Serial casting


Many walking and leg pain issues in children are related to range-of-motion limitations in the ankle. These range-of-motion limitations cause pain, abnormal walking patterns, fatigue, muscle cramps and damage to other joints.

The serial casting program at Children’s Minnesota is designed to address the need to improve ankle flexibility. The goal of serial casting is to increase the length of the calf muscles through growth, not through stretching. Fiberglass casts are applied weekly at slight tension. They do not cause pain and can appropriately lengthen tight muscles while preserving the muscle’s strength potential.

Our program is unique among casting programs because it does not depend on a prior injection of Botox and because casts are applied by a physical therapist. We have a 93% success rate in attaining the target range of motion.

Serial casting has been used successfully to treat:

  • Toe walking
  • Contractures due to cerebral palsy and other neurological problems
  • Limitations from peripheral neuropathy due to treatment for childhood cancers
  • Foot and ankle pain
  • Lower leg trauma

The post-casting program involves wearing foot orthotics to assist with maintaining the range of motion and physical therapy to help develop a good walking pattern. A child’s primary physician can refer their patient for services. A course of serial casting typically lasts between 6 and 10 weeks. During that time there is no limitation on the physical activities of the child except that the casts cannot get wet.

Serial casting is offered at three sites: Minneapolis, St. Paul, and Minnetonka.