Serial Casting - The Who, Why and How
What is Serial Casting?
Serial casting is a treatment where a child’s limb—often a foot/ankle—is placed in a cast for a short period of time to gradually stretch the muscle. After a few days of wearing the cast, we review the movement and progress the stretch. As this is done of a series of casts, it is called ‘Serial Casting.’ This process usually takes between 3 and 6 weeks.
For children with tight muscles, secondary joint stiffness, or certain foot or leg conditions, serial casting can be a highly effective way to improve movement. But what exactly is it, and how does it work?
Who can benefit from Serial Casting?
Serial Casting is commonly used for conditions such as:
Limited joint range of motion after injury or surgery
Cerebral palsy
Neuromuscular Conditions such as Ducenne Muscular Dystrophy or Beckers Muscular Dystrophy
Rare Genetic Conditions
Seizure Conditions
How Does Serial Casting Help?
The goal of serial casting isto gradually lengthen tight muscles and improve joint movement. By holding the limb in a slightly stretched position over time, muscles and soft tissues adapt, helping your child to walk with an improvement movement pattern.
Benefits can include:
Reduced muscle tightness
Improved range of motion
Improved posture and gait, including able to achieve a heel-strike when walking
Decreased pain or discomfort
What to Expect During an Appointment
Initial assessment – Your paediatric physiotherapist and/or podiatrist will carefully examine your child’s movement. If serial casting is considered a good intervention option, we will schedule the appointments. We usually aim see a child twice a week for 3 weeks to effectively progress the stretch.
Cast application – The limb is gently stretched and placed in a cast. Children often report some pressure at the time of applying the cast, and can sometimes experience discomfort in their leg as their muscles adjust to the new position.
Follow-up casts – Casts are usually reviewed every 3-4 days over a period of 3 weeks to gradually increase the stretch.
Ongoing therapy – Physiotherapy exercises are often recommended alongside casting to support strength, balance, and efficient movement patterns.
Tips for Parents
Keep the cast dry, clean and in shoes at all times.
Encourage safe activity – your child can often move around, but certain activities may need to be limited with the casts on.
Watch for discomfort – contact your physiotherapist if your child experiences swelling, redness, or pain.
Stay patient – serial casting is a gradual process, but the improvements in mobility are usually long-lasting.
Serial casting is a gentle and effective way to improve flexibility and function in children with tight muscles or joint limitations that can often prevent surgical intervention for children with tight muscles. When combined with physiotherapy, it can make a significant difference in their movement, comfort, and confidence.
If you think your child would benefit from Serial Casting, don’t hesitate to reach out and get in contact with our team!