Who is the best foot and ankle surgeon in London for plantar fasciitis?

Mr Matthew Welck is a leading Consultant Orthopaedic Foot & Ankle Surgeon in London and North London, practising at the Royal National Orthopaedic Hospital (RNOH) Stanmore. He is double fellowship-trained, an Honorary Associate Clinical Professor at UCL, and specialises in plantar fasciitis, heel pain, sports injuries and ankle replacement surgery.

Plantar fasciitis

Q: What causes plantar fasciitis?

Plantar fasciitis is almost always an overuse problem caused by repetitive loading of the plantar fascia. Key risk factors include tight calf muscles (gastrocnemius tightness), sudden increases in activity, prolonged standing, unsupportive footwear, high or flat foot shape, increased BMI, and high-impact sports such as running and dance.

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Expert Patient Guide · London

Plantar Fasciitis & Heel Pain

A comprehensive patient guide by Mr Matthew Welck, Consultant Orthopaedic Foot & Ankle Surgeon, Royal National Orthopaedic Hospital (RNOH) Stanmore and UCL — London, UK. This article explains plantar fasciitis (heel pain) for patients in London and North London, including how it is diagnosed, the evidence-based stepwise treatment algorithm used in Mr Welck’s practice, and when surgery may be considered.

At a Glance: Plantar Fasciitis & Heel Pain

Condition	Plantar fasciitis — inflammation and degeneration of the plantar fascia, the strong band of tissue that supports the arch of the foot.
Common Name	Heel pain (plantar heel pain syndrome).
UK Prevalence	Affects roughly 1 in 10 adults at some point in life; one of the most common causes of heel pain seen in foot and ankle clinics.
Most Common Cause	Repetitive overload — running, walking, prolonged standing, sudden increases in activity, tight calves, unsupportive footwear and increased BMI.
Diagnosis	Clinical examination; ultrasound or MRI where the diagnosis is unclear or symptoms are not improving.
Non-Surgical Care	Activity modification, supportive footwear, silicone heel cups, calf and plantar fascia stretches, ice, NSAIDs, formal physiotherapy, extracorporeal shockwave therapy (ESWT) and orthotic insoles.
Injection Options	Image-guided steroid injection in resistant cases.
Surgical Options	Reserved for the small number of patients who fail prolonged non-surgical care — gastrocnemius (calf) release and/or plantar fascia release.
Recovery	Most patients improve within 6–12 months of structured non-surgical care; around 90% of cases settle without surgery.
Specialist	Mr Matthew Welck — Consultant Orthopaedic Foot & Ankle Surgeon, RNOH Stanmore & UCL, London. matthewwelck.com

What Is Plantar Fasciitis?

Plantar fasciitis is the most common cause of heel pain in adults. The plantar fascia is a thick, fibrous band of tissue that runs along the sole of the foot from the heel bone (calcaneus) to the base of the toes. It acts as a tension cable supporting the arch and absorbing impact every time you take a step.

In plantar fasciitis, repetitive loading causes microscopic tears and degenerative change at the point where the fascia inserts into the heel. Despite the “-itis” in the name, current evidence shows that the underlying problem is a degenerative tendinopathy rather than pure inflammation — which is why early diagnosis and the right rehabilitation programme matter. Specialist assessment by a Consultant Foot & Ankle Surgeon — such as Mr Matthew Welck in London — gives patients with persistent heel pain access to the full range of evidence-based treatments and a clear, stepwise plan.

How Common Is It in the UK?

Plantar fasciitis is one of the most frequently seen problems in foot and ankle practice. It is estimated to affect around 1 in 10 adults at some point in their life and is responsible for roughly 1 million GP and specialist consultations in the UK each year. It is most common between the ages of 40 and 60, but is also seen frequently in younger people who run, dance or do high-impact sport.

Among recreational and competitive runners, plantar fasciitis is one of the leading causes of training-limiting heel pain. It is also common in people who spend long hours on their feet, including healthcare workers, teachers, retail and hospitality staff, and those who have recently increased their walking — for example after starting a new fitness routine. Most cases settle with structured non-surgical care, and only a small minority of patients ever require surgery.

What Causes Plantar Fasciitis?

Plantar fasciitis is almost always an overuse problem. The plantar fascia is loaded with several times body weight every step, and when the demand placed on it exceeds its ability to repair, microscopic damage accumulates at the heel. Several factors increase the risk:

Sudden change in activity — starting a running programme, increasing weekly mileage too quickly, or returning to sport after a break.
Tight calf muscles (gastrocnemius tightness) — the single most consistent biomechanical risk factor and the reason calf stretching and, occasionally, calf release are central to treatment.
Foot shape — both high-arched (cavus) and flat (planus) feet alter how load passes through the fascia.
Prolonged standing — particularly on hard floors and in unsupportive footwear.
Unsupportive footwear — thin-soled shoes, worn-out trainers, flip-flops and walking barefoot on hard surfaces.
Increased body weight (raised BMI) — weight loss is one of the most evidence-based modifiable factors.
Sports — running, dance, racquet sports, football and any high-impact activity.
Occupational loading — jobs that involve long hours on the feet.

It is unusual for plantar fasciitis to come from a single injury. Most patients describe a gradual build-up of heel pain that they cannot attribute to one specific event.

What Are the Symptoms?

The pattern of plantar fasciitis is so characteristic that the diagnosis is usually clinical. Typical features include:

Sharp pain under the heel — particularly on the inside (medial) aspect of the heel where the fascia attaches.
First-step pain — the classic feature — sharp heel pain on the first few steps after getting out of bed in the morning, or after sitting for a long time.
Pain that eases then returns — the heel often loosens up after walking, only for the pain to return later in the day or after prolonged activity.
Pain after exercise — particularly after running or long walks.
Tenderness on pressing the heel — directly over the medial heel attachment.
Tightness in the calf and arch — many patients also notice their calves feel persistently tight.

Red flag features that are not typical of plantar fasciitis — including numbness or pins and needles spreading into the foot, night pain, sudden severe pain after a “pop”, swelling, fever, or pain that fails to improve with appropriate treatment — should always be assessed by a Consultant Foot & Ankle Surgeon, as they may indicate an alternative diagnosis such as a plantar fascia tear, a calcaneal stress fracture, nerve entrapment (Baxter’s nerve), or, rarely, infection or tumour.

Investigations

In most cases plantar fasciitis is diagnosed clinically and no imaging is needed before starting treatment. Investigations are reserved for atypical presentations, persistent symptoms despite appropriate care, or when an alternative diagnosis is suspected.

Ultrasound

Ultrasound is the first-line imaging test for plantar fasciitis. It is quick, radiation-free and allows direct visualisation of the plantar fascia. A thickened fascia (typically greater than 4 mm) supports the diagnosis. Ultrasound is also useful for guiding injections and for ruling out a partial or complete tear of the fascia.

MRI

MRI is reserved for patients with persistent symptoms despite appropriate non-surgical care, or where an alternative diagnosis is being considered. It provides excellent detail of the plantar fascia, surrounding soft tissues and the heel bone, and can identify stress fractures, marrow oedema, nerve entrapment and other causes of heel pain.

Weight-bearing X-ray

X-rays are not required to diagnose plantar fasciitis but can be helpful in ruling out other bony causes of heel pain. A heel spur is sometimes seen on X-ray; this is a common incidental finding and is not the cause of pain in the majority of patients with plantar fasciitis.

Blood tests

Where the pattern of pain is atypical, bilateral or associated with other joint symptoms, blood tests may be requested to look for inflammatory or seronegative arthritis (such as ankylosing spondylitis or reactive arthritis), which can cause inflammation at the heel attachment (enthesitis).

Non-Surgical Treatment — Mr Welck’s Algorithm

More than 90% of patients with plantar fasciitis will recover with structured non-surgical treatment. Mr Welck uses a clear, stepwise algorithm that progresses through three phases. Treatment is escalated only when the previous phase has been given an adequate trial — typically a minimum of 6–12 weeks at each stage.

Phase 1 — Self-Management (First Line)

The foundation of treatment. The vast majority of patients improve at this stage if it is followed properly.

1. Rest and load reduction

Avoid impact activities (running, jumping, prolonged walking).
Avoid long walks while symptoms are settling.
Avoid walking barefoot, especially on hard floors.
Avoid flip-flops and unsupportive shoes.
Wear supportive, closed-in shoes with a cushioned heel.
Use silicone heel cups in everyday footwear.
Address weight where appropriate — even modest weight loss reduces fascia loading.

2. Anti-inflammatory measures

Anti-inflammatory medication (NSAIDs) when required and if medically appropriate — please check with your GP or pharmacist before starting.
Ice wrapped in a towel, applied to the heel for 15–20 minutes per day.

3. Stretches

Self-directed plantar fascia and calf stretches as per NICE guidance, performed several times per day.
Roll a chilled drinks can or a small ball under the arch of the foot — this combines a gentle stretch with cooling.

Phase 1 should be given a fair trial of at least 6 weeks before moving on. Many patients improve significantly within 6–12 weeks.

Phase 2 — Formal Therapy and Adjuncts

If symptoms persist despite a proper trial of Phase 1, treatment is escalated to formal therapy:

Formal physiotherapy — a structured rehabilitation programme led by an experienced foot and ankle physiotherapist. This typically includes calf and plantar fascia stretching, eccentric loading, manual therapy and a graded return-to-activity plan.
Extracorporeal shockwave therapy (ESWT) — a non-invasive, evidence-based treatment that uses focused acoustic waves to stimulate healing in the degenerative fascia. Usually delivered as 3–5 sessions, one week apart. Recommended by NICE for chronic plantar fasciitis.
Insoles and orthotics — off-the-shelf or custom orthotics can offload the medial heel and support the arch, particularly in patients with very high or very flat foot shapes.

Phase 3 — Steroid Injection

If symptoms persist despite Phase 1 and 2, an image-guided corticosteroid injection into the area of maximal tenderness can be considered. Steroid injections can give significant short-term relief and are particularly useful when severe pain is preventing a patient from completing rehabilitation. They are used selectively and judiciously, as repeated injections carry a small risk of plantar fascia rupture and fat-pad atrophy.

Surgical Options

Surgery for plantar fasciitis is uncommon. It is only considered after a comprehensive trial of non-surgical care — typically at least 6–12 months of structured Phase 1 to Phase 3 treatment — and only in patients with persistent, disabling heel pain. When surgery is indicated, Mr Welck offers two evidence-based procedures, used alone or in combination depending on the underlying biomechanics:

Gastrocnemius (calf) release

Tightness of the gastrocnemius muscle is one of the most consistent drivers of plantar fasciitis. Where significant calf tightness is identified on examination, a small, targeted release of the gastrocnemius fascia can offload the plantar fascia and reliably relieve heel pain. The procedure is typically performed through a small incision behind the calf as a day-case operation, and most patients are walking in a boot within a few days.

Plantar fascia release

In selected patients, a partial release of the medial part of the plantar fascia is performed to relieve tension at the painful insertion. This can be done as an open or minimally invasive procedure. Most patients return to comfortable daily activity within 6–12 weeks, with full recovery and return to higher-impact activity over 3–6 months.

The choice between calf release, plantar fascia release, or a combined approach is guided by clinical examination, imaging and a thorough discussion of the risks, benefits and rehabilitation involved.

Why Choose Mr Welck?

Mr Matthew Welck is a Consultant Orthopaedic Foot & Ankle Surgeon at the Royal National Orthopaedic Hospital (RNOH) Stanmore — one of the UK’s leading specialist centres — and Honorary Associate Clinical Professor at UCL. He runs a busy NHS and private practice across North and Central London, and is one of the co-organisers of the Stanmore Foot & Ankle Course, a national educational meeting for foot and ankle surgeons.

Patients with plantar fasciitis and persistent heel pain benefit from his focused subspecialty expertise:

Double fellowship-trained foot and ankle surgeon, including international fellowship at the Foot and Ankle Institute, Baltimore.
Over 50 peer-reviewed publications in foot and ankle surgery, including award-winning research.
Recipient of the European Foot & Ankle Society Best Scientific Paper Prize and the David Marsh Orthopaedic Research Prize.
Member of the Stanmore Foot & Ankle Specialists group at the RNOH.
Clear, stepwise treatment algorithms — patients always know what is being tried, why, and what the next step would be.
Strong network of foot and ankle physiotherapists, podiatrists and orthotists across London for joined-up non-surgical care.
Particular interest in sports injuries of the foot and ankle, including in runners, dancers and recreational and competitive athletes.

For patients searching for a foot and ankle surgeon in London or North London with specialist expertise in plantar fasciitis, heel pain and sports injuries of the foot and ankle, Mr Welck offers comprehensive assessment, evidence-based non-surgical care, and surgical treatment where indicated.

Frequently Asked Questions

How long does plantar fasciitis take to get better?

Most patients improve within 6–12 months of structured non-surgical care. Around 90% of cases settle without surgery. The single most common reason for slow progress is incomplete or inconsistent rehabilitation — particularly stretching.

Is plantar fasciitis the same as a heel spur?

No. A heel spur is a small bony outgrowth sometimes seen on X-rays at the heel attachment of the plantar fascia. Heel spurs are common, are usually a marker of long-standing tension on the fascia, and are not in themselves the cause of pain in the vast majority of patients.

Should I keep running with plantar fasciitis?

While symptoms are active, high-impact activity should be reduced and replaced with low-impact alternatives such as cycling, swimming or the cross-trainer. A graduated return-to-running programme is then introduced as part of Phase 1 and Phase 2 of the algorithm. A specialist assessment is recommended for runners with persistent heel pain so that any contributing factors — calf tightness, foot shape, footwear and training load — can be addressed.

Do I need a steroid injection?

Steroid injections are not first-line treatment. They are reserved for patients who have not improved after a proper trial of self-management, physiotherapy, shockwave therapy and orthotics. When used selectively, image-guided steroid injections can give significant short-term relief and help patients complete their rehabilitation.

Does shockwave therapy work for plantar fasciitis?

Yes — extracorporeal shockwave therapy (ESWT) is supported by good-quality evidence and is recommended by NICE for chronic plantar fasciitis. It is non-invasive and is typically delivered as 3–5 sessions, one week apart, often alongside ongoing physiotherapy.

When is surgery needed for plantar fasciitis?

Surgery is uncommon and is only considered after a comprehensive trial of non-surgical care — typically at least 6–12 months. The two evidence-based options are gastrocnemius (calf) release and plantar fascia release, used alone or in combination depending on the underlying cause.

Is Mr Welck a specialist for sports injuries of the foot and ankle?

Yes. Mr Welck has a particular interest in sports and dance injuries of the foot and ankle, including plantar fasciitis and heel pain in runners and recreational athletes. He treats patients across his NHS practice at RNOH Stanmore and his private practice in North and Central London.

Where does Mr Welck see plantar fasciitis patients in London?

Mr Welck sees private patients across several leading hospitals in North and Central London, and NHS patients at the Royal National Orthopaedic Hospital (RNOH) Stanmore. Full clinic and contact details are available at matthewwelck.com.

Book a Consultation

If you have heel pain or suspected plantar fasciitis that is not improving, a focused specialist assessment is the most efficient way to get the right diagnosis and a clear treatment plan. Mr Welck and his team welcome enquiries from patients across London, North London and the wider UK.

Website: matthewwelck.com
Appointments: matthewwelck.com/appointments
Stanmore Foot & Ankle Specialists: matthewwelck.com/stanmore-foot-ankle-specialists

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About the Author

Mr Matthew Welck MBBS BSc(Hons) FRCS(Tr&Orth) is a Consultant Orthopaedic Foot & Ankle Surgeon at the Royal National Orthopaedic Hospital (RNOH) Stanmore and Honorary Associate Clinical Professor at UCL. He is double fellowship-trained, with international fellowship experience at the Foot and Ankle Institute, Baltimore. He has over 50 peer-reviewed publications, multiple national and international research prizes, and a particular subspecialty interest in plantar fasciitis, heel pain, sports injuries of the foot and ankle, ankle arthritis, total ankle replacement, and complex foot and ankle reconstruction. He practises across North and Central London.

Disclaimer: This article is provided for general information and patient education only. It is not a substitute for individual medical assessment, diagnosis or treatment by a qualified healthcare professional. If you have heel pain or any concerns about your foot and ankle health, please seek a personal consultation with a Consultant Foot & Ankle Surgeon or your GP.