After A Cast is Removed & Waterproof Casting

Woman removing cast on patient

After having a cast removed, it is normal to experience pain, stiffness and decreased range of motion in the area(s) that were immobilized.

Symptoms can last up to twice the amount of immobilization time. For Example, if the patient was in a cast for 3-4 weeks, symptoms may last up to 6-8 weeks.

Pain and Stiffness

Minimal amounts of discomfort and stiffness are normal after the cast has been removed. Tylenol can be used for pain and Motrin can be used for swelling. You may also alternate between the Tylenol and Motrin. Elevating the extremity, above the heart is also beneficial to decrease swelling.

Range of motion

Decreased range of motion is expected. Physi-cal Therapy is not typically prescribed when a cast is removed, as decreased range of motion resolves over time. Do not force the range of motion. A transition brace is not always pre-scribed because it may delay the return of range of motion.

Deformity

Callus formation takes place at the fracture site. This is good and shows that the bone has healed. However, the callus can make the fracture site looked deformed. It can take several months for the callus formation to remodel and smooth out.

Dry skin

Wash with soap and water. Use a non- alcohol based lotion. Picking at loose skin will increase irri-tation. Dry skin may take a few days to a week resolve completely.

Bruising

It is not abnormal to see bruising and discoloration after a cast has been removed.

Little girl showing her arm after cast was removed

Restrictions

It is typically advised to refrain from any running, jumping or sports for a period of time lasting from a few days to a few weeks. After that, you may return to activities as tolerated.

Frequently Asked Questions

Q: Why did my doctor not prescribe Physical Therapy?

A: It is not common to prescribe Physical Therapy after a cast is removed. Children often have better results for regaining muscle tone and range of motion after the cast is removed when they progress to activities as tolerated. Do not force range of motion during this time.

Q: Why did my doctor not prescribe a brace after the cast was removed?

A: It is often uncomfortable to work on range of motion when a cast has been removed. It is not common to prescribe a brace during this time. Further immobilization after the cast has been removed will only delay the return of range of motion.

Q: Why is my child still limping after his or her cast was removed?

A: It is not uncommon for a child to limp after a cast has been removed from their leg. The x-ray shows that the bone has healed enough to remove the cast. However, once the cast is removed the child will need to work on regain-ing muscle strength and range of motion. This may take up to twice the amount of time that the cast was on. During this time, your child may walk with his or her foot or leg pointed out or turned in. As your child begins to increase activities, the limping may wax and wane until it finally resolves.

Man speaking on cell phone

When should I call the office?

  • Pain that is not relieved by alternating between Tylenol and Motrin.
  • Signs of decreased circulation. The extremity should be warm to the touch and nail bed color should return within 2 seconds after blanching. Compare these tests to the other extremity.
  • If it has been a few weeks and you are not seeing any improvement in range of motion.
  • If you have any other questions or concerns.