Botox for Calf Tightness and Foot Spasticity in London

Tight calf muscles pull on the Achilles tendon and heel, and limit how far the ankle can bend upwards. This can add to heel pain, forefoot pain and an uneven walking pattern. In people with spasticity, overactive calf muscles can also make the foot point downwards or turn in, or the toes curl. At LSRI, Dr Prashant Sankaye, Consultant MSK Radiologist, assesses the calf and foot and, where it is right for you, gives Botox (botulinum toxin) injections into the calf muscles under ultrasound guidance, alongside a stretching and strengthening programme.

Who it may help

• Tight calf muscles that keep contributing to heel pain, plantar fasciitis, Achilles tendon pain or forefoot pain, when a well-structured stretching programme has not been enough.
• Foot and ankle spasticity, for example after a stroke, brain or spinal cord injury, or with multiple sclerosis or cerebral palsy, when overactive calf muscles cause the foot to point down, turn in or the toes to curl.

How Botox works

Botulinum toxin temporarily blocks the signal from a nerve to the muscle it supplies, so the injected muscle relaxes. The effect usually starts within a few days, builds over about two weeks and lasts around three to four months, after which the muscle gradually recovers. The treatment can then be repeated if it helped.

Botox works best as part of a wider plan. Relaxing the calf gives a window to stretch and strengthen it, and some people also benefit from physiotherapy, insoles or splints.

Botulinum toxin is an established treatment for spasticity. Using it for calf tightness in people without spasticity is a newer, off-label use, and the evidence is still limited. Dr Sankaye will talk through whether it is likely to help you.

What to expect

1. Assessment: Dr Sankaye reviews your symptoms, walking and any previous treatment, examines the ankle and calf, and scans with ultrasound to check the tendon and heel and plan the injection.
2. Injection: Botox is injected through a fine needle into selected points in the calf muscles, guided by ultrasound so it reaches the right muscle.
3. Afterwards: you can walk out of the clinic and carry on with most normal activities. You will be given aftercare advice and a stretching programme.
4. Review: the full effect is usually seen after about two weeks. A written report is sent to you and, if you wish, your GP, physiotherapist or neurology team.

Risks and side effects

• temporary weakness in the calf, which can make running, jumping or climbing stairs feel harder for a few weeks;
• soreness or bruising where the needle went in;
• short-lived flu-like symptoms, which are uncommon;
• rarely, the effect spreads beyond the injected muscle and causes weakness elsewhere.

Botox may not be suitable if you are pregnant or breastfeeding, have myasthenia gravis or another condition affecting the nerves and muscles, have an infection where the injection would go, or take certain antibiotics (aminoglycosides). Please tell us about all your medicines, including blood thinners, before your appointment.

Seek urgent medical help if you have difficulty swallowing, speaking or breathing after a Botox injection. This is very rare.

Why choose LSRI

• Consultant-led care from Dr Prashant Sankaye, Consultant MSK Radiologist with more than 20 years’ experience.
• Assessment and ultrasound-guided injection from the same specialist.
• Two clinics: LSRI Harley Street (W1G 9QJ) and LSRI Northwest London in Harrow (HA2 7SJ).
• No GP referral needed, and all major insurers accepted.

Frequently asked questions

How soon will Botox work?

Most people notice the muscle relaxing within a few days, with the full effect after about two weeks.

How long does it last?

Usually around three to four months. Treatment can be repeated, normally no more often than every three months.

Will my leg feel weak?

The calf can feel a little weaker for a few weeks, which is part of how the treatment works. Dr Sankaye will adjust the dose to your needs and activities.

Do I still need to do stretches?

Yes. Botox gives the muscle a chance to relax, but stretching and strengthening are what make the improvement last.

Other uses of Botox at LSRI

• Botox for plantar fasciitis
• Botox for trapezius and neck muscle pain
• Botox for muscle spasticity
• Botox for excessive sweating (hyperhidrosis)
• Can Botox help Raynaud’s phenomenon?

See all our Botox injections.

Book an appointment

Call 0203 633 5040 or book online. Clinics at LSRI Harley Street (The Harley Street Hospital, 19 Harley Street, London W1G 9QJ) and LSRI Northwest London (Medic Care Direct, 62 Station Road, Harrow HA2 7SJ).