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
Skiing Injury Treatment in London
Skiing is the sport people do hardest, for the longest hours, with the least preparation. Six days of it, once a year, on legs that spend the other 51 weeks at a desk. Most ski injuries start there rather than on the piste.
Overview
Skiing and snowsports injuries
The ski week is a strange training block: near-zero volume for a year, then six consecutive days of sustained eccentric quad load at altitude. Very little else in sport looks like that.
What we see in skiers, on both sides of the season:
- Knee ligament injuries: ACL and MCL, from the twisting fall and the boot-top lever.
- After ACL reconstruction: staged rehabilitation, including planning the return to the mountain.
- Anterior knee pain: from days of sustained quad load, often appearing on day three.
- Low back pain: from a flexed position held for hours and long transfers.
- Shoulder injuries: from falling onto an outstretched arm or a planted pole.
- Thumb injuries: skier's thumb, from the pole strap in a fall.
The most useful appointment a skier books is in October, not February. Building quad and knee capacity before the trip changes both the enjoyment and the risk, and it is a straightforward block of work rather than a long rehabilitation.
Physiotherapy leads both pre-season conditioning and post-injury rehabilitation, and soft tissue therapy helps with the load of consecutive days. See also knee pain, post-operative rehabilitation and low back pain.
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!
Ski physiotherapy can help to:
Get ready before you go
The most useful ski appointment is in October, not February. Around 8 to 12 weeks of building quad and knee capacity changes both the enjoyment and the risk of a six-day block, and it is straightforward work rather than a long rehabilitation.
Stop the day-three knee pain
Anterior knee pain appearing partway through a ski week is usually quad capacity running out, not damage. Our clinics sit inside gym facilities, so building that capacity happens with real load in the same building as the assessment.
Get a knee injury assessed properly
Swelling within a few hours, or a knee that gives way, points towards a ligament injury. Early diagnosis and a clear plan beats waiting to see how it settles, particularly if there is a decision about surgery to make.
Rehabilitate back to the mountain
After a reconstruction, plan on 9 to 12 months to pivoting sport with testing throughout, including at least 90 per cent symmetry between legs. We also talk about what terrain to return on, which is a real part of the plan.
Look after your back on the trip
Hours in a flexed position plus long transfers is a reliable way to irritate a back. Where you already get back pain, we build the tolerance beforehand and give you something practical to do during the week itself.
Plan an honest return
Sometimes the answer is that this season is not the one. We will say so if that is what we think, and then tell you what needs to happen for the next one, rather than clearing you and hoping the conditions are kind.
Why it happens
What causes skiing injuries?
-
Twisting falls with the foot fixed in a boot, the dominant knee ligament mechanism
-
The boot-top lever in a backward fall, loading the ACL directly
-
Sustained eccentric quad load over consecutive days without prior conditioning
-
Falling onto an outstretched arm or a planted pole, injuring the shoulder or thumb
-
Fatigue late in the day, when most ski injuries actually happen
-
A year of near-zero sport-specific load before a six-day block of it
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 skiers?
Physiotherapy & Sports Therapy
From £75Pre-season conditioning to build the quad and knee capacity a ski week demands, and staged rehabilitation with return-to-sport testing after a ligament injury or reconstruction.
See treatment detail →Soft Tissue Therapy
Price on enquiryManaging the load of consecutive skiing days, and scar work from around 6 to 8 weeks after knee surgery to restore tissue glide.
See treatment detail →Shockwave Therapy
£230 for 3 sessionsFor stubborn patellar tendon pain that has not settled with loading alone, alongside the rehabilitation rather than instead of it.
See treatment detail →FAQ
Frequently asked
questions
When should I start getting ready for a ski trip?
Around 8 to 12 weeks out is ideal, which for most people means October. The goal is quad and knee capacity for consecutive days of eccentric load. It makes the week more enjoyable as well as safer, and it is a straightforward block of gym work.
My knees hurt by day three every year. Is that normal?
It is common, but it is not something you have to accept. It usually reflects quad capacity running out rather than anything damaged. Building that capacity beforehand generally removes the problem, and it is one of the more satisfying things to fix.
Can I ski again after an ACL reconstruction?
Usually yes. Plan on 9 to 12 months before returning to pivoting sport, with structured testing along the way including at least 90 per cent strength symmetry between your legs. We will also talk honestly about what terrain and conditions to return on first.
I hurt my knee on the mountain. What should I do first?
Get it assessed properly rather than waiting to see how it settles. Swelling that comes on within a few hours, or a knee that gives way, both point towards a ligament injury that benefits from early diagnosis and a clear plan rather than guesswork.
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