Serial Casting
A series of leg casts
What is Serial Casting?
Similarly to when an arm or leg is broken and it is wrapped in a hard protective casing to prevent the bone from moving while it heals, serial casting refers to a series of leg casts—usually two or three—that provide a prolonged stretch to your child’s calf muscle. The cast goes from just below your knee down to your toes.
The purpose of serial casting is to immobilise your foot and ankle in a position that provides a steady sustained stretch to calf muscles that are tight, and/or to reduce stiffness in your calf muscle associated with increased tone. This improves the range of motion available at your ankle joint. You will be allowed to walk in your cast!
We will see you each week to remove the cast, assess how much your calf muscle has lengthened, and to re-apply a cast if further stretch is needed. This process may be repeated for 2-3 casts on average, but may extend depending on response and the goal you are trying to achieve.
Who is Serial Casting for?
If your child has tight calf muscles that are having a significant impact on their function, they may benefit from serial casting. Commonly, we use serial casting for children with Toe Walking or Cerebral Palsy / other neuro-developmental conditions which lead to calf tightness.
The goal of serial casting can be different between children, but may include:
- increasing your ankle mobility to achieve a more stable and efficient walking pattern
- to support use of an Ankle Foot Orthotic (AFO): this can include improving tolerance of AFO use or reducing pain or skin breakdown when wearing and AFO
- to improve the alignment of your foot and ankle to prevent joint contracture as you grow.
Depending on your goals, we are able to support you with serial casting as an independent intervention, or, we may work with your multidisciplinary team to deliver serial casting at the same time as other tone management interventions such as Botulinum Toxin-A injections, before or after orthopaedic surgery, or associated with fitting a new ankle-foot orthosis (AFO).
What Does the Service Involve?
Serial casting is typically a short-term process. The number of casts is dependent on the goal for each child, but the total duration is generally between two to three weeks.
The Casting Details
- If your child was able to stand and/or walk prior to casting we will ensure they are able to stand, balance, and walk in their cast before you leave the clinic.
- Your child is typically able to continue with most of their daily activities while they are wearing the cast, including attendance at day care, school, and other settings.
- Your child’s cast will need to stay clean and dry. This will mean avoiding environments where debris could get inside the cast- like sand and chipbark; and that the cast cannot get wet.
- After five to seven days, the cast can be removed at home. This is done by simply unravelling the casting material.
Frequently Asked Questions
Q: Can serial casting cause weakness?
A: Yes. Your Physiotherapist is trained in delivering this intervention, considering the impact of weakness from being in a cast. Your child will be encouraged to walk in their cast, which helps to minimise this, however the length of time they are undergoing serial casting for, will be discussed with this in mind. We will also avoid over-lengthening your child’s calf muscle, with serial casting, as this can be detrimental. Having serial casting delivered by a trained Physiotherapist who is experienced with this intervention is therefore essential.
Q: Will calf shortening / ankle stiffness return with further growth or continue toe walking?
A: This can happen and is why your Physiotherapist will discuss the pros and cons of casting with you, taking into account the other therapy approaches you are considering for your child. For example, whether your child will have an ongoing home program of exercises following casting versus needing a custom orthotic to wear to help maintain the gains made, with further growth. There are lots of factors to consider here, each unique to every child and family, so feel free to ask your Physiotherapist lots of questions to ensure the best approach for your child
Q: How long does the entire serial casting process take?
A: The total duration of serial casting is generally between two to three weeks, involving a series of two or three casts.
Q: Can my child still walk while wearing the cast?
A: Yes, the casts can be walked on, and your child can typically continue with most of their daily activities.
Q: What is the goal of serial casting?
A: The overall aim is to increase the calf muscle length and range of movement at the ankle to enable improved function with walking or better tolerance of an AFO (Ankle Foot Orthotic).
How to Make an Appointment
Joining is easy!
- Call us on 0422 229 971 or fill in the enquiry form below.
- Our team will arrange an initial chat
- We’ll book your first session and welcome your child to Developmental Therapies
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Suite 1/66 Jessica Boulevard
MINYAMA QLD 4575
(In shared rooms with Orthotic Solutions)
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Tuesday 9am – 5pm
Wednesday 8am – 5pm
Thursday 8am – 5pm
Friday 8am – 12noon