Serial casting

Information for children and their parents

What is serial casting?

Serial casting involves the use of a lightweight cast over several weeks, to gradually stretch the muscle.

Why have I been referred for serial casting?

The main reason to use serial casting is to stretch tight muscles that do not seem to be stretched enough with exercises alone.

Often stretching a tight muscle can improve the way you walk. The best person to ask is your physiotherapist; they will be able to explain in more detail.

What are the benefits to using serial casts?

We use soft cast plaster as this remains slightly flexible and is lighter than plaster of Paris. It comes in many different colours and patterns; so put your order in, just in case we run out of your favourite colour.

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Applying the cast while the patient is laying on their stomach

What types of casts are available?

There are two types of cast we can use.

  1. We can put a cast over your knee to stretch your thigh muscles, if it is difficult to straighten your knee.

  2. We can use a cast over your foot and ankle to stretch your calf muscle, if it is difficult to put your heel down.

How does the physiotherapist put the cast on, and more importantly how do they take it off?

The casting takes place in the Physiotherapy Department with two physiotherapists. It normally takes between 40 and 60 minutes to apply to both legs.

Putting the cast on is easy; we just wrap the soft cast around your leg like a bandage. We usually do this with you lying on your stomach (see photo above). We can place a mirror in front of you, so you can keep an eye on us. Do not forget to bring some toys or a book to read.

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Casting on both legs

First we put padding on, so it will be comfortable, and then we put the special resin cast bandage on.

We make the bandage wet before we put it on, to make it set properly. It sets so quickly you can walk on it for short distances as soon as we finish. You can even run around on it after half an hour.

Getting it off is even easier. You and your parents can unwrap it. Seriously it is that easy. No tickling plaster saw in sight.

What can I do while I am in my cast?

You should be able to do most things. You can walk without crutches. We have even seen people running, but you have to be careful not to trip. You can go to school, and can even join in with PE.

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If you do not feel confident walking in the casts we will give you an exercise program to help you, because the more you move around in your casts the better they will work.

The only thing you cannot do is get your cast wet. If it becomes soggy you cannot dry it properly, so no proper baths whilst wearing your plaster and avoid puddles no matter how tempting.

How long will the cast be on?

Usually from three days to one week, and then you take the plaster off at home the night before your next appointment. (Bath-time!)

When you come for your next appointment the following week, we check to see if your movement has improved before going back into the plaster for another three days to one week.

You will normally need about four or five casts in total, although some people may need less and some may need more.

What should I wear?

Come to your appointment in either shorts or a skirt which can be rolled up above your knee. If you have a pair of loose fitting or adjustable sandals then wear those, however if you do not have any of these we can provide them for you.

What happens if I have problems?

Very few people feel discomfort wearing their plaster. If you do have problems such as swelling, blisters, or pins and needles in your feet you can contact your physiotherapist immediately for advice (see Physiotherapy Department telephone number below).

When the casts are removed it is normal to see a mark similar to a sock mark; just like a sock mark this should resolve quickly. If you are very worried we are happy for you to take off your casts first and then contact us.