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
Muscle Injury Treatment in London
A half-rehabbed muscle is a muscle that tears again: most hamstring re-injuries happen in the first month back because strength was never rebuilt and never tested. Muscle injury treatment in London and Henley for hamstring strains, calf tears, quadriceps and adductor injuries, with graded loading and structured return-to-sport testing so the next sprint is not the one that sends you back to square one.
Overview
Understanding muscular injuries
Muscle strains and tears are the most common acute injury in running, football, rugby and field sport. Hamstring strains alone account for a large share of time lost in elite football, and in amateurs recurrence rates run as high as 63 % when return-to-sport criteria are skipped. A half-rehabbed muscle is a muscle that tears again.
Recovery is staged, and the loading is the part that actually rebuilds the tissue:
- Protect and load early: settle the acute injury, then begin gentle loading as soon as pain allows, usually within the first week.
- Progressive eccentric loading: the mid-stage work, including Nordic-style hamstring exercise, that rebuilds strength through range.
- Sport-specific and reactive drills: the late stage before return-to-sport testing, at least 90 % limb-strength symmetry and drills under fatigue rather than a discharge on 'feels OK'.
Grades guide the timeline: most Grade 1 strains clear in 2 to 3 weeks and Grade 2 in 4 to 8 weeks, while a Grade 3 full rupture usually needs a surgical opinion before rehab proceeds. Every plan is filmed through Track Rehab so the loading is repeatable between sessions.
Physiotherapy leads the rehab. Soft tissue therapy helps with chronic tension and fibrotic scarring within the muscle belly, and for a stubborn adductor or proximal hamstring tendinopathy shockwave therapy can accelerate the response. Muscular injuries sit within our wider sports injury care, and recurring running strains often warrant a running gait analysis to find the driver.
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!
Physiotherapy for muscle injuries can help to:
Grade the injury accurately
Grade 1 strains keep full strength and settle in 2 to 3 weeks. Grade 2 brings bruising and weakness and needs 4 to 8. A suspected Grade 3 rupture needs same-week imaging and a surgical opinion. Getting the grade right on day one shapes everything that follows.
Load the muscle early, at the right dose
Ice and compression help for the first 24 to 48 hours; beyond that, gentle range-of-motion and very early loading do the healing. Prolonged rest lets the muscle waste while the injury scars. We start the loading work within the first week wherever the tissue allows.
Rebuild eccentric strength through range
Hamstrings re-tear when rehab stops at pain-free jogging. The middle stage here is progressive eccentric loading, including Nordic hamstring variants, worked through the full range that sprinting and kicking demand rather than the range that feels comfortable in the clinic.
Retest before you sprint again
Recurrence in amateurs runs as high as 63 percent when return-to-sport criteria are skipped. Clearance here means limb-strength symmetry of at least 90 percent, full range of motion, and sport-specific drills under fatigue. The benchmarks are measured, agreed with you and retested before release.
Fix the sprint mechanics behind it
Poor hip extension, hip drop and trunk lean overload the hamstring at exactly the point in the stride where it is most vulnerable. We assess sprint mechanics as part of rehab, and for runners a sensor-based gait review identifies the movement fault driving the repeat strains.
Deal with the fibrotic scarring
Chronic tension and fibrotic scarring within the muscle belly can hold a strain back mid-rehab. Soft-tissue therapy supports the loading plan in these cases, and for a stubborn adductor or proximal hamstring tendinopathy, shockwave therapy accelerates the response when loading alone has stalled.
Why it happens
What causes muscular injuries?
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Sudden mechanical overload at high muscle length under tension (sprint, change of direction, kicking)
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Cumulative overload: training-volume spike or fatigue at the end of training/match
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Strength deficits in the affected muscle group (especially eccentric strength of hamstring)
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Movement-pattern faults: poor sprint mechanics, hip drop, trunk lean
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Inadequate warm-up or rapid temperature drop during play
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Previous muscle injury without full rehab clearance: strongest predictor of recurrence
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 muscular injuries?
Physiotherapy & Sports Therapy
From £75Staged loading rehab is the core treatment for muscle injury: protect-load early, progressive eccentric mid, sport-specific late. Most Grade 1 strains clear in 2 to 3 weeks; Grade 2 in 4 to 8 weeks.
See treatment detail →Soft Tissue Therapy
Price on enquiryUseful for chronic muscle tension, fibrotic scarring within the muscle belly, and adjunct support during the mid-rehab phase. Not a stand-alone treatment for an acute strain.
See treatment detail →Shockwave Therapy
£230 for 3 sessionsFor chronic adductor or proximal hamstring tendinopathy that has not responded to loading alone, ESWT accelerates the response when added to the rehab plan.
See treatment detail →FAQ
Frequently asked
questions
How do I know if a muscle injury is serious?
Three rough buckets. Grade 1 (mild): localised tenderness, full strength, full range of motion, ability to walk normally. Grade 2 (moderate): visible bruising within 24 to 72 hours, weakness on testing, gait limp. Grade 3 (severe/rupture): immediate sharp pain with a 'pop', visible defect or muscle bunching, severe loss of function, often unable to weight-bear. Grade 3 needs same-week imaging and surgical opinion; Grade 1 and 2 are routine physiotherapy cases.
When should I return to running or sport?
Only after structured return-to-sport testing: limb-strength symmetry of at least 90 %, full range of motion, sport-specific drills under fatigue, and psychological readiness. Skipping these stages is the strongest predictor of re-injury (more than 50 % of recurrent hamstring injuries happen within the first month post-return when criteria are skipped). We test against measurable benchmarks rather than discharging on "feels OK".
Should I ice my muscle injury?
For the first 24 to 48 hours, ice + compression + relative rest helps with pain and swelling. Beyond that the evidence for icing is weak, and for some tissue (tendon-dominant injury) prolonged ice may slow healing. Move to gentle range-of-motion and very early loading work as soon as the acute pain settles, usually within the first week. We will guide the timing at your first appointment.
Why are hamstring injuries so likely to come back?
Three reasons: athletes return to sport before strength has actually rebuilt, eccentric strength is rarely tested before clearance, and underlying movement-pattern drivers (sprint mechanics, hip drop) are not always addressed. Modern rehab: Nordic hamstring exercise variants, eccentric loading throughout range, biomechanical assessment of sprint mechanics: has cut elite recurrence rates substantially. We use the same approach for amateurs.
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
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