Dynamic Serial Casting

Explore Serial Casting Before Botox or Surgery.

A non-invasive orthopedic treatment to correct bone and joint alignment in children with conditions such as clubfoot, idiopathic toe walking, and cerebral palsy. Promotes proper alignment, increase range of motion, and improves overall function.

The Problem

When the foot is not properly aligned in standing, the entire body tries to fix it. The toes curl, the arches collapse, the hips and knees flex, the body crouches, the arms are in high guard, and balance and coordination are challenged. Whatever the reason behind a foot deformity or foot alignment issues (neuromotor, orthopedic, or sensory based), walking is not efficient or ideal and gait suffers or walking becomes impossible. Orthotic appliances (braces) are difficult to fit, skin breaks down, calluses form, deformity worsens, and children face invasive procedures like Botox Injections or non-reversible surgical interventions.

The Process

Dynamic Serial Casting should never be painful but it does require teamwork and commitment. Following careful manipulation and alignment, casts are applied using a combination of Fiberglass soft cast and Plaster materials in our clinic. Most of the time, the child can stand immediately following application and postural alignment and function are typically immediately improved. Standing and walking on the casts is the catalyst for the stretch and actually is part of the process.

Casts are easily removed at home after 4-5 days in order to allow the child to use the newly acquired range of motion and to encourage strengthening and therapy (and bathing) between casts. A new cast is applied on day 7 and the stretch continues. A typical casting series lasts between 6 -12 weeks, depending on the child’s range of motion, spasticity, tightness, or response to casting. Most kids don’t mind wearing the casts and some actually even prefer it.

The child walks directly on the cast and it should be kept dry and clean, if possible, so we recommend wearing a non-slip sock over the cast and “sponge-bathing” while the cast is in place. We will record progress with measurements and video analysis and can work with you and your child’s therapist for strengthening and progression of home programming.

Who Benefits?

  • Cerebral palsy

  • Idiopathic Toe Walking

  • Club Foot/Club Foot relapse

  • Charcot-Marie-Tooth

  • Traumatic Brain Injury

  • Duchenne Muscular Dystrophy

  • Spasticity (abnormal muscle tone)

  • Soft Tissue Contracture

  • Foot deformities

  • Foot and ankle alignment issues

What makes us different?

Skilled precision alignment by highly trained therapists is the key to our success. It is not enough to simply stretch the ankle joint and apply a cast because the hind-foot, mid-foot, and forefoot must all be considered. The child’s entire posture must be observed and improved. The casts must be tuned and allow for optimal standing posture and gait improvements and the child should rarely experience skin irritation or discomfort in this process. We see improvements with every cast not only in the foot alignment but also in the whole body posture. We also have a lot of fun and encourage a playful, non-threatening process that involves the whole family.

The Proof

Case Study: 10 year-old child and lifetime toe-walker

Follow the journey of This 10 year old who was facing surgery to correct muscle contractures from many years of extreme toe walking. We corrected his alignment and through dynamic serial casting

Studies Show

Have Questions?

Find out if dynamic serial casting is right for you child.

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