Managing Your Child's Serial Casting to Treat Idiopathic Toe Walking

Serial casting is a common treatment for idiopathic toe walking, which requires casts on both feet for six weeks. Can a child really go six weeks without a bath? What about playing outside? These tips for managing your child's serial casting will answer those questions and more.

Serial Casting Management: Bathing tips

Because fiberglass casts can't get wet, traditional bathing becomes an impossibility while treating your child's idiopathic toe walking. It's just not practical or safe to plunk your child in the tub with both feet hanging out the side. Sponge bathing is the route to go.

Hospitals typically use a pre-moistened, rinse-free cleansing washcloth for sponge bathing. My local hospital used Sage Comfort Personal Cleansing Bath Essential Cleansing Washcloths, which can be found online for sale here . These washcloths make sponge bathing so easy. The washcloths use a mild soap for cleansing, with vitamin E and aloe to avoid excessive drying of the skin. Just pop them in the microwave for 30 seconds to warm the wipes, and you're set for sponge bathing your child with serial casts.

Serial Casting Management: Weather-Proofing Tips

To protect against snow or rain, slip a plastic bag over the cast. Any kind of plastic bag will work, but I found that grocery bags were more durable than bread bags. Then slide a tube sock over the plastic bag and the cast, then put on the walking boot. This will not only keep the casts dry, but it will also keep your child's feet warm. Just be sure to take the plastic bags and socks off when indoors to prevent excessive sweating.

Serial Casting Management: Exercise Tips

Note to parents and teachers, especially gym teachers: Don't limit a child's physical activity due to the serial casting. Serial casts are a corrective measure for idiopathic toe walking, so there is no need to worry about damaging a broken bone as is the case of a regular cast. Exercise is important, and children with serial casts can walk, run and play just like other children.

Serial Casting Management: Skin Care Tips

After serial casting for idiopathic toe walking, the skin beneath the cast is very delicate and awfully smelly. The first reaction will be to scrub the lower leg and foot, but this is not recommended. During one of my son's cast changes, the nurse soaked my son's feet in a solution of lotion soap and water. Although it did nothing for the smell, it felt good on my son's feet.

At the last cast change, the doctor lathered his hands up with lotion soap and applied it directly to my son's skin. After letting it soak in for a couple minutes, he wiped it off with a damp towel. The direct application of lotion soap really helped with both the stink and the cleansing without scrubbing.

Once home, soak your child in the bathtub. (He really needs it anyway after six weeks of sponge baths!) Pat your child's skin dry, then liberally apply lotion to the skin. Your child's skin will heal within a day or two.