Advice following casting

General advice:

The following information is for patients or parents of patients who have undergone serial casting for tight Achilles Tendons. It aims to provide general information about what to expect following the casting process and to advise on specific exercises in order to maximise the benefit from the casting.

Once the last casts have been removed, it is normal for feet to feel stiff and strange. It takes time to adjust to any new movement that has been gained from casting. Not only will the Achilles tendon be more flexible, but the tendons on the front of the legs will be working hard to control new movement. This may cause aching. The best course of action is to take things slowly and take pain relief in the first few days if necessary. Do not be surprised if the aching persists for a few days to a week, continue with the advice as outlined below and things will begin to improve.

Perform the exercises on this leaflet every day to help to reduce any stiffness in the ankles from the casting. This will help to reduce any aching and help to encourage a “normal” walking pattern again. If you have been given splints to wear, ensure these are worn every night to help maintain the new movement.

Movement:

Keeping your legs still, move your ankles so your feet point up to the ceiling and down to the floor. You can also circle them in both directions.

Hold for ___seconds Repeat ___times

Stretching:

Stand with your toes on the edge of a step. With straight legs, drop your heels down over the step.

Hold for ___seconds Repeat ___times

Stand with your feet facing forwards. The leg to be stretched is placed behind. Keep this knee straight and heel on floor as you bend your front leg. Keep feet and bottom facing directly forwards.

Hold for ___seconds Repeat ___times

Lie on the bed or on the floor. Place your hands around the thigh of the leg to be stretched. Slowly straighten the leg on that side until you feel a pull at the back of your leg.

Hold for ___seconds Repeat ___times

Balance:

Stand in front of something stable (like a sink). Stand on one leg and try to keep your balance. Gradually reduce the amount you are holding on until you can stand on one leg without holding on. Make sure your hips stay level.

Hold for ___seconds Repeat ___times

For the first few days, try to walk with a ‘normal’ pattern making sure that the heel touches the ground first, then the whole foot flat, taking the weight forward towards the front of the foot and then over the toes as the foot lifts up. Limit the distance you have to go and try to stop for a rest if you start limping or your walking pattern deteriorates.

Follow the specific advice that your physiotherapist has given you, but as a general rule the whole exercise programme should be performed twice daily as a minimum.

The key exercises to help improve movement and walking pattern are below. If these are not performed on a daily basis, it is unlikely that the aching or walking pattern will improve as quickly.

Further advice

Please be aware that this handout is to be used as a guide. If you find these exercises painful please seek advice from your physiotherapist or GP.

Contacts

Please contact clinic 6 reception on 01223 216410 to leave a message for your physiotherapist, or to enquire about appointments.