After a good night's rest, it can be alarming to step out of bed and immediately have pain at the back of your calf. This thick tendon, called the Achilles, is where your two calf muscles attach to your foot. There are two common reasons you might have a sore Achilles tendon in the morning — injury or positioning.
If you participate in sports or are physically very active, you may have an overuse tendinopathy — a condition that causes micro-tearing of fibers in the tendon. While you sleep, your ankle is relaxed, placing your calf muscles in a shortened position. When you stand up, this muscle is stretched, which may cause the back of your heel to hurt when you wake up.
Anatomy of the Achilles
Your Achilles tendon is a band of connective tissue that joins your heel bone to the two major muscles in your calf used for walking and running. These calf muscles, known as the gastrocnemius and the soleus, generate the power your foot needs to push off and take a step or rise up on your toes, such as when you are jumping.
Achilles Tendon Pain in the Morning
Any activity that puts stress on your Achilles tendon, such as running or jumping, can cause injury. Tight calf muscles or a sudden increase in the amount or intensity of exercise can lead to Achilles tendon pain in the morning. Exercising with improper shoes or running on uneven surfaces can increase your risk of developing this condition.
Symptoms of Achilles Strain
Your Achilles tendon may feel especially stiff and painful right after you wake up in the morning or after any long period of inactivity. You may also feel pain in your heel and up along the tendon as you walk or run later in the day. It may be especially painful if you walk up stairs or on an incline. You may feel swelling and warmth in the area due to inflammation, and your Achilles tendon may be painful to the touch.
Treatment for Achilles Pain
Rest your foot and ankle and avoid unnecessary movement if you have pain in your Achilles tendon. Make an appointment to see your doctor for a definite diagnosis if the pain lasts more than a few days or interferes with your ability to walk. Your doctor may recommend further treatment, such as ice packs, exercise or medication, depending on the cause of pain. In some extreme cases, surgery may be necessary.
Stretching tight muscles and tendons can improve flexibility and help reduce risk of injury or pain if your Achilles hurts in the morning. You can do this stretch at night before going to bed, before physical activity, then again when you first get up in the morning.
HOW TO DO IT: Stand facing a wall with your feet staggered, with your injured leg in the back. Place your hands on the wall at shoulder height for balance.
Keeping your front knee bent and back leg straight, slowly lean in toward the wall until you feel a stretch along the back of your calf. Hold for 20 to 30 seconds, and repeat three times.
Repeat this stretch, but with a slight bend in your back knee. Continue to keep the back heel on the ground. This will target the soleus muscle.
- Oxford University Hospitals: Achilles Tendinopathy: Advice and Management
- American Academy of Orthopaedic Surgeons: Foot and Ankle Conditioning Program
- Journal of Orthopaedic & Sports Physical Therapy: Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy: Revision 2018