What’s Causing My Morning Heel Pain (Post-Static Dyskinesia)?

Does the following sound familiar to you…?

After a relaxing night’s sleep, you step out of bed to get ready to take on another day. Suddenly you’re stopped in your tracks as you experience a sharp, stabbing pain in your heel. It hurts so bad that you are hesitant to take another step and just want to go back to bed. You tentatively take a few more steps and the pain begins to ease, as you limp gingerly to the bathroom. Throughout your day the pain further decreases, only to return again after sitting for a period of time. If you have experienced this, you have likely suffered post-static dyskinesia.   

What is it

Post-static dyskinesia is a medical term used to describe pain that occurs after rest. Although it can occur anywhere in your body, it is most commonly associated with heel pain. A common question we are asked in clinic is “why am I experiencing pain in the morning, when I have not been on my feet?”

Podiatry Heel Pain
Morning heel pain locations

The cause

Despite your morning pain occurring with that dreaded first step, your hours of sleep prior to this event is a large contributing factor. As we sleep our feet often rest in a ‘plantar-flexed’, or downward pointed position. This allows the plantar-fascia to relax and shorten. The plantar fascia is a thick connective tissue that spans from your heel to your toes, to support the arches of your feet. After the plantar-fascia shortens throughout your sleep, the first step in the morning causes it to suddenly stretch, pulling forcefully on its insertion in your heel, resulting in excruciating pain and hence post-static dyskinesia. This pain is most commonly associated with plantar fasciitis.

Podiatry Heel Pain
Foot posture whilst sleeping may promote tightness of the plantar fascia.

5 home remedies

The main focus in avoiding that dreaded first step pain is to warm-up and stretch out your foot before placing any weight on your feet at all. Here’s how:

  1. Add heat by applying a heat pack safely to the area of pain. Snap heat packs work well, as they remove the need for you to walk to the microwave to heat-up a wheat pack or alike. Do this for 3-5 minutes.
  2. Stretch the arch of your foot by placing a towel over your forefoot and toes, pulling them back towards you, whilst slowly adding tension to the towel. This stretch directly focuses on stretching the plantar fascia.
  3. Mobilise your foot by drawing the shapes of each letter of the alphabet. This will allow the muscles to lengthen and wake-up.
  4. Massage the muscles of the bottom of your foot to allow them to relax and loosen. Using your thumb or a tennis-ball massage through the arch of your foot, avoiding the direct area of pain (most commonly at the central portion of the bottom of the heel).
  5. Plantar fascia night splints help to reduce the foot muscles and plantar fascia from tightening whilst you sleep. By reducing this tightness, it allows these structures to be more resilient to the stress placed on your feet from the first few steps of your day.
Podiatry Heel Pain
Tennis ball foot massage: avoid directly massaging the point of pain at the heel.

Professional treatment

At OnePointHealth we help hundred’s of people every year to overcome plantar fasciitis and its associated morning heel pain. If you experience this pain, it is important that the causative factors are found promptly, before it becomes a chronic problem. When left untreated the injury often becomes more difficult to manage and pain relief may take longer to gain. Initially, anti-inflammatory and pain relief medication, along with rest and icing can help to decrease the pain and inflammation. Additionally, we will prescribe a stretching and conditioning program specific to you, which can help reduce the strain on your plantar-fascia. If required, further treatments may also be recommended. These may include:

Don’t ignore the signs. Treating your heel pain early is the best way to gain relief from that dreaded first step in the morning.

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