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Trouble Walking in the Morning?

By Alan Williams, PT, OTR/L, ATC, CSCS

I wake up at the whir. Rather than be rudely jolted from my slumber by a blaring alarm, I’ve set my CD alarm clock to wake me with music. When 5:47am hits, the CD makes a whirring noise for just a moment before the music starts, and my subconscious has come to recognize this as the “wake up” sound. But even though my subconscious knows it’s time to wake up, the rest of me takes a while to get with the program. At least for me, this groggy, half-conscious state is pretty much limited to my brain. But for some people, morning time doesn’t just present difficulty in waking up, but also in even getting up. There are a couple of reasons why walking in the morning may be difficult. First I’ll discuss two possible culprits, and then I’ll explain how some of the symptoms of each can be alleviated.

Plantar fasciitis (named for inflammation of the plantar fascia ligament) develops when the plantar fascia (which runs along the bottom of the foot, alternately stretching and relaxing with every step) must absorb excessive or abnormal amounts of stress. This causes minute tears along the ligament and most often presents as sharp pain in the center of the heel. Fortunately, plantar fasciitis is rarely serious enough to warrant surgery, but it can easily become a chronic condition if not treated properly.

Plantar fasciitis is often at its worst first thing in the morning. As you sleep, the plantar fascia remains still rather than stretching and relaxing as it would if you were awake and moving. Because it doesn’t get to stretch, it slowly constricts and becomes tighter. This can make walking in the morning quite painful until the ligament has a chance to loosen up from being active. But therein lays the key to managing plantar fasciitis pain – keep the ligament stretched and loose. Before getting out of bed, try to warm up your feet a little. Do slow, gentle toe points and foot circles. It may hurt at first, but that should pass as the ligament relaxes. Also consider visiting your physical therapist or doctor; they will be able to show you specific stretches for your particular needs and additionally may recommend wearing foot splints while sleeping to keep the plantar fascia from tightening during the night.

A second culprit may be arthritis. The term “arthritis” comes from the Greek word artho, meaning “joint,” and itis, meaning “inflammation.” Arthritis is defined as “inflammation of the joints due to infectious, metabolic, or constitutional causes (Merriam-Webster).” According to the CDC, arthritis accounts for 18% or nearly 9 million reports of disability, making it the number one cause of adult disability. But not all arthritis cases are the same. Arthritis may be the primary cause of a person’s symptoms or may appear secondary to another condition, such as gout, lupus, sarcoidosis, Lyme disease, or many others.

Although moving painful joints may seem like less than a stellar idea, it’s really the best thing for them. Movement can help to slow the progression of arthritis by encouraging the joints to remain active rather than succumbing to immobility. This is essentially what happens to a lesser degree while you sleep – your joints stiffen from inactivity. Arthritis in your ankles, knees, hips, and the joints in your feet can make for awkward, painful movement when you wake. As with plantar fasciitis, the key is to start slowly and warm up before getting up. And don’t forget general pain control techniques like heat/ice to reduce inflammation and over-the-counter pain relievers if approved by your doctor.

Don’t hesitate to see your physical therapist or doctor for more specific ways you can reduce your morning walking problems. Waking up in the morning shouldn’t have to be more difficult than it already is. And who knows? You may become a morning person yet.

Don’t let foot pain hold you back. Call 463-0022 today for your FREE Foot Pain Assessment!