ROCKPORT — For some children, walking on their toes or having limited ankle flexibility can make it difficult to develop a typical heel-to-toe walking pattern. At MaineHealth Pediatrics Physical Therapy Rockport, a specialized pediatric casting clinic is helping children improve mobility and range of motion through a gentle, evidence-based approach.

 

The clinic provides serial casting and specialized bracing for children experiencing persistent toe walking, tight heel cords and other mobility limitations. These challenges can occur for a variety of reasons and may be associated with developmental, orthopedic or neurological conditions, according to MaineHealth, in a news release. The service was developed after pediatric physical therapists Christine Buss and Camaran Wilt completed specialized training in serial casting in Colorado, bringing a treatment option to the Midcoast that had not previously been readily available.  

 

Toe walking occurs when a child walks primarily on the balls of their feet or toes, with little or no contact between their heels and the ground. While it can be a normal part of development for toddlers, persistent toe walking may contribute to shortening of the Achilles tendon, reduced ankle mobility and gait abnormalities over time.  

 

“Sometimes toe walking is obvious, and sometimes it isn’t,” said Lisa Manley, PT, Pediatric Physical and Occupational Therapy manager for MaineHealth Pediatrics Physical Therapy Rockport and Belfast. “A child may compensate in other ways, such as turning their feet outward to move forward. That’s why a physical therapy evaluation looks at gait, alignment and range of motion.”

 

For children who have developed tightness in the muscles and tendons around the ankle, serial casting can gradually improve flexibility and movement. Serial casting is a nonsurgical treatment that uses custom-molded casts to gently stretch tight muscles and tendons over time. Therapists position the foot and ankle at a comfortable stretch and then mold the cast to hold that position. As flexibility improves, the cast is adjusted to gradually increase range of motion, helping children achieve a more typical gait pattern.

 

The clinic uses a specialized moldable casting material that is heated and shaped around the child’s foot and ankle like a sock. Once cooled, it maintains the desired position while remaining comfortable to wear and remove with a zipper. Children typically wear the casts overnight, while daytime bracing and physical therapy may also be incorporated into individualized treatment plans.

 

“It is a slow and gentle process that does not hurt,” Manley said. “I often describe it as nighttime therapy because most of the work happens while the patient is sleeping.”

 

The clinic has seen meaningful results. In several cases, children with significant ankle contracture experienced substantial improvements in range of motion through serial casting, bracing and physical therapy. The gains allowed the children to develop a more typical gait pattern and participate more fully in activities, including sports.

 

The clinic currently serves six to 10 children each month and works closely with pediatricians and other health care providers throughout the region. Manley encourages families to seek an evaluation if they have concerns about their child’s walking pattern.

 

“A lot of times we see pediatric patients later than we need to,” she said. “The earlier we can identify a concern, the more options we have and the better the outcome can be.”

 

The Pediatric Casting Clinic is part of MaineHealth Pediatrics Physical Therapy Rockport’s comprehensive pediatric rehabilitation program, which includes physical, occupational and speech therapy services in one convenient location. For more information speak with your primary care provider or visit: Pediatric Physical Therapy | Occupational Therapy | MaineHealth Pen Bay Hospital