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Heel pain during activity

Plantar Fasciitis

Plantar fasciitis is the most common cause of heel pain. It develops when the thick band of tissue on the sole of the foot becomes overloaded and degenerates, causing sharp pain with the first steps of the day and after periods of rest.

Prof Paul LeeReviewed byProf Paul LeeLast reviewed 1 May 2026
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Symptoms and diagnosis

  • Sharp pain under the heel, worst with the first steps in the morning.
  • Pain after sitting or resting that eases with gentle movement.
  • Aching or burning along the sole of the foot after prolonged standing.
  • Pain that worsens with increased activity or barefoot walking.

Diagnosis is typically clinical. Ultrasound can confirm thickening of the fascia, and MRI may be used to rule out other causes of heel pain.

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Treatment at London Cartilage Clinic

Treatment follows a structured, evidence-based pathway tailored to the duration and severity of your symptoms.

  • Calf stretching, plantar fascia loading exercises, and footwear guidance.
  • PRP injection to support tissue repair at the fascial attachment.
  • mFat therapy for chronic cases resistant to other treatments.
  • Custom orthotics and night splints to reduce strain on the fascia.

We treat the tissue biology, not just the symptoms. Steroid injections are used cautiously because repeated use can weaken the fascia and risk rupture.

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Heel injection preparation

You may have more options than you think

Most patients have more treatment options than they have been told

At London Cartilage Clinic we follow a structured clinical framework across four areas of treatment. Before recommending a single procedure, we assess which combination of approaches gives you the best outcome.

Preserve

Protect what you have. Slow degeneration and manage symptoms.

Repair

Fix specific damage. Torn tissue, unstable joints, structural problems.

Regenerate

Rebuild lost tissue. Biological treatments that stimulate new growth.

Replace

When other options are exhausted. Joint replacement as a last resort.

Explore the full range of treatments available for your joint. Each hub page shows every option we offer, organised by clinical approach.

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Frequently Asked Questions

What causes plantar fasciitis?

The plantar fascia is a thick band of tissue that runs along the sole of the foot from the heel to the toes. Overloading through increased activity, weight gain, tight calves, or poor footwear causes micro-tears and degeneration at the calcaneal attachment, producing heel pain.

Why is the pain worst first thing in the morning?

During sleep, the plantar fascia contracts in a shortened position. The first steps of the day re-stretch the tissue, causing sharp pain at the heel. This start-up pain is one of the hallmark symptoms of plantar fasciitis.

How long does plantar fasciitis take to resolve?

Most cases improve within 6 to 12 months with structured treatment. However, chronic cases can persist longer. Early, targeted treatment shortens recovery and reduces the risk of the condition becoming entrenched.

What treatments are available beyond stretching?

In addition to calf and plantar fascia stretching, options include shockwave therapy, PRP injection, mFat therapy, custom orthotics, night splints, and targeted physiotherapy. We tailor the approach based on symptom duration and severity.

Still have more specific concerns?

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