Assessment
Your physiotherapist discusses your symptoms, goals, medical history and lifestyle, then completes a thorough assessment. Initial appointments are typically 45 to 60 minutes, so there is time to do it properly.
What We Treat
Foot & Ankle Pain Treatment in London
Your foot takes your whole body weight several thousand times a day, so a problem down there rarely stays quiet. Whether it is a rolled ankle that never quite recovered, morning heel pain or an Achilles that has been grumbling for months, it is treatable and it responds well to being loaded properly.
Overview
Understanding foot & ankle pain
Foot and ankle problems are the ones people most often decide to run through. That works for a while, and then it stops working.
The common pictures we treat:
- Achilles tendinopathy: pain and stiffness at the back of the heel, worst first thing in the morning.
- After Achilles repair: staged rehabilitation following rupture, surgical or conservative.
- Ankle sprains: including the ones that never fully settled and now feel unreliable.
- Plantar heel pain: that sharp first-step pain under the heel.
- Shin pain and bone stress: load-related pain in runners that needs taking seriously.
- Forefoot pain: including nerve-related pain between the toes.
Tendon problems in particular reward getting the load right and punish both rest and pushing through. That is the whole game with an Achilles, and it is why a plan beats a stretch sheet.
Physiotherapy leads the plan. Shockwave therapy has one of the strongest evidence bases of any tendon treatment for chronic Achilles pain, and running gait and performance reviews show what your foot is doing at speed. This work overlaps with sports injuries, muscular injuries and post-operative rehabilitation.
Excellent
From 4 five-star Google reviews
Source: Google
I first started using Tom last year to help relieve back pain, he has been extremely helpful and now he's supporting me with sprint and fitness training, whilst helping with any minor injuries. Can't recommend him and his team more highly.
I went to Tom with a shoulder injury that had not improved for several months. Tom is very knowledgeable and quickly identified the issue and put me on a course of exercises that, in conjunction with a couple more sessions, steadily resolved the problem. I would highly recommend him.
Parinita was brilliant! Identified my knee problem immediately, used a range of equipment and exercises not only to strengthen my knee, but to maintain it and improve my running long-term.
Excellent service! Sanchez is a true professional who helped me heal a previous injury. Highly recommend!
Foot and ankle physiotherapy can help to:
Settle a stubborn Achilles
Achilles tendinopathy responds to progressive load and to very little else. We work out how irritable the tendon is, set the starting load accordingly, and track your morning stiffness as the measure. Where it stays stubborn, shockwave is available in clinic.
Fix an ankle that keeps rolling
A sprain that never fully rehabilitated leaves the ankle unreliable rather than damaged. Balance and control work restores what the ligament used to provide, and it is one of the more satisfying things to fix because the change is quick and obvious.
Take the first step without wincing
That sharp first-step pain under the heel has a predictable pattern and a predictable response to loading and load management. We will also tell you plainly how long it usually takes, because plantar heel pain rewards patience more than it rewards intensity.
See what your foot does at speed
A foot assessed on a couch tells you very little about a foot at mile eight. Our running gait and performance reviews use DorsaVi to capture what actually happens under load, which is what we then change.
Rule out bone stress properly
Not all running pain is soft tissue. Load-related bone pain that worsens through a run and is sore to press on the bone needs taking seriously and offloading, and sometimes imaging. Missing it is the expensive mistake, so we screen for it.
Rehabilitate after an Achilles repair
Whether your rupture was managed surgically or conservatively, we work to the protocol and layer staged progression and testing on top. Our clinics are inside gym facilities, so the calf strength work the later stages demand is in the same building as your assessment.
Why it happens
What causes foot & ankle pain?
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Achilles tendinopathy from training load rising faster than the tendon adapts
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Achilles rupture, most often in mid-life return-to-sport players in change-of-direction sport
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Lateral ankle sprain, and the residual instability when it is not rehabilitated properly
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Plantar heel pain, commonly with a sudden increase in standing or running
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Bone stress injury in the shin, foot or metatarsals from repetitive loading
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Footwear and surface changes, including a rapid move to different running shoes
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Reduced ankle range restricting how the whole leg loads
What happens at your first physio appointment?
Initial appointments are typically 45 to 60 minutes. You leave with a clear explanation of your condition, treatment recommendations, a report explaining it in simple language, and a personalised rehabilitation plan.
Follow-ups run 30 to 45 minutes, and we reassess at every visit rather than selling you a block of sessions up front.
A thorough, honest, and understandable explanation. Then the best treatment to get you back to a level of activity beyond your pre-injury status. If we can't get you better, we will recommend the world's leading healthcare professionals in London that can.
- Founded in 2015 by Tom Astley: 7 clinicians working across 3 clinics in Crouch End, Marylebone and Henley-on-Thames.
- Our team has successfully worked with local, national and international athletes at 6 major multi-sport events, from London 2012 to Gold Coast 2018, and we bring that expertise to everyone who enters our service.
- Rated 4.9 from 88 Google reviews; recognised by 5 major UK insurers, and self-funded patients book online with no GP referral.
Fees and insurance
Book directly online through Splose. Self-funded patients need no GP referral; if you are claiming through insurance, obtain prior authorisation before booking.
- Physiotherapy with Tom Astley: £85 initial consultation, £77 follow-up
- Sports and dance therapy with Laura Fornoni: £75 initial consultation, £70 follow-up
- Shockwave therapy: £230 for the initial consultation plus 3 sessions, then £80 per further treatment
- Running gait and performance reviews: £80 Base, £135 Intermediate, £185 Expert
- Recognised by Bupa, Cigna, Vitality, WPA and Simply Health
How physiotherapy works
from assessment to return to sport
Book today to get an assessment, advice, a report and a rehabilitation plan. We combine hands-on treatment with gym-based rehab to get you well, today, and we reassess at every visit.
Advice and report
A clear explanation of your condition and a report explaining it in simple language, alongside hands-on treatment: manual therapy, soft tissue techniques and joint mobilisation where they help.
Rehabilitation plan
Exercise rehabilitation tailored to your goals and condition, delivered through Track Rehab. Our clinics sit inside gym facilities, so the plan has the equipment and technology it actually needs.
Return
Structured programmes and return-to-sport testing before you go back, so you return safely and confidently. The goal is a level of activity beyond your pre-injury status, not just less pain.
What our physiotherapists treat
- Manual therapy and joint mobilisation
- Exercise rehabilitation through Track Rehab
- Dry needling for stubborn trigger points
- Shockwave therapy for chronic tendinopathy
- Sensor-based running gait analysis
- Sports massage, scar work and soft tissue therapy
- Women's health, Mummy MOT and postnatal rehabilitation
- Post-operative and ACL rehabilitation
- Return-to-sport testing
Treatment approach
How do we treat foot & ankle pain?
Physiotherapy & Sports Therapy
From £75Assessment to establish which tissue is involved and how irritable it is, then a progressive loading programme, which is what actually rebuilds a tendon.
See treatment detail →Shockwave Therapy
£230 for 3 sessionsFor chronic Achilles and plantar heel pain that has not settled with loading alone. About 80 % of patients report a marked reduction in pain after 3 to 4 sessions, alongside the rehabilitation rather than instead of it.
See treatment detail →Running Gait & Performance Reviews
From £80Where the pain is running-related, DorsaVi-assisted gait analysis shows what the foot and ankle do at foot strike, which changes what we load and how.
See treatment detail →FAQ
Frequently asked
questions
Why is my Achilles worst first thing in the morning?
Morning stiffness that eases as you move is one of the most characteristic signs of Achilles tendinopathy. The tendon stiffens overnight and needs load to settle. How long that stiffness lasts is a useful measure, and we use it to track whether the plan is working.
Does shockwave therapy work for Achilles pain?
For chronic Achilles tendinopathy it has one of the strongest evidence bases of any tendon treatment. In clinic about 80 per cent of patients report a marked reduction in pain after three to four sessions. It works alongside a loading programme, which does the actual rebuilding.
My ankle sprain was months ago but it still feels unreliable.
That is common and very treatable. Ligaments heal, but the balance and control that protect the ankle do not come back on their own, which is why a sprained ankle often keeps rolling. Restoring that control is straightforward rehabilitation and worth doing properly.
Should I stop running completely?
Usually not. Complete rest de-loads the tissue and you lose the fitness you will need to come back. More often we modify the volume, surface or pace while loading the tendon deliberately. Bone stress injuries are the exception, and those we take seriously and offload.
Related What We Treat
Get Started
Book a physiotherapy appointment
in Crouch End, Marylebone or Henley.
Tom Astley Physiotherapy • Park Road Pools & Fitness, Crouch End, London N8 8JN
BookAppointments typically available within 1–2 weeks