Serial casting is a modality used in physical therapy to help stretch a muscle to facilitate an increase in range of motion that a joint can achieve. Here at the Center for Pediatric Movement, serial casting is completed by a physical therapist with advanced training and competency in casting.

Your child will first be evaluated to ensure they are a good candidate for serial casting. At their first casting appointment, a fiberglass cast is applied to the lower leg (from the knee to the toes) holding the ankle in a position of slight stretch. Then your child goes about their week as normal, and can participate in sports, school, and other activities. The following week, the old cast is removed, and a new cast is placed holding the ankle in a position of stretch again, using the new range of motion that was gained the previous week. This process is repeated until the range of motion goal is achieved or until a plateau in range of motion is identified by your physical therapist.

Each appointment lasts about 2 hours, and casting can range anywhere from 4-8 weeks depending on the severity of contracture identified at your child’s evaluation.

Your child can run and play and participate in all activities as normal, but casts cannot get wet. A wet cast can lead to complications such as blistering, skin irritation, or mold growth. Otherwise, all activity is encouraged as more activity often leads to faster gains in range of motion.

After the last cast is removed, your child will need to transition into an orthotic to maintain proper alignment and maintain the range of motion they have gained over the course of the past several weeks. Additionally, skilled physical therapy is necessary to continue helping your child achieve their physical therapy goals, such as improving efficiency of their walking, decrease fatigue, and decrease pain.