Sports
Rehabilitation

Cast Care Instructions & Precautions

Part I – General Cast Care

Regular Casts (non-waterproof casts) – Keeping your regular cast dry is very important! There are no devices that are 100% effective in keeping any cast dry. Sponge baths are the safest way to keep the cast dry. If you have to take a bath or shower, please follow these instructions:

  • Place a towel or washcloth around the upper portion of the cast
  • Cover the entire cast with 2 plastic bags (use two in case one has a leak)
  • Secure the bag at the top with tape or a rubber band
  • If the cast gets moist, dry the top or bottom of the cast using a blow dryer. Use only the cool or low setting
  • If the cast is soaked all the way through, it needs to be changed (call our office)**

* Please note: these methods will not protect a cast in the pool or if submerged underwater.

** Most insurance companies do not pay for unscheduled cast changes due to wet casts.

Waterproof Casts: If you are able to have a waterproof cast, then the cast is completely waterproof. You are allowed to submerge the cast in any amount of water including bathing/showering. If your provider allows you to swim in your cast (“stable fractures only”), you cannot swim at the beach or in dirty water. Debris may be left behind in the cast and cause an infection. Waterproof casts are not used around ankles and elbows because skin irritation and pressure sores develop when the water does not fully drain from the cast. We also do not use waterproof casts immediately after surgery because of the possibility of infection.

To make sure your waterproof cast stays clean, please run warm, soapy water through the cast as needed and rinse thoroughly.

Basic Cast Care:

Foreign Objects

  • NEVER PUT ANYTHING INTO YOUR CAST!
  • Sticking a coat hanger, ruler, etc. into the cast can scratch the skin, which could lead to an infection.
  • Whatever you stick in the cast can get stuck, also causing irritation, infection, or an abscess.
  • Please contact our office if you get something stuck inside your cast.

Itching

  • You may use a hairdryer (cool or warm setting only) since moisture inside the cast is often a source of itching.
  • Rubbing a ruler or similar object on the OUTSIDE of the cast can often stop itching as the friction on the outside of the cast mimics scratching.
  • Benadryl may also stop the itching. It is available over the counter without a prescription.

Swelling – Occurs most often in the first 48-72 hours after injury. To minimize swelling and complications in your cast, follow these simple instructions:

  • Raise the cast above the level of the heart.
    • Arm casts – it is important to raise your hand above the elbow to make sure it is high enough. If you raise the elbow portion on the pillows alone, the hand is likely to swell. A simple method is to lie down on your back with the arm out to your side and the fingers pointed toward the ceiling.
    • Leg casts – lie down on your back with the leg propped up on one to two pillows. The pillows should be under the calf and heel area, not just under the knee. Elevating leg casts on a stool or sitting in a recliner is not high enough.
  • Wiggle the uninjured fingers or toes often (every hour for 24 hours, then every 4 hours)
  • Use your sling for two weeks after injury unless you are told otherwise by your provider. The sling is to be removed for elevating your arm when you are not walking around.
  • Non-steroidal anti-inflammatory medications (such as Motrin or Advil) can be taken as directed on the bottle. (Discontinue if stomach pain occurs!)
  • If these methods fail, your cast may need to be split down the sides to allow the swelling to resolve.

PART II – Precautions

These things can be signs of problems in the cast and if any of these occur please contact our office immediately or go to the nearest emergency room:

  • Unexplained fever (temp greater than 100.4 F)
  • Inability to move fingers or toes
  • Foul odor or fluid coming from the cast
  • Complaints of burning or rubbing inside the cast
  • If toes or fingers become discolored, numb or painful with small movements
  • If the toes or fingers swell approximately twice the size of the unaffected side
  • Cast edges causing a breakdown of the skin
  • If the cast is too loose

* These instructions are meant to be used as a general guideline. If you have any questions about the information in this handout or otherwise, please call our Cast Care Hotline at 678-686-6841.