That Stabbing Heel Pain When You First Get Up? Here's What Your Physio Wants You to Know
That Stabbing Heel Pain When You First Get Up? Here's What Your Physio Wants You to Know
You wake up, put your feet on the floor, and the first few steps feel like you are walking on glass. After a few minutes it eases off — so you get on with your day and try to forget about it. Then tomorrow morning, it happens again. If this sounds familiar, you are most likely dealing with plantar fasciitis, and the sooner you understand what is happening, the sooner you can work towards getting on top of it.
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What Is Plantar Fasciitis?
The plantar fascia is a thick band of tissue that runs along the bottom of your foot, connecting your heel bone to the base of your toes. It acts as a shock absorber and supports the arch of your foot every time you take a step. When this tissue becomes overloaded or irritated, it causes the condition known as plantar fasciitis.
Despite the name ending in "itis" — which suggests inflammation — plantar fasciitis is now understood to be more of a degenerative or overload condition rather than a purely inflammatory one. This matters because it changes how it responds to treatment. Ice and rest alone are rarely enough to resolve it. What works is addressing the load going through the tissue and progressively building its capacity to handle that load.
Common Symptoms
Plantar fasciitis has a very characteristic presentation. You might recognise yourself in several of these:
- Stabbing or sharp pain at the bottom of the heel, especially with the first steps in the morning
- Pain that eases after you have been walking for a few minutes, only to return after prolonged standing or activity
- Pain that gets worse after rest — sitting at a desk for a few hours and then standing up can trigger it again
- Tenderness when you press on the inside of the heel or along the arch
- Aching through the foot after long days on your feet
- Tightness in the calf that seems connected to the foot pain
What Causes It?
Plantar fasciitis develops when the load placed on the plantar fascia exceeds its current capacity to handle it. Common contributing factors include:
Sudden Changes in Activity
Starting a new exercise routine, dramatically increasing your step count, or ramping up your running mileage faster than your body can adapt are among the most common triggers. The tissue simply has not had time to build the capacity to handle the new demand.
Prolonged Time on Hard Surfaces
Jobs that require standing on hard floors for long periods — hospitality, retail, healthcare, construction — put repetitive load through the plantar fascia without enough recovery time. This is one of the most common situations we see at PHYZFIT.
Calf and Achilles Tightness
The calf muscles, Achilles tendon, and plantar fascia work as part of the same chain along the back of the lower leg and foot. When the calf is tight, it places more stress on the plantar fascia with every step. This is why calf stretching and loading is a core part of plantar fasciitis management.
Footwear Changes
Switching to flat soled shoes or going barefoot more than usual — particularly if you have been wearing supportive footwear — can change the way load is distributed through the foot. What feels like a healthy choice can sometimes tip a previously manageable stress into a symptomatic one.
Reduced Foot Strength and Control
Weakness in the small muscles of the foot, or poor control of how the foot loads during walking and running, can mean the plantar fascia is doing more work than it should. Addressing this with specific foot and lower limb strengthening is often a key part of long term recovery.
Dealing with heel pain every morning?
Our physio team at PHYZFIT can assess what is driving your plantar fasciitis and build a plan to help you work towards lasting relief. No referral needed.
Book an AssessmentWhy It Does Not Go Away on Its Own
This is the question most people ask. They rest it for a week or two, it feels a little better, they get back to normal activity, and then it flares again. This cycle can go on for months or even years.
The reason it keeps coming back is that rest reduces the load on the tissue temporarily, but it does not build its capacity to handle that load when you return to your normal activity level. The tissue needs to be progressively exposed to the right amount of stress to actually adapt and recover.
Without the right loading program, the underlying weakness or tightness that contributed to the problem remains unchanged — so every return to normal activity brings the pain back. This is exactly what physiotherapy addresses.
How We Treat Plantar Fasciitis at PHYZFIT
Our approach is not to just manage symptoms — it is to understand what has overloaded the plantar fascia and address that directly. Treatment is tailored to your lifestyle, activity level, and what we find in the assessment.
What to Expect When You Come In
We assess your foot, calf, and lower limb mechanics — along with your footwear and activity demands — to understand what has overloaded the tissue and why it is not settling.
Manual therapy to address calf tightness, joint stiffness in the foot and ankle, and reduce irritation in the plantar fascia — helping you feel more comfortable while we build your capacity.
A targeted program to progressively strengthen the plantar fascia, calf, and foot — building the tissue's capacity so it can handle your normal activity without being overloaded.
Practical advice on footwear, activity modification, and taping or orthotics if needed — so you can manage your load day to day while your heel continues to recover.
What You Should Not Do With Plantar Fasciitis
- Do not rest completely for weeks — the tissue needs progressive load to adapt, not total offloading
- Do not ignore footwear — walking barefoot on hard floors, particularly first thing in the morning, significantly increases stress on the plantar fascia
- Do not assume it will sort itself out with time alone — without addressing the cause, it often persists for 12 to 18 months or longer
- Do not rely only on stretching — stretching can help, but the evidence shows that loading exercises are far more effective for long term recovery
- Do not push through significant pain — some discomfort during loading exercises is normal, but working through sharp or worsening pain tends to slow recovery
⚠️ See a Doctor Promptly If You Experience:
- Heel pain that is severe and came on suddenly without a gradual buildup
- Significant swelling, bruising, or deformity around the heel or foot
- Numbness or tingling spreading through the foot
- Heel pain accompanied by fever or feeling unwell
- Pain that is severe during the night as well as during activity
Tired of that morning heel pain?
Our team at PHYZFIT can help you work out what is causing it and put a plan together to address it properly. Same day appointments available at Bexley North and Marrickville.
Book Now 📞 (02) 8021 0969 | admin@phyzfit.com.auFrequently Asked Questions
How long does plantar fasciitis take to heal?
With the right treatment and management, most people notice significant improvement within 6 to 12 weeks. That said, it can take longer if the condition has been present for many months before seeking help. The key is starting the right loading program early and staying consistent with it. Without proper management, plantar fasciitis can persist for well over a year.
Why does my heel hurt most in the morning?
During sleep, your foot is in a relaxed, slightly pointed position and the plantar fascia shortens. When you take those first steps in the morning, the tissue is suddenly stretched and loaded before it has had time to warm up, causing the sharp pain. This is why wearing supportive footwear first thing in the morning — rather than walking barefoot — makes such a difference to morning symptoms.
Can I still run or exercise with plantar fasciitis?
Often yes, but with modifications. High impact activity may need to be temporarily reduced and replaced with lower impact alternatives while the tissue recovers. A physio can help you work out an activity plan that keeps you moving without aggravating symptoms — so you do not lose fitness while your heel settles.
Do I need orthotics for plantar fasciitis?
Not always. Orthotics can be helpful for some people as part of overall management, particularly if foot mechanics are contributing to the overload. But they are not a fix on their own — and many people recover fully without them. Your physio will advise whether they are likely to benefit you based on your specific assessment findings.
Is it better to stretch or strengthen for plantar fasciitis?
Both have a role, but strengthening — particularly through a program called progressive calf and plantar fascia loading — has the strongest evidence for long term recovery. Stretching alone often provides temporary relief without addressing the underlying capacity issue. A combination of both, guided by a physio, gives you the best result.
Do I need a referral to see a physio at PHYZFIT?
No referral is needed. You can book directly through our website or by calling (02) 8021 0969. We see patients with plantar fasciitis at both our Bexley North and Marrickville clinics. If you have a Chronic Disease Management plan from your GP, you may be eligible for Medicare rebates — just let us know when you book.
Ready for Us to Help You With Your Pain?
You do not have to accept heel pain as part of your routine. Book in with our physio team at PHYZFIT and let us work with you on a plan to support your recovery and get you back to your normal life.
Book Now📍 20 Shaw Street, Bexley North 2207
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