15-year-old female gymnast (high school student).

Reason for coming to Barefoot Physiotherapy:

Sprained right ankle 9 days ago. Saw GP and was given moonboot to de-load ankle and restrict movement until MRI. Referred for MRI – all clear (no broken bones or significant tissue damage).

Goal = Camping and walking on the sand during holidays within 10 days. After this, return to gymnastics

Presented with:

Bruised, swollen ankle
20% Neural irritation
Non-weightbearing in a moonboot using crutches to walk
40% active movement at the ankle joint
Calf Raise 0% (movement up onto toes) on the right foot
10% Balance in single leg stance (< 5 seconds with eyes open) on the right foot


Neural interface treatment
Joint glides of ankle joint in lunge position
Dry needling and trigger point release of right peroneals and medial soleus
Home exercise program (daily) of joint mobility, muscle releases, strength, balance/proprioception and walking practice, all of which were given in email format with photos of the client performing the exercises in clinic

Outcome (3 sessions in 8 days):

No Bruising/Swelling
No neural irritation
Full Active movement of the ankle joint
Calf Raise = 100% single leg x20+
100% Balance on single leg
100% hopping on the spot with accuracy
Full return to gymnastics
Able to walk on sand and swim on holidays

Influence on the Result:

Client was not at school during this time so she was able to make rehabilitation her top priority. The client tolerated some discomfort during the treatment sessions to ensure swift recovery. This was the client’s first significant injury. The client had supportive parents helping with exercises and attending sessions.