July 14 2026
Dr Jackson Tisdell (Podiatrist)
I hear some version of this almost every day: “I’m fine once I get going, but those first few steps out of bed are brutal.”
Sometimes it’s a tradie who’s been on his feet all day and swears the pain hits hardest the morning after, not during the job. Sometimes it’s someone who didn’t think it was worth mentioning until I asked. Either way, it’s one of the clearest clues I get before I’ve even looked at the foot that it’s most likely plantar fasciitis.
What helps most with the diagnosis of plantar fasciitis is the location and the pattern of the pain:
There are a few theories as to why your foot may hurt in the mornings. Firstly, overnight your foot relaxes, and the plantar fascia (the band of connective tissue under your foot) shortens. The moment you stand up in the morning or during the night, it’s stretched out fast with zero warm-up. If that tissue already has some irritation, those first steps are when you feel it the most.
Secondly, there may be an accumulation of inflammatory fluid. Whilst you lie stationary overnight, fluid can pool around the irritated area. That first step compresses the fluid and triggers pain.
Thirdly, nerve irritation local to the ankle or coming from the lower back can become more sensitive overnight due to the positioning and compression of nerves while you sleep. This is why I always check further up the leg for nerve issues in my examination, not just around the heel.
The fact that your heel pain settles once you’re moving doesn’t mean it’s healed, it just means the tissue has been temporarily desensitised. I see this constantly: people manage it themselves for months, the mornings get worse, and the warm-up time stretches from five minutes to twenty, and eventually it stops settling altogether. By the time they come in at that stage, treatment takes longer than if they’d come in early.
Most first-step heel pain is plantar fasciitis, but I’ve seen the same story turn out to be:
The standard advice of stretch it, rest it, and get cushioned shoes, can actually aggravate some of these other diagnoses, which can be really frustrating for you. That’s why a proper examination from a podiatrist matters before starting treatment.
Once we know what we’re dealing with is plantar fasciitis, treatment usually involves:
Plantar Fasciitis is not a quick fix, but it’s one of the more predictable conditions we treat when it’s picked up early. That first painful step isn’t your body being dramatic. It’s telling you something specific about the tissue under your heel — and it usually responds well once someone actually looks into it properly.
If those first steps have become something you brace for, don’t wait it out. Come and get it checked.
If you're dealing with a foot or ankle issue and you think you may need to see a podiatrist, one of the first questions you will have is "what will this actually cost me?" At Spring Podiatry, we believe in full transparency with the pricing of our clinical services....