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We want to step out of bed each morning feeling recharged and refreshed, but for many, these first few steps are welcomed with pain and discomfort, oftentimes in the heel area. This issue tends to be more common in athletes or individuals who put a fair amount of stress on their feet every single day. So what’s causing this morning heel discomfort, and more importantly, how can a physical therapist help us treat it? In today’s blog, we explain how athletes can work to overcome morning heel pain.

Why Do My Heels Hurt In The Morning?

Morning heel pain is quite common in athletes due to their daily routine and the anatomical structure of our feet. That’s because our heel bone (the calcaneus) is surrounded by soft tissue tendons and fascia that are primarily made of collagen fibers. These collagen fibers are strong and flexible, but because they handle an immense amount of stress during an activity like running where they may handle 5x-10x our body weight, these fibers are constantly tearing and being rebuilt. Normal stress typically leads to microtearing that may not be obvious in the moment, but you may be more prone to noticing their presence with your first steps in the morning, and we’ll explain more on why that is in a bit.

Our bodies have the amazing ability to repair these collagen tears, but this process takes time. Since we’re on our feet for a good portion of the day, the ideal time for this repair process to really take hold is when we’re asleep. This hours-long stretch without any stress on our feet gives our body time to mend microtears and ensure these collagen fibers are once again ready for the stress that’s to come. When this process occurs correctly, you shouldn’t notice any discomfort when you step out of bed in the morning.

However, this process doesn’t always occur correctly, which can lead to discomfort during your morning routine. The two main issues that can contribute to dysfunction with the repair process include not getting enough rest and putting too much stress on your feet during the day. If you’re not getting enough sleep or you’re not giving yourself off days from strenuous activities, your body won’t have time to make the necessary repairs. Similarly, if you put too much stress on your feet during the day, like if you’re a runner or an athlete, these microtears may end up being a little bit larger, which will require more time to adequately repair.

When one or both of these factors are present, the collagen fibers won’t be repaired correctly. This chronic or incomplete tearing can lead to excessive, disorganized or incomplete collagen formation. These fibers are not as good at handling stress, meaning that they can retear more easily without as much strain being placed on the foot.

The reason we may notice this heel discomfort first thing in the morning is because this healing process typically takes place when we’re sleeping, and if the process is incomplete or your collagen fibers are disorganized, that first moment when you step out of bed and put strain on the area after an extended period of inactivity can lead to collagen fiber retearing. Left untreated, and this morning foot pain may become an unfortunate routine.

Treating Morning Heel Pain

Fortunately, there are a few ways to combat morning heel pain and make it so you no longer dread stepping out of bed in the morning. Some treatments we typically recommend to patients dealing with soft tissue heel pain in the morning include:

  • Rest/Activity Avoidance – Back off your exercise or athletic activity load for a little bit to give your body more time to fully address these collagen tears.
  • Physical Therapy – Physical therapy can help to strengthen collagen fibers, soft tissues and nearby supportive structures so that your feet can better handle stress and limit the burden on these areas.
  • Revamped Training – A physical therapist can also help you work towards your specific wellness goals with a revamped workout or training routine that limits stress on your feet. Instead of always going for a run, consider doing some lap swimming or an elliptical workout that still helps you get exercise without putting high-impact stress on your feet.
  • Diet Improvements – Improving your diet habits can help you shed a little weight, and the less you weigh, the less stress your feet will be under as you move around throughout the day. Weight management is incredibly helpful in treating soft tissue tendonitis or a condition like planar fasciitis in the foot.

Don’t wake up with heel pain any longer. Instead, connect with the team at OrthoRehab Specialists and let us work to improve the health of key soft tissues in your feet. For more information, or for help with a different physical issue, reach out to our team today at (612) 339-2041.

Dr. Andy Masis, PT
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