Heel Pain in the Morning or After Running: Causes & Self-Care

Heel pain is common. People of all ages and activity levels can develop heel pain, although physically active people and women tend to be at a higher risk. One of the most frequent causes of heel pain is Plantar Fasciitis, a repetitive stress injury that damages the tissue on the bottom of your foot. If you're waking up with sharp heel pain in the morning or find your heel pain worsening after a period of walking, running, or standing, you might be experiencing this condition.

Let’s look at what may be behind your heel pain, what you can do yourself to relieve your heel pain, and treatment options.

Heel pain can develop from several different causes - even things like ill-fitting shoes can cause discomfort. Most common reasons for heel pain, however, are repetitive stress injuries, where the load of your activities exceeds your body’s capacity to handle it.

• Plantar Fasciitis: affecting 10% of the US population, this is the most common cause of heel pain. Some people with Plantar Fasciitis also have heel or arch pain during or after activities, or after a period of inactivity.

• Heel Spurs: these are bony growths on the heel bone. Similar to Plantar Fasciitis, heel spurs can develop due to repetitive stress of your everyday activities.

• Achilles Tendonitis: this condition involves inflammation of the Achilles tendon, which connects the calf muscle to the heel bone. Though this is the strongest tendon in our bodies, it can develop inflammation and pain in the heel when overburdened.

• Bursitis: bursitis is an inflammation of the fluid-filled sacs (bursae) that cushions bones, tendons, and other tissue. When bursitis is around your heel, it can cause heel pain.

• Stress Fractures: tiny fractures in the heel bone, often caused by overuse or repetitive, high-impact activities like running.

That said, Plantar Fasciitis is the most common culprit behind heel pain, especially if you experience pain in the morning when they first get out of bed. For more on understanding your foot pain by location, take a look at our foot pain chart!

Plantar fascia is responsible for maintaining the healthy spring of your arch, which absorbs the shock and load when you stand or take a step. When the load is too much, tiny tears form in the fascia, causing pain and discomfort.

• PT exercises: granted, this is not a short-term fix, but building strength and stability in your foot, ankle, and calf is the only surefire way to make sure Plantar Fasciitis won’t come back. Here, we share our take on the best PT exercises for Plantar Fasciitis, but the easiest thing to do is to follow our Plantar Fasciitis Guided Recovery Program. You get the structure and guidance you need to maximize the benefit of your efforts.

• Gradual increase in activity: for running, be deliberate about how you increase your distance and intensity. Ramping up your distance and speed gradually builds your strength and resilience, which helps you avoid overloading your feet. Sudden changes in activity levels can aggravate Plantar Fasciitis pain.

• Focus on technique: when walking or running, focus on a proper form. With each step, don’t land on your heels. Instead, make sure to land on the middle or front of your foot to help reduce the impact on the heel.

• Build strength with cross-training: if you tend to do more cardio, make sure to incorporate eccentric strengthening exercises. Plantar Fasciitis-specific strengthening exercises, like the ones you’d use in our Plantar Fasciitis Guided Recovery Program, are best suited to prevent heel pain while running or walking, as they target the small muscles and tendons that work together to maintain the arch, supporting the overloaded plantar fascia.

If your heel pain is acute (i.e., you just developed it in the last 1-2 weeks), it’s possible you can get it under control with rest and massage. However, once it becomes chronic, you'll likely need active treatment to get relief that sticks.

• Physical therapy: the gold standard of treatment for heel pain from Plantar Fasciitis, a comprehensive PT plan for Plantar Fasciitis includes load management (taping or bracing), soft tissue mobilization (massage), and progressive strengthening (PT exercises). The good news: you can replicate this non-invasive and effective method without the wait, hassles, and copays, using our Plantar Fasciitis System 2 to treat heel pain yourself.

• Cortisone shots: for persistent inflammation, a podiatrist may recommend cortisone shot (corticosteroid injections) to reduce your heel pain. Relying on cortisone shots for Plantar Fasciitis has some important downsides, and doctors don’t recommend more than one shot every 3-6 months.

• Shockwave therapy: this non-invasive treatment uses high-energy sound waves to facilitate healing in the affected area of the heel and reduce pain. While some heel pain patients report quick, significant pain reduction from shockwave therapy, the results aren’t consistent and there aren’t large-scale studies to understand who would benefit from this treatment.

Alleviate was founded by a patient-clinician duo to bring the effective chronic pain treatment from physical therapy offices to everyone's home. With the all-in-one Plantar Fasciitis System 2, you can easily follow the Alleviate Method to treat your arch and heel pain, get relief now, and make it stick - all without the hassle and cost of traditional physical therapy.