Advanced post-traumatic ankle osteoarthritis (PTAO) is a severe condition that affects less than one percent of the population, with rare incidence. It accounts for less than 5% of all osteoarthritis (OA) cases. Physiotherapy enhances functionality by strengthening the dynamic stabilizers of the ankle, such as the calf, soleus, tibialis anterior, and peroneal muscles, and by improving proprioception, which aids in balance and coordination. As OA progresses, individuals may experience early losses in their ability to perform everyday activities and job tasks. Occupational therapy and cardiovascular exercises are crucial for conserving energy while walking and improving posture at work. This case report involves a 39-year-old male who presented to the hospital with pain, swelling, difficulty walking, and an equinus deformity. After diagnosing him with ankle arthritis, the orthopedic specialist recommended an X-ray. Medication and physical therapy were administered to educate and rehabilitate the patient, aiming to improve pain, range of motion (ROM), strength, and walking capacity. A four-week treatment plan, along with medication, resulted in significant improvements in pain reduction, ROM, strength, and walking ability. This case report also underscores the importance of focusing on preoperative care to ensure that post-surgery, the hip and knee ranges are normal, and the patient experiences less difficulty walking. Future studies are needed to explore this condition further and to evaluate the effectiveness of ultrasound therapy in such cases, as it was not effective in reducing pain in this instance.