- What makes my joints stiff in the morning?
- Ask the doctor
- Ankle Osteoarthritis Symptoms
- Common Signs and Symptoms of Ankle Osteoarthritis
- Foot & Ankle
- Conditions We Treat
- Stiffness in the Feet
- Foot & Ankle Specialty Blog
- Stay active, even with stiff ankles
- Exercise and stretch daily to keep ankles flexible.
- A tricky joint
What makes my joints stiff in the morning?
Ask the doctor
Published: October, 2016
Q. Why are my joints so stiff when I wake up? Is there anything I can do about it?
A. Stiffness in the back, knees, or feet is a common complaint I hear from older individuals. People often say, “I’m just getting old,” but old age alone does not cause morning joint stiffness. It is usually an indication of worn joints, muscle tightness, or inflammation from arthritis.
As your joints get older, the spongy cushion of cartilage begins to dry out and stiffen. The joint lining also produces less synovial fluid, which lubricates the joint. Weak muscles and stiff tendons also tend to tighten during sleep. Osteoarthritis, (the “wear and tear” kind), and rheumatoid arthritis, (which involves swelling and inflammation), both can trigger morning stiffness.
The average episode lasts only about 10 to 15 minutes. The stiffness goes away as you move and warm up the joints and muscles. However, stiffness from rheumatoid arthritis may last more than an hour.
You cannot reverse the effects of joint aging, and while certain medications can help manage arthritis pain and inflammation, stiffness can still occur. Still, you can reduce the severity and frequency of morning joint stiffness by being more active and engaging in exercise to increase muscle strength and flexibility. Maintaining a healthy weight also can help. Finally, don’t be swayed by joint health supplements, such as glucosamine or chondroitin. These do not appear to help manage symptoms in the long term.
—William Kormos, M.D.
Editor in Chief, Harvard Men’s Health Watch
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When you hear the term, “morning gel,” what comes to mind? Hair styling aids? Eye cream?
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Actually, medical experts use this term to describe joint stiffness from lack of movement, whether after a night’s sleep or binge-watching your favorite show.
According to Patricia Paczos, PA-C, “gel” is shorthand for the word, “gelatin.” Just as gelatin hardens as it sits, becoming the wobbly, brightly-colored dessert of summer picnics, so too do our joints sometimes stiffen up overnight from lack of movement.
What’s causing your morning gel?
There are various possible causes for morning gel, including osteoarthritis (the common arthritis people many experience with age) and inflammatory arthritic conditions that involve problems of an overactive immune system, such as rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis.
Determining the cause of morning gel is important for diagnosis and treatment, particularly when it comes to autoimmune conditions because they require more specialized care.
“When stiffness is prolonged — lasting for one hour or more — we suspect an autoimmune disorder. Usually, when it comes to the more common issue of osteoarthritis, the stiffness eases up more readily,” Dr. Paczos says.
She adds, “When we’re talking about a younger person with morning gel, that’s another signal that it’s potentially an autoimmune disorder that needs a rheumatologist’s attention.”
How is severe osteoarthritis diagnosed?
If a person has severe osteoarthritis, this can make diagnosis a little more involved. In these cases, the morning gel can be more prolonged even in the absence of an autoimmune disorder.
“This can occur when a person has little or no cartilage to offer cushion in the joint,” Dr. Paczos says. “It tends to become more problematic as people age, and the effects can also be accelerated by injuries, such as years of playing football.”
Unfortunately, there isn’t much that doctors can do to repair such damage, but you can maintain good lifestyle habits that help with symptoms.
Also, some people may be more or less predisposed to osteoarthritis based on their genetics. “Your genetics can influence how bad osteoarthritis gets and how early it starts,” Dr. Paczos says.
If morning gel is severe and there’s a question about whether it is rooted in an autoimmune issue, doctors make look at the following:
- Blood tests. Blood can show signs of inflammation.
- Appearance of the joint itself. Distribution and location of arthritis on the joint.
- Tests of fluid removed from the joint. Doctors test this for inflammatory cells.
How does a rheumatologist treat autoimmune problems?
If you get morning gel for more than an hour at a time, see a rheumatologist.
He or she will work with you to reduce the damage if you do have an autoimmune disorder. This may include:
- Drug treatment. Your doctor may prescribe medications to calm down inflammation, such as Disease Modifying Anti-Rheumatic Drugs (DMARDS). (These drugs don’t work for osteoarthritis.)
- Physical therapy. Specific exercises can sometimes help with pain and stiffness.
- Healthy lifestyle. It’s especially important to eat well, exercise, manage your weight, and focus on getting enough sleep.
- Reduce stress. Stress makes a lot of medical problems worse, and it plays an important role with rheumatologic conditions, according to Dr. Paczos.
When can morning gel be mistaken for something else?
Sometimes, people mistake other problems for morning gel, including:
- Stiffness from a new, vigorous exercise routine. “This actually involves the muscles rather than the joints,” Dr. Paczos says.
- Sluggishness in the morning. This can be related to many other problems, such as thyroid issues, fibromyalgia, obesity and/or a sedentary lifestyle.
What can you do to prevent and relieve morning gel?
For people with osteoarthritis, over-the-counter pain medicines can help. But the best prevention and remedy are lifestyle changes, Dr. Paczos says.
“It is so important to take care of your health every day, which will prevent and ease problems in your joints.”
She says the formula is simple and well known, but takes commitment to do regularly: Watch your weight, exercise, eat right and get proper rest.
“Do all you can to keep your weight in check and exercise 30 minutes/day several days a week. Walk, bike or swim if you like. Also, really pay attention to your diet and sleep habits.”
She tells patients, “You can start small and slowly build up to create good habits.” Another tip: Try writing down your goals. Remember that goals can change as you achieve them over time. Just by making a regular effort to show up and do your best each day will make you stronger and healthier.
If you hop out of bed with a spring in your step, good for you. But too many of us gingerly ease out of bed, wincing or hobbling through the first steps of the day. “Because you’re not actively moving while you sleep, the soft tissue and joints in your feet can tighten overnight,” explains Isaac Tabari, DPM, a podiatrist and founding director of NYC Podiatry Center of Excellence in New York City.
That can lead to morning foot pain for people with conditions like plantar fasciitis—inflammation of the plantar fascia, the ligament that runs down the bottom of your foot—or Achilles tendonitis, which is pain in the tendon that connects the lower calf muscle to your heel. Rheumatoid arthritis can also be a culprit, because it can cause foot and ankle joints to stiffen, adds Tabari. (Want to pick up some healthier habits? Sign up to get FREE fitness tips and more delivered straight to your inbox!)
What can you do to ease the throb? The following moves can help you start your day on the right foot.
Before You Get Out of Bed
These gentle stretches can loosen up tight muscles and improve blood flow. You can also take an anti-inflammatory to relieve the pain, says Tabari.
1. Towel stretch
Sit up in bed, legs stretched in front. Loop rolled-up towel (or exercise band if you have one handy) beneath ball of right foot. Keeping leg straight, gently pull towel toward you and hold 20 to 30 seconds. Repeat 3 to 5 times, then switch sides.
MORE: 60-Second Fix For A Stiff Neck
2. Sitting stretch
Cross left leg over right knee. Grasp base of toes on left foot and stretch toward your shin. Hold 20 to 30 seconds. Repeat 3 to 5 times, then switch sides.
MORE: 6 Simple Moves To Ease Sciatica
Stretch and Strengthen
Do these simple moves daily to help ward off those morning aches.
3. Heel stretch
Stand arm’s length away from wall; place hands flat at eye-level. Step left foot back and push against wall, bending right knee while keeping left heel on floor; don’t bounce. You should feel a stretch in the muscles in the back of your left leg. Hold for 20 to 30 seconds (or about 4 to 5 breaths). Repeat 3 to 5 times, then switch sides.
4. Kneeling stretch
Kneel on mat with toes tucked beneath you. Gently sit back on heels, stretching bottoms of feet. Hold 20 to 30 seconds. Repeat 3 to 5 times.
MORE: How To Start Walking When You Have 50+ Pounds To Lose
5. Heel raises
Stand on edge of step and hold onto railing for support. Stretch left heel down at least 30 seconds. Press up with same foot 10 seconds. Repeat 3 times and then switch sides.
6. Ice roll
While seated in chair, place frozen water bottle beneath arch of one foot. Gently roll back and forth 5 minutes. Switch sides.
Sharon Liao Sharon Liao is a former associate editor with Prevention.
Ankle Osteoarthritis Symptoms
Ankle pain, stiffness, and joint cracking or popping are classic signs of ankle osteoarthritis. These symptoms are often blamed on an old injury acting up. Left untreated, these symptoms can gradually worsen and start to interfere with everyday activities.
Common Signs and Symptoms of Ankle Osteoarthritis
Pain is the most common symptom of ankle arthritis, but there are many others. Recognizing these symptoms can help lead to early treatment.
People may experience pain in the lower shin (tibia), back of the foot, or middle of the foot. The pain may be aching and dull or sharp and intense. The pain may come and go or there may be a chronic low level of pain with intermittent flare-ups of more intense pain. In the early stages, many patients report experiencing pain only after certain activities that place strain on the ankle joint, such as jogging or extended walking. Typically, this ankle pain can be lessened with rest, elevating the foot, and an ice compress.
Joint swelling and bone friction make the ankle stiff and less flexible. The ankle’s range of motion can become more limited, making it difficult to point and flex the foot or move the foot side-to-side.
When ankle cartilage wears away, the fibula, tibia and talus bones can rub together, resulting in irritation. The ankle may produce excess joint fluid in an attempt to reduce the friction. This excess fluid results in swelling.
In This Article:
- What Is Ankle Osteoarthritis?
- Ankle Osteoarthritis Symptoms
- Ankle Osteoarthritis Causes
- Ankle Osteoarthritis Diagnosis
- Treating Ankle Osteoarthritis
Ankle popping or crunching
Sensing a crunching or hearing a popping or squeaking sound when pointing or flexing the toes is a sign that that cartilage has worn away and is not protecting the bones from friction. The medical term for this symptom is “crepitus.” (Crepitus without other symptoms is not a cause for concern.)
Walking may occasionally cause the ankle to lock or buckle, potentially causing the ankle to turn out or in. (These episodes can be reduced or eliminated by wearing supportive footwear with low heels.)
Gait is affected
Advanced osteoarthritis can cause the ankle cartilage to deteriorate unevenly. The bones and joint material can shift in an effort to compensate for the uneven deterioration. This can affect the way a person walks and eventually even cause arthritis in the knee and hip joints.
Inactivity makes symptoms worse
Ankles can become stiff after prolonged inactivity. People with ankle osteoarthritis may find that stiffness and pain are most noticeable when they try to get out of bed in the morning or out of a chair after a long period of sitting.
In most but not all cases, the symptoms of ankle osteoarthritis come and go, becoming worse and more frequent over months or years. Left untreated, ankle arthritis has the potential to severely impede mobility.
On the other hand, getting treatment in the early stages of arthritis can significantly slow the progression of symptoms.
Foot & Ankle
Conditions We Treat
Accessory Navicular Syndrome: When your teenage child complains of pain on the inside of the foot just above the arch, your child may have an extra bone or cartilage there. This additional bone is harmless, but if it irritates the bones around it, it requires treatment.
Achilles Tendinitis: The Achilles tendon connects the calf muscles to the heel bone. It can handle a great deal of stress and activity, but it can rupture or begin to break down if you do a lot of running and jumping, or if you are on your feet for long periods. You may develop pain and stiffness, especially in the morning.
Acquired Flatfoot: A number of different conditions can create a painful flatfoot, so the symptoms can vary from patient to patient. You may have pain along the inside of the foot that gets worse when you walk or exercise, or you may feel pressure on the outside ankle bone. If it’s an old injury, painful bumps can form in the middle of the foot.
Anterior Impingement Syndrome of the Ankle: When bone spurs form on the front of the ankle joint. They can cause pinching of the nerves inside the ankle. Doctors see this in athletes who have many small injuries to the ankle—particularly in soccer players.
Arch Pain/Strain: Many factors can cause a painful arch: a direct injury to the foot, a sprained ligament or tendon, a strained muscle, overuse, arthritis, and a number of others. Our doctors can diagnose the cause of your pain, recommend the best course of treatment, and find the right way to lessen or end your pain.
Arthritis, Great Toe (Halix rigidus): Every time you take a step, you bend your big toe—so if arthritis causes the toe to lock in place, walking can be difficult or even impossible. Both non-surgical and surgical treatments can be effective in relieving pain and keeping you on your feet.
Arthritis, Midfoot: Midfoot arthritis often develops after an injury to the foot or ankle, but it’s also common among athletes. In middle-aged people, the pain and stiffness in the middle of the foot can make it difficult to climb stairs or do similar activities.There are many non-surgical treatments for this condition.
Arthritis, Hindfoot: Pain, stiffness, and limited range of motion in the joint where the foot meets the ankle can signal arthritis. This often surfaces years after an injury to the ankle joint. Hindfoot arthritis may be corrected by arthroscopic surgery, or by a joint replacement in many cases.
Bunions: A sore, swollen bump where your big toe meets your foot is a bunion, a painful affliction of more than half the women in the United States. Bunions are most often caused by shoes that are too tight, or by pressure on the toes created by wearing high heels. A simple change to comfortable shoes can relieve many bunions, but surgical removal is also an option.
Cavus Foot (High-Arched Foot): An abnormally high arch is called a cavus, and it can cause discomfort when you wear shoes with little or no arch support. Custom-made orthotics, created for you using plaster casts of your feet, often can restore your comfort.
Charcot Arthropathy:If you have lost sensation in your foot or ankle because of diabetes or another disease that strikes the nerves, you may fracture or dislocate bones in your foot without even knowing it. When small injuries become larger, they can cause redness, swelling, and warmth in your foot joints—and you may not be able to walk.
Chronic Lateral Ankle Pain: After a sprained ankle, some people have chronic or recurring pain on the outer side of the ankle. Swelling, stiffness, and difficulty walking are all symptoms of this condition.
Crossover Toe: If your second toe drifts toward your big toe and eventually crosses it, you’re sure to feel pain in the bottom of your foot—and it will be hard to find shoes that are comfortable.The pain will begin before the toe crosses over, however, and early diagnosis is an important part of treatment.
Diabetic Foot Ulcers: Foot sores are very common in people with diabetes, especially if you have lost some of the feeling in your foot. The Foot and Ankle Institute can debride and treat foot ulcers and provide the bracewear and special shoes to help distribute your weight evenly, so you don’t develop any new ulcers by putting too much weight on one part of your foot.
Equinus: Tightness in the Achilles tendon can cause you to lose the ability to bend your foot upward toward the front of your leg. When this happens, many patients try to compensate by changing the way they walk—which causes additional injuries. In many cases, the tightness is present at birth, but it can also come from spending months in a cast or from high-heeled shoes.
Extra Bones (Accessory Ossicles): Some people are born with more than the usual 26 bones in their feet. These may be painless and require no treatment, or they may give you some discomfort. Your doctor at the Foot and Ankle Institute can help you decide what to do about these bones.
Flexible Flatfoot: When you have arches while you’re sitting down but they disappear when you stand up, you have flexible flatfoot. You may have pain in your heel, arch, or ankle, pain in your shins, and overpronation—your foot may splay outward at an abnormal angle.
Forefoot Pain (Second MTP Synovitis, Metatarsalgia): A sharp pain in the ball of the foot can signal one of several conditions. It’s caused by bones in the area starting to separate from the long bone of the foot (the metatarsal)—which can come from an abnormally high arch, a long second toe, some forms of arthritis, or wearing high heels.
Fractures: All broken bones are known as fractures. The Foot and Ankle Institute can diagnose and treat any kind of fracture in the foot or ankle, and is ready to work with you on recovery and rehabilitation.
Ganglion Cyst: These round or oval lumps may form on the tendons or joints of your ankles or feet. They are non-cancerous and filled with a jelly-like fluid, and they may be painful if they press on a nerve. These often go away on their own, but your doctor can treat your cyst as well.
Gangrene in Feet: When blood stops flowing to a part of your body, the tissue dies—and when this happens in a foot, it can mean a loss of function. People with diabetes, peripheral arterial disease, trauma to a foot or leg, or atherosclerosis may develop gangrene. If you suspect that you have gangrene in any part of your body, go to the nearest Emergency Department immediately.
Haglund’s Deformity: If you notice a bony, inflamed bump on the back of your heel, you may have this condition—one that’s also known as “pump bump.” It can be caused by women’s pumps, shoes that rub against the back of the heel—although men’s dress shoes, ice skates, or other shoes with a rigid back can cause the same bump. The deformity can be treated non-surgically (but you’ll have to switch to softer shoes).
Hammer Toes/Claw Toes/Mallet Toes: If your second, third or fourth toes are bent and held in a position for a long enough time—all day for months in the same ill-fitting shoes, for example—the muscles tighten, and the toes can no longer stretch out straight. The bent toes look like hammers or mallets, or they may bend under and look like claws. There are non-surgical treatments for this, but you can prevent hammertoes by wearing comfortable shoes with plenty of space for your toes to spread out.
Heel Spurs: When a calcium deposit forms on the underside of the heel bone, it can protrude from the heel by as much as half an inch. This is a heel spur, and it often rubs up against the plantar’s fascia, a band of tissue that connects the heel bone to the ball of the foot. The result is a pain that feels like a nail in the bottom of the foot. Treatment can include orthotics, injections, or minimally invasive surgery.
Insensitive (Numb) Feet: Diabetes and some neurological disorders can cause you to lose sensation in your feet. This is a dangerous situation, because you can’t tell if you have a sore that might develop into an ulcer. Your doctor may recommend special shoes to keep you from injuring your feet, as well as regular inspections of your feet to be sure there are no lesions.
Lisfranc Injuries: Usually the result of an impact accident, this injury involves the metatarsal bones, the ones that form the arches of the foot. When these are dislocated from their proper place, they leave a gap, usually between the joints in the first and second toes and the rest of the foot. Small dislocations can be managed without surgery.
Morton’s Neuroma: A burning or sharp pain in the ball of your foot can be caused by this condition, in which a nerve thickens because it has been squeezed for prolonged periods. The neuroma is caused most commonly by tight, narrow, or high-heeled shoes.
Osteochondral Lesions of the Talus: The talus is the bottom bone of the ankle joint. After a traumatic injury to the ankle, a part of the talus surface may come loose and lodge somewhere in the ankle, causing the ankle to freeze in place. Surgery may be required to remove the fragment and reshape the talus to move smoothly again.
Peripheral Neuropathy and Nerve Compression Syndrome: Numbness, tingling, prickling sensations, and muscle weakness are all signs of damage to the part of the nervous system that transmits messages to your feet. This issue can be genetic, or it can show up later in life after a physical injury or a disease that affects the entire body (including diabetes).
Peroneal Tendinitis: On the outside of the ankle, the peroneal tendon connects the heel to the muscles that allow movement. Overuse can make the tendon thicken and enlarge, a painful situation that will heal with rest and a special boot to permit walking.
Plantar Fascitis (Heel pain): Possibly the most common cause of heel pain, this inflammation causes a stabbing pain that is at its worst first thing in the morning as you step out of bed. The more you sit during the day, the more this pain increases. It can continue indefinitely without treatment—and custom-made orthotics can eliminate the pain entirely. If these don’t work, injection therapy and minimally invasive surgery may be indicated.
Posterior Tibial Tendonitis:This important leg tendon attaches the calf muscle to the bones on the inside of the foot. It provides support to the foot’s arch, especially when you are walking. People who play high-impact sports often injure or tear this tendon. The result is pain and a loss of arch support, making it difficult to run.
Sports-related Sprains and Instability: Ankle sprains are the most common reason that people find themselves in the Emergency Department, and many of these are the result of instability—collapse of the ankle under stress. The Foot and Ankle Institute can treat any kind of sprain or instability, helping you maintain your mobility and avoid such accidents in the future.
Stress Fractures: Tiny fractures may not seem like major injuries, but they can be a sign of osteoporosis or other more serious conditions. If you have pain and swelling on the top of your foot or in your ankle, call the Foot and Ankle Institute for an appointment in our Urgent Care department—even if the injury hasn’t slowed you down.
Tarsal Coalition: This abnormal connection in the back of the foot forms between cartilage, tissue and the tarsal bones. In most cases it forms before birth and presents itself later when the child has a limited range of motion in one or both feet.Many non-surgical methods help to reduce pain and increase motion, and surgery is a distant option.
Tarsal Tunnel Syndrome: On the inside of the ankle next to the ankle bone, there’s a tunnel that contains—among other things—the posterior tibial nerve (see above). When the tunnel contracts because of an injury or abnormality, it compresses this nerve. You may feel something like an electric shock, a burning sensation, numbness, or shooting pain. Your doctors can recommend many non-surgical methods for reducing pain and relieving the symptoms.
Stiffness in the Feet
I have a weird symptom that I can’t really find much about on the Internet. Simply put, I have stiff feet in the morning; that’s it…they are just stiff. They don’t hurt or ache, but I can barely walk to the bathroom. After a little while the stiffness clears but then sometimes it returns if I’ve been sitting for long periods of time. The symptom has been coming and going for about eight months now. So, what causes stiff feet? Am I coming down with some kind of arthritis?
— Lee, Virginia
Stiffness limited to the feet may be due to osteoarthritis (a degeneration of the joint) of the big toe or the midfoot. The joint at the base of the big toe (first metatarsophalangeal joint) can become rigid because of bony spurs (osteophytes) and reduction of the cartilage space, and thus feel stiff. Osteoarthritis in the midfoot joint is commonly due to a previous injury. A rheumatologist can be helpful in this case.
At times women who wear high-heel shoes may get shortening of the Achilles tendon (the heel cord) and can experience stiffness there if they try to wear low-heel or flat shoes. Or, the special connective tissue at the sole of the foot (plantar fascia) can get irritated, inflamed, and may scar inwardly. This too can cause stiffness, but it is usually also painful. In this case, orthotic inserts in the shoe, physical therapy, and, if needed, nonsteroidal anti-inflammatory drugs can help. A rheumatologist or an orthopedist can diagnose and treat plantar fasciitis.
Foot & Ankle Specialty Blog
Stiff Feet Upon Waking Up in the Morning
This is a common problem, especially among both men and women and especially those with mild arthritis. The reason for the foot stiffness when first placing your feet on the floor in the morning is a reduction in fluid that provides lubrication to your joints as well as loss of cartilage in the foot joints. Fortunately, the pain and stiffness usually goes away after taking a few steps. If it does not, you may have another foot issue such as tendonitis or plantar fasciitis.
Problems with Footwear
Shoes that do not fit properly and high-heeled shoes for women are both common causes of foot stiffness. In the latter case, a habit of wearing high-heeled shoes can cause the Achilles tendon to shrink and become painful. This can continue for some time after switching to shoes without a heel or when walking barefoot. The formation of calluses and scars on the connective tissue of the foot’s sole can also lead to painful stiffness.
Wearing shoes that are the right size for your feet with the proper heel and arch support is essential to avoid discomfort. Dr. Sweeney would be happy to recommend a specific type of shoe and/or inserts if you are struggling to find something both comfortable and supportive. We also encourage you to schedule an appointment if you struggle with the above issues or any other type of foot stiffness.
Stay active, even with stiff ankles
Exercise and stretch daily to keep ankles flexible.
Published: April, 2019
Ankle stiffness can do a number on your mobility. It can make it difficult to remain active or even get out of bed in the morning and walk across the room. “Motion restriction usually occurs more in the upward than downward direction, so it becomes harder to walk uphill, wear flat shoes, or keep feet pointed straight ahead,” says Dr. Christopher DiGiovanni, chief of foot and ankle surgery at Harvard-affiliated Massachusetts General Hospital.
A tricky joint
The ankle is a vulnerable structure. It’s made of the ends of the lower leg bones (the tibia and fibula), which hold the talus bone of the foot in between them. The joint is stabilized by ligaments and powered by muscles that work in concert to enable ankle and foot motion and accommodate uneven surfaces when you stand or walk.
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