Casting Information – Patient information leaflet

A leaflet explaining how the physiotherapy department at Walkergate Park use casting and splinting as part of treatment.

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This leaflet may not be reproduced in whole or in part, without the permission of Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

The physiotherapy department may use casting and splinting as part of your treatment to assist in achieving your goals at Walkergate Park.

  • When would casting be used?

    It can beneficial to apply external devices in the form of casts or splints when loss of range of movement has occurred at a joint. Most commonly treated joints are elbows, knees, ankles, wrist and fingers.

  • Why would joints lose movement?

    The most common causes for loss of movement following brain injury are:
    • Muscle weakness
    • Over activity of muscles
    • Altered muscle tone
    • Muscle shortening

  • The casting process

    The affected joint is stretched to a comfortable position by a physiotherapist then padding is applied over the whole limb. With the limb held on a stretch, a chosen plaster material will be applied around the joint and allowed to harden.

    The cast will be removed, usually after 3-7 days using a plaster cast saw and safety scissors. Once the cast is removed the skin will be checked for any redness or marking, this will be reported to the medical and nursing team if present. A new cast may be applied shortly after if the skin is intact and casting will continue until the agreed range of movement has been achieved and maintained.

    The process may take up to six weeks.

    Following casting a removable splint may be made, which can then be worn to maintain the range of movement gained in the casting process. Your physiotherapist will advise on an individual regime for wearing the splint, if this is required.

  • Side effects of casting

    – Marks or breaks in the skin
    – Pain around the joint which has been casted
    – Swelling of the limb.
    – Numbness of the limb

    If you experience any of the above side effects during the casting process please report and seek advice immediately from the nursing and physiotherapy team.

  • Websites

  • References

    • Gracies J-M. (2001) Pathophysiology of impairment in patients with spasticity and use of stretch as a treatment of spastic hypertonia Physical Medicine and Rehabilitation Clinics of North America 12 (4): 747-68
    • Leung, J, Stroud, K. (2018) Long Term Resolution of Severe Ankle Contractures Using Botulinum Toxin, Serial Casting, Splinting and Motor Retraining. Physiotherapy Canada 70 (2): 152-159.
    • Moseley A.M. (1993) The effect of a regimen of casting and prolonged stretching on passive ankle dorsiflexion in traumatic head-injured adults Physiotherapy Theory and Practice 9: 215-221
    • Moseley AM, Hassett LM, Leung J, Clare JS, Herbert RD and Harvey LA (2008): Serial casting versus positioning for the treatment of elbow contractures in adults with traumatic brain injury: a randomized controlled trial. Clinical Rehabilitation 22: 406-417
    • Pohl M et al (2002) Effectiveness of serial casting in patients with severe cerebral spasticity: A comparison study Arch Phys med rehabil 83: 784-789
    • Singer B.J et al (2004) Non-surgical management of ankle contracture following acquired Brain injury disability and rehabilitation 26(6) 335-345

  • What if I have a comment, suggestion, compliment or complaint about the service?

    If you want to make a comment, suggestion, compliment or complaint you can:
    • talk to the people directly involved in your care
    • ask a member of staff for a feedback form, or complete a form on the Trust website (click on the ‘Contact Us’ tab)
    • telephone the Complaints Department 0191 245 6672
    • email Please note that information sent to the Trust via email is sent at your own risk
    • We are always looking at ways to improve services. Your feedback allows us to monitor the quality of our services and act upon issues that you bring to our attention.
    You can provide feedback in the following ways:
    – the quickest way for you to do this is to complete our short online survey at
    – complete a Points of You survey, available from staff.

  • Information about content, other formats and version control

    Further information about the content, reference sources or production of this leaflet can be obtained from the Patient Information Centre. If you would like to tell us what you think about this leaflet please get in touch.

    This information can be made available in a range of formats on request (eg Braille, audio, larger print, easy read, BSL or other languages). Please contact the Patient Information Centre Tel: 0191 246 7288

    Published by the Patient Information Centre
    2021 Copyright, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
    Ref, PIC/112/0621 June 2021 V5 Tel: 0191 246 7288
    Review date 2024