution or walking with an imbalanced gait can continuously stress the fascia.

A thorough analysis of your standing and walking posture can identify these biomechanical errors. Based on this analysis, specific recommendations can be made to correct these issues. This correction might involve exercises to strengthen particular muscles, changes in footwear, or even orthotic interventions. The goal is to achieve a more balanced, less strain-inducing posture during daily activities, which helps alleviate current pain and is crucial in preventing the recurrence of plantar fasciitis.

Dealing with foot pain when waking up and walking can significantly impact daily activities. Recognising the signs of plantar fasciitis, understanding why the feet hurt in the morning, and implementing appropriate measures such as gentle stretching, proper footwear, orthotics, and physiotherapy can effectively manage and alleviate the discomfort caused by this condition. Consulting with a physiotherapist can provide tailored guidance to address plantar fasciitis and prevent its recurrence, enabling a return to pain-free mornings and improved foot health.

Dr Sharon Wang

Principal Physiotherapist

Dr Sharon Wang, writes from her heart and her personality shines through during her physiotherapy session with her patients. This exercise enthusiast loves a good workout, and you can catch her doing her Yoga to dance routine any day.

Common Questions people ask online and our answers

1. My Feet Hurt When I Wake Up and Walk:

Upon waking and taking those initial steps, the sensation of pain in the feet, particularly in the heel area, is a classic symptom of plantar fasciitis

Plantar fasciitis, characterised by irritation or inflammation of the thick band of tissue that go around the sole and joins the heel bone to the toes, can cause discomfort and stiffness, especially after rest periods like sleeping.

2. Why Do My Feet Hurt When I Wake Up:

The primary reason for experiencing foot pain in the morning is the tightening and shortening of the plantar fascia overnight. During sleep, the feet are relaxed for an extended period. When you stand up after this rest, the sudden stretching of the fascia causes microtears and triggers pain and discomfort. Factors like excessive physical activity, improper footwear, high arches, flat feet, obesity, or tense calf muscles may be a factor in the onset of plantar fasciitis. 

3. Heel Pain in the Morning:

Plantar fasciitis often manifests as intense pain around the heel, mainly the underside. This discomfort is commonly felt with the day’s first steps and can gradually improve as the foot warms up and the tissue becomes more flexible. However, if left unaddressed, the pain may persist and become chronic, affecting daily activities and overall quality of life.

4. Feet Hurt in the Morning:

The morning foot pain experienced with plantar fasciitis can vary in intensity. It might present as a sharp, stabbing sensation or a dull ache. Some individuals report that the pain diminishes as they continue walking or after performing stretches concentrating on the plantar fascia and calf muscles.

5. Feet Hurt When I Wake Up:

It’s crucial to note that while the pain associated with plantar fasciitis is most acute in the morning, it can resurface after prolonged sitting or standing periods. The discomfort tends to ease as the tissue becomes more limber with movement but can return when the feet are at rest again.

 

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