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What is Serial Casting?

Serial casting is making and wearing a series of casts that immobilise a joint in a position of stretch. Each cast stretches the muscle and joint a little more in order to gently increase range of movement. The casts are made specifically to fit your child by a specialist physiotherapist and can be removed daily or weekly. At, our specialist physiotherapists are able to provide an excellent standard of assessment, serial casting and review due to extensive training and valuable clinical experience.

Mobilisation and stretch exercises applied by a paediatric physiotherapistAbove: Mobilisation and stretch exercises applied by a paediatric physiotherapist

Conditions treated with Serial Casting

Serial casting can be used to treat any condition that causes stiff, tight muscles and a reduced range of movement. It is essential that children achieve and maintain maximum possible range of movement at the joints in order to facilitate effective hygiene and movement. Children with reduced range of movement due to: are all likely to benefit substantially from serial casting.

Physiotherapy and Serial Casting

Your physiotherapist will carry out a detailed neurological assessment of your child’s symptoms, functional problems and goals in order to determine if serial casting is a suitable treatment intervention for the individual. Your child’s muscle strength, tone, range of movement, sensation and proprioception and movement patterns will be assessed in detail. The findings of the assessment will be discussed with you and if appropriate, the method and advantages of serial casting. Due to the complex nature of neurological conditions such as cerebral palsy, muscular dystrophy and spina bifida it is often the case that your child will require intensive physiotherapy treatment alongside serial casting sessions.

Depending on your child’s problems, physiotherapy treatment will focus on muscle mobilisations and soft tissue stretches, massage, strengthening exercises, practice of functional tasks and monitoring of skin integrity. For optimum improvement in range of movement, your physiotherapist may discuss the provision of botulinum toxin (Botox) injections which paralyse muscles preventing them from getting tighter. Serial casting can be used after botox injections to maintain range of movement. The benefits of serial casting include:
  • Increased range of movement
  • Increased active movement
  • Increased ability to carry out functional activities
  • Increased confidence and self esteem
  • Improved alignment of structures of the joint
  • Improved ability to wear braces and splints
  • Improved balance
  • Reduced pain
  • Reduced need for tendon lengthening surgery
  • Reduced risk of falls
  • Reduced fatigue when walking or running
Serial casting is a pain-free treatment intervention that is tolerated well by children of all ages. Serial casting may require two physiotherapists, one to hold the limb in a position of stretch and a second to carry out the casting procedure. Your physiotherapist will discuss the importance of monitoring your child’s skin integrity whilst wearing the splint in order to avoid developing sore areas. Over a period of time, serial casting will gently increase your child’s range of movement and this will be re-assessed regularly using a goniometer to provide an objective record of your child’s physical improvement.

Why for serial casting

At, we understand the problems and discomfort caused by significant muscle tightness and spasticity. Our specialist physiotherapists have valuable experience in the safe and effective design and application of serial casts. Serial casting is an evidence based treatment technique that can significantly improve range of movement and your child’s overall quality of life.
  • Detailed explanation of serial casting and education of how to apply cast
  • Use of outcome measures to keep a record of your child’s improvement
  • Access to botulinum toxin (botox) injections
  • Access to hydrotherapy
  • Experienced knowledgeable physiotherapists
  • Treatment at home or in the clinic
  • Treatment at any stage of your child’s condition
  • No waiting lists
  • Provision of aids and equipment your child may require whilst wearing the cast
  • Professional liaison with multi-disciplinary team involved in your child’s care
Clinical evidence states that serial casting significantly improves your child’s range of movement over a period of time. Physiotherapy sessions and serial casting can be provided in your child’s home or at one of our clinic locations. To discuss the advantages of serial casting with a specialist physiotherapist or to make an appointment, please contact us now on 0330 088 7800. You can also book appointments online

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