Mr West, a 63-year-old gentleman, suffered a trimalleolar fracture of the right ankle and underwent open reduction internal fixation surgery. The surgery was successful and, after cast removal, he was referred to Physiotherapy by his GP for re-education.

A thorough examination revealed a moderately restricted ankle joint and foot, altered gait and poor balance, quite common after a period of immobilization.

Treatment consisted of specific mobilisation and manipulation of the ankle and foot to restore the complex movements that are necessary to walk and balance correctly, coupled with a comprehensive exercise program to re-educate functional movement.

At the end of the course of treatment, Mr West was walking normally and able to continue to recover his full strength on his own by following his specific exercise program and the advice given.