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Background: Bunions are one of the most common foot deformities, often treated by conservative or surgical intervention. With over 100 different surgical approaches, post-operative care varies between patient populations. Therefore, the purpose of this case report is to highlight the use of balance and strength training in the rehabilitation management of an adolescent individual after a Lapidus fusion and gastrocnemius recession. Case Description: The patient is a 16-year-old female who presented to an outpatient clinic eight weeks status-post left Lapidus fusion and gastrocnemius recession. Following the surgery and subsequent immobilization of the ankle, the patient presented with deficits in lower extremity strength, limited ankle/foot range of motion, decreased balance, and altered gait mechanics. Intervention: Over the 7-week course of treatment, emphasis was placed on lower extremity strength and balance training as well as the late integration of plyometric/agility drills. Both strength and balance activities emphasized progressive intensity to promote adaptations across the entirety of patient care. Strength training was progressed through changes to load and repetitions while balance was modified via alterations to cognitive load. Outcome Measures: The primary outcome measure utilized was timed balance under a variety of conditions including the One-Legged Stance Test. Additional measures recorded included the Lower Extremity Functional Scale, ankle range of motion, plantarflexion strength, and the Six Minute Walk Test. Discussion: Over the course of physical therapy the patient demonstrated improvements in all recorded outcomes. Principles of progressive loading were incorporated into both the patient’s strength and balance training. This case report acts to support the integration of balance and strength training in a comprehensive care plan for patients presenting to physical therapy post-bunionectomy and gastrocnemius recession.