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
Triathlon Injury Treatment in London
Three sports, three loading patterns, and one body absorbing all of it. Triathletes rarely get injured because of one session. They get injured because the total keeps climbing while the recovery does not.
Overview
Triathlon injuries
The thing that makes triathlon hard to manage is that no single discipline looks excessive. It is the sum that does the damage, and the sum is easy to lose track of across three training logs.
What we treat most in triathletes:
- Achilles and calf problems: from run volume, often worsened by cycling in a stiff shoe.
- Runner's knee and patellar tendon pain: the most common run-derived complaint.
- Shoulder pain: from swim volume, particularly with heavy paddle or band work.
- Low back and neck pain: from time in an aggressive aero position.
- Bone stress injuries: in the shin, foot or femur, which we take seriously.
- Hip and ITB pain: from the combination of cycling volume and run mileage.
Running off the bike is where a lot of it shows up. Your legs arrive at the run already fatigued and moving differently, so the mechanics that hold up on a fresh run do not necessarily hold up in a brick session. That is worth assessing specifically.
Running gait and performance reviews use DorsaVi to capture what happens under real load, at 3 levels: £80 Base, £135 Intermediate, £185 Expert. Physiotherapy builds the plan, and shockwave therapy is available for stubborn tendon pain. See also running injuries, tendinopathy and foot and ankle 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!
Triathlon physiotherapy can help to:
Look at the total, not one session
No single discipline usually looks excessive. It is the sum across three training logs that does the damage, and it is easy to lose track of. We look at all of it rather than only the sport you were doing when it started hurting.
Keep two disciplines while one heals
Triathletes rarely need to stop everything. Loading one discipline down while keeping the others is usually possible, which means the fitness is still there when you come back rather than having to be rebuilt.
See what happens off the bike
Run mechanics on fatigued legs are not the mechanics of a fresh run. Our running gait and performance reviews capture what actually changes under load, at three levels from £80 Base to £185 Expert.
Sort out swim shoulder
Shoulder pain from swim volume needs the irritated tissue settled and the overhead capacity built. Both, not one. Our clinics sit inside gym facilities, so that loading work happens properly rather than as a band routine at home.
Take bone stress seriously
Load-related pain that worsens through a run and is tender to press on the bone needs offloading and sometimes imaging. In endurance sport it also prompts a conversation about whether you are eating enough for the training you are doing.
Make an honest call on race day
Sometimes the answer is that the race is still on with a changed build, and sometimes it is not. You will get our actual view either way, in time to do something about it.
Why it happens
What causes triathlon injuries?
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Total training load across three disciplines rising faster than recovery
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A block of increased run volume, which carries the highest injury rate of the three
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Swim volume increases, particularly with paddles or heavy band work
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Time in an aggressive aero position without the mobility to hold it
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Brick sessions, where run mechanics change on already-fatigued legs
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Low energy availability relative to training volume, raising bone stress risk
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 triathletes?
Running Gait & Performance Reviews
From £80DorsaVi-assisted analysis of what your legs actually do under load, which matters most in triathlon because run mechanics off the bike differ from a fresh run.
See treatment detail →Physiotherapy & Sports Therapy
From £75Diagnosis of the specific tissue plus a look at total load across all three disciplines, then a plan that keeps as much training as the injury allows.
See treatment detail →Shockwave Therapy
£230 for 3 sessionsFor chronic Achilles and plantar heel pain that has not responded to loading alone. About 80 % of patients report a marked reduction in pain after 3 to 4 sessions.
See treatment detail →FAQ
Frequently asked
questions
Do I have to stop all three disciplines?
Almost never. One of the advantages of triathlon is that you can usually keep training while one discipline is loaded down. We work out what to reduce and what to keep, which often means the fitness is still there when you return.
Why do I only get injured running?
Running carries by far the highest impact load of the three, so it is where accumulated fatigue tends to surface. That does not always mean running caused it. Often the swim and bike volume set it up and the run revealed it, which is why we look at the total.
My legs feel completely different off the bike.
They are. Run mechanics on fatigued legs differ from a fresh run, which is why brick sessions produce injuries that standalone runs do not. It is worth assessing specifically, and a gait review under load shows what changes.
I have a race in eight weeks. Is it still on?
Often yes, with a modified build. We will tell you honestly what we think and what the risks are, rather than writing it off or pretending it is fine. That conversation goes much better before the taper than during it.
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