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Background: Descriptions of treatments are sparsely cited in the literature when using a symptom-based approach to physical therapy after a lateral medullary stroke. However, there are many treatment options available for gait progression in the inpatient rehabilitation setting whether the patient is having a good or bad day (referring to symptoms). Case Description: The patient was a 53-year old male who suffered posterior circulation strokes (later named Lateral Medullary Syndrome) and had a 30-day stay on an inpatient rehabilitation unit. Outcome Measures: FIM scores were used to evaluate progress from initial evaluation to discharge. Daily subjective reports were also used to monitor and direct treatments. Discussion: Many interventions may be utilized in the inpatient rehabilitation setting to address gait along with other functional activities. A patient’s rehabilitation journey following lateral medullary syndrome is their own and should not be compared too closely to another’s. Post-stroke physical rehabilitation is not a linear progression, and requires flexibility in treatment decision making, often daily.