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Serial Casting

Non-surgical, cost-efficient intervention for toe walking

About Serial Casting

Serial Casting is a technique for correcting severe toe-walking. Temporary casts are used to increase mobility in the ankle. The casts iteratively increase the mobility in the ankle, gradually returning the ankle to its natural range of motion.

The goal of Westside’s serial casting program is to achieve long-term results for our children that will sustain through adulthood. We never forget that a kid is a kid by ensuring therapy is fun, safe, and inviting. Our expectation: life-changing results.

What is it used for?

Toe Walking that occurs over a long period of a child’s development can lead to severe stiffness of the muscles in the foot and the ankle. At this point, serial casting is needed to correct the condition. Surgery is often the only alternative to serial casting, and the costs, pain, and rehab timeline can be significantly higher than the process of using non-invasive serial casting. Serial casting is a way to avoid the risks and costs of surgical intervention and at the same time maximize medical outcomes for your child.

Everything you need to know about Serial Casting

What does the process look like?

The casting process first entails weekly cast changes on the involved ankle(s). Each of these visits will be minimally 1 hour per foot. If both feet are being casted, expect at least 2 hours of appointment time per week. That is just the first part, though. After the casting has helped the child regain the ankle range, the muscular strength and the habitual brain patterns need to be reworked to achieve normal walking. Otherwise, old habits return. The second part involves at least a year of walking in AFOs to keep their heel down while they are re-training their brain and muscles. Depending on the compliance of the child, this timeline can be extended.

Do we do physical therapy with Serial Casting?

Yes! This is ideal. It depends on each person’s insurance, but the advantages of this are huge. It is strongly recommended to maximize casting outcomes.

When do AFOs get worn?

Following casting, AFOs should be worn during daytime hours for a timeframe of 1 year. Night splints are worn during nighttime. Therapists will guide families if this standard protocol should change.

Can my child still do activities?

After getting used to the additional weight and awkwardness of the cast, your child should be able to everything that he/she was doing without the cast. In fact, we encourage your child to be as active as possible. Keep the cast from getting wet, and wear a sock over the front to keep the casts clean.

What does it cost?

The cost depends on your insurance plan. Please give us a call at (815) 469-1500 and ask for our billing team. We can confirm your benefits and give you a good-faith estimate of your weekly costs for the casting process.

How long does serial casting take?

It depends on how much range has been lost in the ankle flexion. The more contracted the ankle is the longer it takes. We can achieve 2-5 degrees of regained ankle bend every week depending on how stiff the ankle is and how old the child is (older children take longer). Based on this, treatment can take as little 3 weeks and as long as 6 months.

Getting Started With Serial Casting

If you are interested, submit an inquiry below. Our Patient Coordinator will call to help you determine a plan forward.  If you are still unsure, you can call us anytime at (815) 469-1500 for more information.