Serial Casting Advice

What is Serial Casting?

Serial casting is used to give a prolonged stretch to muscles and tendons that have become tight or shortened. The ankle and/or knee will be help in a desired position and a fibre glass cast will be applied. A series of casts may be applied to gradually improve the child’s range of movement. The number of casts necessary depends on improvement over time. Casts are usually removed and replaced at 1 week intervals to maintain skin integrity.

Why does my child need Serial Casting?

The reasoning behind Serial Casting is individual to a particular child. Serial casts are often used to:

  • Improve passive range of movement.
  • Improve gait (walking pattern)
  • Pre/post Botox injections (a treatment for high tone)

What happens during the casting appointment?

You will be given an appointment at the Plaster room, Main Outpatients at the Queen Elizabeth Hospital, Gateshead. Please bring shorts or trousers that are able to be rolled up.  You may need to bring toys to distract your child as it may be upsetting. The casting should not cause pain however due to stretching may be uncomfortable. Padding will be applied under the cast to prevent rubbing, the fibre glass cast will then be applied and set in the desired position. Your child can choose the colour of the fibreglass.

What happens after the appointment?

You will be advised by your Physiotherapist how long the cast will be on and when it will be changed/removed. Your child will be given plaster shoes so that they can walk with these shoes on, the casts are not to be walked on without the plaster shoe as they can be very slippery.

Depend on your child’s level of mobility and the casts applied, they may be able to walk, play, go to school as normal, however they may need to use a wheelchair for mobility/long distances. Your child won’t be able to take part in PE or swimming as the cast is not allowed to get wet.

Things to look out for

Ensure that you check the casts regularly. Look out for:

  • Circulation in the toes- changes in skin colour temperature
  • Swelling of the toes/lower limbs- ensure the legs are elevated on a cushion
  • Sharp edges around the cast
  • Rashes/abrasions or rubbing

What not to do

  • Do not allow the cast to become wet
  • Do not insert anything into the cast to scratch an itch
  • Do not let anything get inside the cast e.g. sand
  • Do not allow your child to stand or walk on the cast without wearing the plaster shoes.

If you have any queries or questions please contact someone on the following numbers

How do I make a comment about my visit?

We aim to provide the best possible service and staff will be happy to answer any of the questions you may have.

If you have any suggestions or comments about your visit, please either speak to a member of staff or contact the patient advice and liaison service (PALS) on 0191 445 6129 (09.00 – 17.00, Monday to Friday).

You can also email PALS at [email protected]

Alternatively, you may wish to complain by contacting our complaints department:

Chief Executive,

Gateshead Health NHS Foundation Trust,

Trust Headquarters,

Queen Elizabeth Hospital,

Sheriff Hill,



The PALS team will listen to your concerns, suggestions or queries and is often able to help solve problems on your behalf.

Data Protection

Any personal information is kept confidential.  There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible.

In order to assist us to improve the services available, your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews and Statistics. 

Further information is available via Gateshead Health NHS Foundation Trust website (Privacy – Gateshead Health) or by contacting the Data Protection Officer by telephone on 0191 445 8418 or by email [email protected].

This leaflet can be made available in other languages and formats upon request