Serial Casting

Serial casting is a non-invasive conservative therapeutic technique.  A cast provides a long-term passive stretch to increase muscle length and improve alignment and function.

Did You Know?

Serial casting can also be used for constraint-induced therapy regimens.  What is this? If a child does not use one arm or one leg as much as the other, the more functional arm or leg could be casted for short periods of time to require the child to increase the use of the other arm/leg.

Serial Casting FAQs

  • Correcting shortened muscles, tendons, or ligaments
  • Increasing functional range of motion
  • Increasing muscle length to better align bones for movement
  • Improving overall function
  • Improving the results of Botox injections
  • Preventing the need for surgery
  • Enhancing orthotic outcomes

Serial casting is performed by a specialty trained Physical or Occupational Therapist.

  • Casts are applied in series for long term passive stretching.
  • Clients are scheduled once per week for a total of 4-6 weeks, unless otherwise noted on the physician referral or if the casting therapist determines an alternate schedule would be optimal.
  • At the initial session, we will take range of motion measurements and apply the first cast(s).
  • Each cast is usually worn for 1 week.
  • At each subsequent visit, we will remove the previous cast, assess new range of motion, check for skin integrity, and apply the next cast if applicable.
  • We have the ability to offer flexible casting protocols with weekly or bi-weekly cast changes, casting trials, and coordination with botox and surgical interventions to meet the needs of the physicians and families.

Interesting fact: Serial casting is the only research-proven intervention to improve dorsiflexion contractures in patients with cerebral palsy

  • Cerebral palsy                                                                
  • Down’s syndrome
  • Traumatic brain injury
  • Stroke
  • Spinal cord injury
  • Muscular Dystrophy
  • Spina Bifida
  • Idiopathic toe walking (no known reason for toe walking)
  • Foot deformity
  • Clubfoot repair
  • Neurological impairment that causes muscular contracture

Interesting fact: In one study, 66% of children stopped toe-walking after serial casting.

Our therapists will utilize their knowledge of normal and abnormal developmental and movement to assess children for appropriate casting regimens. 

We offer application of fiberglass casts, fabrication of bivalved casts, and application of soft casts. 

  • Your baby will probably enjoy bath time - Snuggle in a towel when bath time is over!
  • Able to calm with rocking, touching, and gentle sounds
  • Enjoys a variety of movements
  • Cries when startled
  • Sleeps throughout most of the day about 1-2 hours at a time
  • Will sleep a total of 14-17 hours

Interesting Fact:  Did you know an infant this age has a fully developed sense of smell unless there are concerns?

How to Get the Most Success from Serial Casting?

Our casting program is used in conjunction with our orthotics program to increase efficacy of treatment.  Follow-up treatment is also recommended post-casting, as we specialize in the multi-disciplinary treatment of children with special needs.  We will be able to optimize the results of serial casting with therapy immediately following your serial casting treatment.

Types of Casts

Fiberglass casts

Static positioning solid casts that must be removed with a cast saw by a trained therapist or medical personnel and cannot get wet.  Families are given cast shoes to be worn at all times with specific written instructions for questions, concerns, and precautions.

Soft casts

Semi-flexible casts that cannot get wet, and can be removed by the caregiver by simply unwrapping the cast.  They can be used to determine appropriateness of orthotics, to determine tolerance to casting, to gain initial weight bearing skills, or for long term passive stretch in children without severe hypertonia.   Families are given cast shoes to be worn at all times with specific written instructions for questions, concerns, and precautions.

Bivalved casts

Fiberglass casts split into a clam shell design and attached with Velcro straps for long term passive stretching.  They are typically used as night splints after a serial casting course is completed for maintenance of range of motion.  Families are given written instructions for wearing schedules and precautions.

Success Story - Adriel

My son Adriel has autism and toe walks frequently. Wearing Orthotics alone didn’t decrease his toe walking as much as his father and I hoped so Ms. Sarah recommended serial casting. The serial casting treatment was an excellent option for Adriel. His treatment required casting on both legs. He tolerated each casting session very well and the casts didn’t bother or stop Adriel from being active.  The serial casts helped Adriel to better control his walking speed which increased his awareness of planting his feet flat on the ground when he walked. They also gently stretched his tight calf muscles allowing him to keep his heels down when he walks. Serial casting was the best treatment option for my son!