You take your first step out of bed and it feels like stepping on broken glass. The pain fades after a few minutes of walking, but it comes back later — after sitting at your desk, getting up from the car, or finishing a run.
That pattern is the hallmark of plantar fasciitis, one of the most common causes of heel pain in adults. Roughly 1 in 10 people will develop it at some point in their lives, and with spring running season underway, cases tend to spike.
The good news: most cases resolve without surgery. The bad news: doing the wrong things early can drag recovery out by months.
By the Numbers: Plantar Fasciitis
Plantar fasciitis accounts for approximately 10% of all runner-related injuries and generates roughly 1 million doctor visits per year in the United States.
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 your toes. Think of it like the string on an archer’s bow — it keeps your arch taut and springy with every step.
When that tissue gets overloaded — from running, long hours on your feet, or a sudden jump in activity — small tears develop near the heel attachment. The body tries to repair them, but if the stress keeps coming, the tissue becomes chronically inflamed. That is plantar fasciitis.
People between 40 and 64 are most affected, though runners and workers who stand all day are at risk at any age. A 2024 cross-sectional study using NHANES data found higher rates in women, in people with BMI above 25, and in those with sedentary jobs who also exercise intermittently.
Why Does Heel Pain Feel Worst in the Morning?
This is the question almost everyone with plantar fasciitis asks first, and the answer comes down to what happens while you sleep.
Lying down allows the plantar fascia to shorten and stiffen. The moment you stand up and put weight on the foot, you are suddenly stretching a tight, irritated band of tissue. That sudden load triggers the sharp, stabbing pain most people describe.
After 10 to 15 minutes of walking, blood flow increases, the tissue warms up, and pain typically eases. The same cycle repeats after long periods of sitting. Understanding this explains why targeted morning stretching is one of the most effective tools in recovery.
What Actually Helps (According to Recent Research)
A 2023 revision of the clinical practice guidelines published in the Journal of Orthopaedic and Sports Physical Therapy reviewed the strongest available evidence. The guidelines support plantar fascia-specific stretching, manual therapy, and foot orthoses as effective first-line treatments for both short- and long-term improvement.
A comprehensive 2025 review in Cureus analyzed more than 30 high-quality studies and organized treatment into four phases. Conservative options come first: stretching, night splints, and arch support. Shock wave therapy and platelet-rich plasma injections are reserved for cases that do not respond after three to six months of consistent conservative care.
A large 2025 network meta-analysis of 63 randomized controlled trials (4,170 participants) published in Scientific Reports found that conservative stretching protocols remain the most appropriate starting point for most patients. Prolotherapy showed the strongest sustained pain relief for patients who needed more than conservative care.
Chiropractic evaluation can be helpful here too, especially when foot mechanics, ankle mobility, or lower limb alignment are contributing to the problem. For related structural issues that affect how the body compensates, see our overview of musculoskeletal care services at Slovin Chiropractic.
Simple Stretches You Can Do Right Now
Do these before taking your first steps in the morning:
Towel stretch: Sit on the edge of the bed. Loop a towel around the ball of your foot and gently pull your toes toward you. Hold 30 seconds. Repeat 3 times per foot.
Seated toe stretch: Cross one foot over the opposite knee. Pull back gently on the toes until you feel a stretch along the arch. Hold 20 seconds, 3 repetitions.
Calf stretch on stairs: Stand on a step edge, heels hanging off. Slowly lower heels below the step level, hold 2 seconds, then rise back up. Three sets of 15 reps.
A frozen water bottle rolled under the arch for 5 to 10 minutes after exercise also helps reduce inflammation between sessions.
How to Prevent Plantar Fasciitis Going Forward
Replace worn shoes before they lose their cushioning. Most running shoes need replacement every 300 to 500 miles. Walking barefoot on hard floors during a flare-up makes things significantly worse.
Increase activity gradually. If starting or returning to a running program, the standard guideline is no more than a 10% increase in weekly mileage at a time. Sudden spikes in training volume are one of the most common triggers. Issues like tight hip flexors can also alter gait mechanics and put extra load on the heel, so addressing the full kinetic chain matters.
Daily calf stretching, even on pain-free days, keeps tension off the plantar fascia year-round.
The Bottom Line
Plantar fasciitis is painful and stubborn, but it responds well to early, consistent treatment. The research consistently points to stretching, load management, and proper footwear as the foundation of recovery.
If your heel pain has lasted more than a few weeks or is interfering with daily activities, a hands-on evaluation is worth it. Underlying issues with foot mechanics, ankle mobility, or hip alignment are easy to miss and often part of the picture. You can schedule an appointment online to discuss your symptoms and get a personalized plan. Most people who treat this early get back to full activity within a few months.
Sources & Further Reading
- Riddle DL, et al. Risk factors for plantar fasciitis: a matched case control study. Journal of Bone and Joint Surgery. 2003;85-A(5):872–877. (Prevalence: ~10% of adults affected over a lifetime; ~10% of runner-related injuries.)
- Orr JD, et al. Prevalence, characteristics, and associated risk factors of plantar heel pain in Americans: the cross-sectional NHANES study. PMC. 2024. PMID 39609875.
- Martin RL, Davenport TE, Reischl SF, et al. Heel Pain – Plantar Fasciitis: Revision 2023. Journal of Orthopaedic & Sports Physical Therapy. 2023;53(12). doi:10.2519/jospt.2023.0303.
- Al-Mohrej OA, et al. Comprehensive Review and Evidence-Based Treatment Framework for Optimizing Plantar Fasciitis Diagnosis and Management. Cureus. 2025. PMC12294660.
- Comparative effectiveness of minimally invasive therapies for plantar fasciitis: systematic review and network meta-analysis of 63 RCTs (n=4,170). Scientific Reports. 2025–2026. PMC12992864.
