Why Does My Heel Pain Feel Worst First Thing in the Morning?

By Emily White|2025-11-24T22:55:29+00:00November 24th, 2025|

Heel pain treatment melbourne podiatrist

Many individuals report experiencing sharp heel pain during their first steps in the morning, which gradually reduces after a short period of walking. This distinct pattern is frequently associated with plantar fascia irritation, but it can also indicate other underlying conditions. Understanding the mechanism behind this symptom is essential for effective heel pain treatment in Melbourne.

What Happens to the Plantar Fascia Overnight?

During sleep, the ankle typically rests in a slightly plantarflexed (downward-pointing) position. In this position, the plantar fascia – a strong fibrous band spanning from the heel to the toes – shortens slightly.

If the plantar fascia is irritated or overloaded, this shortened position creates stiffness within the tissue. When weightbearing resumes in the morning:

• The fascia is rapidly lengthened
• The irritated fibres are placed under sudden tensile load• Sharp, localised “first-step” pain occurs

This presentation is characteristic of early plantar fasciitis but can also be observed in a range of heel conditions.

Is Morning Heel Pain Always Plantar Fasciitis?

While plantar fasciitis is the most common cause of morning heel pain, several other conditions can produce a similar clinical picture:

• Calf-Achilles tightness
• Fat pad irritation
• Local nerve entrapment
• Inflammatory arthropathies

A comprehensive biomechanical assessment at our Melbourne Podiatry clinic – including gait analysis, strength testing and pressure evaluation – is recommended to determine the precise cause.

Why Does the Heel Pain Ease With Walking?

With ongoing movement, blood flow increases and soft-tissue temperature rises, resulting in reduced stiffness of the plantar fascia and surrounding structures. However, this relief is often temporary. Recurrent pain commonly appears:

• After prolonged sitting
• After driving
• When rising from rest
• Following extended periods of activity

This fluctuating pattern is typical of plantar fascia overload.

Will My Heel Pain Resolve Without Intervention?

Spontaneous improvement in heel pain is possible but unpredictable. Many individuals alter their gait subconsciously to reduce discomfort, which may involve:

• Taking shorter steps
• Avoiding specific activities
• Selecting footwear based solely on cushioning
• Offloading weight to the outer border of the foot

Such compensations can contribute to secondary issues involving the knee, hip or lower back. Early intervention with one of our Melbourne podiatrists results in more efficient recovery.

How Our Podiatrists Can Help With Your Heel Pain

The podiatrists at our Melbourne podiatry clinic in Camberwell provide structured, evidence-based heel pain treatment, tailored to the underlying cause.

Management may include:

1. Load Modification

Adjusting activities or surfaces to reduce strain on the fascia.

2. Footwear Recommendations

Appropriate shoe selection can substantially reduce morning pain.

3. Custom Orthotics (When Indicated)

Custom orthotics can redistribute pressure and assist the fascia in healing when mechanical overload is present.

4. Mobility and Flexibility Work

Targeted exercises to reduce morning stiffness and improve tissue tolerance.

5. Strengthening Programs

Progressive strengthening to restore long-term function and prevent recurrence.

6. Shockwave Therapy

Extracorporeal shockwave therapy may be utilised in persistent or chronic cases to stimulate tissue repair and reduce pain.

When to Seek Assessment With a Podiatrist

If heel pain persists beyond two weeks, is most noticeable upon waking, or recurs after activity, an assessment by one of our Melbourne Podiatrists is recommended. Morning heel pain is common but not normal, and addressing it early leads to more predictable outcomes.

The team of podiatrists at Melbourne Podiatrists & Orthotics can assist in diagnosing the cause of your symptoms and developing an effective, personalised treatment plan.