Your Child’s Serial Casting
When your child needs serial casting, it’s natural to have questions. Below is information about the procedure and answers to frequently asked questions. We look forward to partnering with you and your child to provide the best, most advanced serial casting care available.
What is serial casting?
Some children have a limited range of motion in a joint because their muscles are too tight or stiff. To help, we sometimes do serial casting. This means we put your child’s ankle or ankles into a series of casts that we change weekly. Casts are hard, plaster pieces that fit around parts of your child’s body. These casts hold the joint in place while slowly stretching the tight or stiff muscle. Each cast stretches the muscle a little bit more. The process may take up to 4 to 8 weeks.
What are the benefits of Serial Casting?
The goal of serial casting is to lessen the stiffness of the muscles around the foot and ankle. Less stiffness and better range of motion (or mobility of the ankle) will help with standing, walking, sitting in a wheelchair and wearing orthotics.
Who benefits from Serial Casting?
Serial casting helps children with muscle tightness and a limited range of motion (limited mobility) of the foot and ankle. Some of the conditions that can cause muscle tightness are:
- Cerebral palsy
- Brain injury
- Spinal cord injury
- Congenital abnormalities
- Muscular dystrophy
- Arthrogryposis
- Club foot
- Idiopathic toe walking
Before casting:
Your child’s physical therapist (PT) will make sure serial casting is right for your child. The physical therapist will measure your child’s range of motion and check muscle strength, walking ability and overall function.
If casting is right for your child, your child will need cast shoes and equipment that keeps your child’s knees still (knee immobilizers). Your child will also need a prescription for serial casting from your child’s doctor. The care team will make sure you have everything your child needs.
On the first day of casting:
- We will welcome you to the casting room. It looks like this.
- Your child can have fun in the playroom before the appointment.
What happens during the casting process?
The casting process takes about 2 hours. Here’s how it works.
- We wrap your child’s legs from the knees to the toes in soft cotton and apply extra foam padding where needed. This keeps your child’s legs comfortable.
- We apply a special fiberglass casting material to make the casts hard.
- We apply plaster to the bottom of the cast. This keeps your child’s legs in the same position (aligned).
- After the casts dry, we help your child practice standing and walking.
Before going home:
- Your child’s physical therapist will partner with you to create and discuss your child’s home exercise program.
- Please let us know if you have any questions or concerns.
- We will make an appointment to see your child in 1 week. At that appointment, we will remove your child’s casts. The physical therapist will tell you if your child needs new casts.
How do we remove the casts?
We use a special instrument (cast saw) to remove the casts. This does not hurt. Some children say they feel a tickle, warmth, or heat.
Important notes:
- The casting process can take several weeks.
- Please avoid getting the casts wet. Avoid showers and baths. Your child may have sponge baths during the casting process.
- Some kids say the casts itch. To stop the cast from itching, try using a hairdryer set on cool and blow air under the cast. You can also ask your child’s team about using an antihistamine.
- If your child’s range of motion does not change in 2 weeks, we will stop the casting process.
To talk with a physical therapist or to find out if serial casting is right for your child, please call the Physical Therapy Department at (212) 598-6248.
We welcome your questions and concerns.
Please let us know what we can do to support your child and family.
Created in partnership with families and expertise from our Sala Institute for Child and Family Centered Care
© NYU Langone Health. All rights reserved. Reviewed for health literacy. This information is not intended as a substitute for professional medical care. Always follow your health care provider's instructions.
Your Child’s Serial Casting
When your child needs serial casting, it’s natural to have questions. Below is information about the procedure and answers to frequently asked questions. We look forward to partnering with you and your child to provide the best, most advanced serial casting care available.
What is serial casting?
Some children have a limited range of motion in a joint because their muscles are too tight or stiff. To help, we sometimes do serial casting. This means we put your child’s ankle or ankles into a series of casts that we change weekly. Casts are hard, plaster pieces that fit around parts of your child’s body. These casts hold the joint in place while slowly stretching the tight or stiff muscle. Each cast stretches the muscle a little bit more. The process may take up to 4 to 8 weeks.
What are the benefits of Serial Casting?
The goal of serial casting is to lessen the stiffness of the muscles around the foot and ankle. Less stiffness and better range of motion (or mobility of the ankle) will help with standing, walking, sitting in a wheelchair and wearing orthotics.
Who benefits from Serial Casting?
Serial casting helps children with muscle tightness and a limited range of motion (limited mobility) of the foot and ankle. Some of the conditions that can cause muscle tightness are:
- Cerebral palsy
- Brain injury
- Spinal cord injury
- Congenital abnormalities
- Muscular dystrophy
- Arthrogryposis
- Club foot
- Idiopathic toe walking
Before casting:
Your child’s physical therapist (PT) will make sure serial casting is right for your child. The physical therapist will measure your child’s range of motion and check muscle strength, walking ability and overall function.
If casting is right for your child, your child will need cast shoes and equipment that keeps your child’s knees still (knee immobilizers). Your child will also need a prescription for serial casting from your child’s doctor. The care team will make sure you have everything your child needs.
On the first day of casting:
- We will welcome you to the casting room. It looks like this.
- Your child can have fun in the playroom before the appointment.
What happens during the casting process?
The casting process takes about 2 hours. Here’s how it works.
- We wrap your child’s legs from the knees to the toes in soft cotton and apply extra foam padding where needed. This keeps your child’s legs comfortable.
- We apply a special fiberglass casting material to make the casts hard.
- We apply plaster to the bottom of the cast. This keeps your child’s legs in the same position (aligned).
- After the casts dry, we help your child practice standing and walking.
Before going home:
- Your child’s physical therapist will partner with you to create and discuss your child’s home exercise program.
- Please let us know if you have any questions or concerns.
- We will make an appointment to see your child in 1 week. At that appointment, we will remove your child’s casts. The physical therapist will tell you if your child needs new casts.
How do we remove the casts?
We use a special instrument (cast saw) to remove the casts. This does not hurt. Some children say they feel a tickle, warmth, or heat.
Important notes:
- The casting process can take several weeks.
- Please avoid getting the casts wet. Avoid showers and baths. Your child may have sponge baths during the casting process.
- Some kids say the casts itch. To stop the cast from itching, try using a hairdryer set on cool and blow air under the cast. You can also ask your child’s team about using an antihistamine.
- If your child’s range of motion does not change in 2 weeks, we will stop the casting process.
To talk with a physical therapist or to find out if serial casting is right for your child, please call the Physical Therapy Department at (212) 598-6248.
We welcome your questions and concerns.
Please let us know what we can do to support your child and family.
Created in partnership with families and expertise from our Sala Institute for Child and Family Centered Care
© NYU Langone Health. All rights reserved. Reviewed for health literacy. This information is not intended as a substitute for professional medical care. Always follow your health care provider's instructions.