Radial vs Focused Shockwave Therapy for Plantar Fasciitis

The goal of this clinical trial is to learn whether focused extracorporeal shockwave therapy (ESWT) provides better outcomes than radial ESWT for adults with plantar fasciitis. It will also learn about the safety and tolerability of both treatments. The main questions it aims to answer are: 1. Does focused ESWT lead to greater improvement in heel pain than radial ESWT? 2. Does focused ESWT improve foot function more than radial ESWT? 3. Do participants experience less discomfort during focused ESWT compared with radial ESWT? 4. What medical problems or side effects occur with either treatment? Researchers will compare focused ESWT to radial ESWT to see whether one treatment offers better clinical outcomes or is better tolerated. Participants will: 1. Receive three shockwave treatment sessions (radial or focused), one week apart 2. Attend clinic follow-up assessments at 6 weeks, 12 weeks, 6 months, and 12 months 3. Complete questionnaires about heel pain and foot function Keep a diary of symptoms, daily pain levels, activity limitations, and any use of pain medication

Inclusion Criteria: * aged 18 years or older; 2. chronic plantar heel pain for at least 3 months; 3. clinical presentation consistent with plantar fasciitis / plantar fasciopathy; 4. baseline average heel pain of at least 4/10 in at least one heel proposed for study treatment; 5. imaging findings supportive of plantar fasciitis / plantar fasciopathy on either: * ultrasound scan (USS); or * magnetic resonance imaging (MRI); 6. able to understand the study and provide written informed consent; 7. sufficient spoken and written English to understand the study information and complete the planned questionnaires and telephone follow-up assessments Exclusion Criteria: * Participants will be excluded for any of the following: 1. previous ESWT to the affected study foot; 2. corticosteroid injection to the affected region within the preceding 3 months; 3. previous plantar fascia surgery; 4. an alternative diagnosis considered to be the principal cause of the heel pain; 5. current or suspected calcaneal or other relevant stress fracture; 6. relevant inflammatory arthropathy; 7. pregnancy; 8. recognised contraindication to ESWT; 9. inability to provide informed consent; 10. insufficient spoken or written English to understand the study information or complete the planned study procedures where appropriately translated materials and interpreter-supported longitudinal follow-up are unavailable; 11. any other clinical factor considered by the investigator to make participation inappropriate or unsafe