What to Expect When Your Cast Comes Off
So you're getting your cast removed soon — and you probably can't wait to get back to life as normal. But it's not as simple as "goodbye, cast; hello, hockey" (or football, basketball, lacrosse, or whatever your sport is). It will take a while for everything to get back to normal. While it does, you'll need to give the part of the body that was in the cast a little extra care and avoid some physical activities.
Here's what you can expect in the coming days and weeks as your cast is removed and your body finishes the healing process.
What Will the Doctor Do?
Before removing the cast, the doctor will examine your limb (the part of your body where the cast was, like your arm or leg). The doctor may want to take an X-ray of the limb when it's still in the cast and check things like your pain level.
If everything seems OK, the doctor or a cast technician will remove the cast with a special saw. It has a dull blade that moves from side to side. It's the vibrations that break the cast apart, so there's nothing to hurt your skin. It might tickle a bit, though.
When your limb is out of the cast, the doctor will examine it again. He or she will check for pain and see if you have a good range of motion. If you still have pain or trouble moving the limb, the doctor may give you a splint to wear until it heals more. Your doc might even decide that you'll need a different cast or one that is shorter than the one you have now.
If you're having a leg cast removed, bring a loose or larger-than-normal shoe with you to the doctor's office. There is a chance your foot might be a bit swollen.
What Will My Limb Look Like?
Don't be alarmed, but there's a decent chance your limb might look a little odd when the cast comes off. All these changes are normal. They should clear up fairly quickly so there's no need to worry about them:
- Your skin might look dry, scaly, flaky, or pale.
- The hair on your arm or leg might seem darker and thicker than usual.
- Your limb might smell a little bit (after all, it's been in a cast and not washed for a while!).
The muscles of your limb will likely appear smaller and weaker because you haven't been using them. Doctors call this being "atrophied." This is normal, too, but it will take a little longer for your muscles to get back to normal. You'll need to take it easy and be careful with your activities during this time.
What Should I Do When I Get Home?
Your skin is going to be very sensitive for the next few days, so you'll need to treat it gently. You may be tempted to scrub or scratch all the dead skin off your limb the moment you get home. Instead of rubbing, scrubbing, or scratching your skin, gently wash it with mild soap and warm water using a soft cloth or gauze pads.
If you had an open wound when your limb was broken or fractured, your skin may have scabs on it. Scratching the scabs could damage the skin and lead to an infection, so resist the urge! If there's still an open wound, follow your doctor's instructions on how to take care of it.
If your limb was in a cast for 3 weeks or more, soak your skin in warm water for 20 minutes twice a day for the first few days after the cast is removed. Gently rub your skin dry with a soft towel. The key word here is gently. Rubbing the skin too hard can damage the new skin.
Support your limb as it continues to heal. After the support the cast used to provide is gone, people often notice a limb feels stiff or sore, or is swollen. Move gradually back into using it. Start with small, easy movements and work your way up to using the limb fully.
Put on lotion after you clean the area where the cast was. This will keep your skin soft, speed healing, and help stop itching. Choose a fragrance-free lotion because perfumes can irritate skin that's delicate or sensitive from being in a cast. Lotions made with cocoa butter work well.
If you've just had a cast taken off your leg, wait for at least 3 days before shaving the hair on your leg. This gives your skin time to recover.
What Should I Do Over the Next Few Weeks?
Ask your doctor what exercises to do and how often. As soon as the cast comes off, you'll want to start doing gentle movement exercises in between periods of rest. Be sure not to overdo it. Your muscles will be smaller and less effective than they used to be for at least a couple of weeks.
Find out when you can start doing your normal activities again. Your doctor will decide when this is right based on a follow-up examination and X-ray. Doctors want to see that bones are completely healed before they give patients the go-ahead to start more demanding activities.
If you have any difficulty moving your limb, the doctor may want you to wear a splint for the first week after the cast comes off. The doctor also may recommend therapy to help you regain a full range of motion in your limb:
- Occupational therapy typically deals with activities of daily living and involves helping people get back to performing everyday tasks like bathing, dressing, and eating.
- Physical therapy is usually focused on helping people regain movement and do things like walk and climb stairs.
Before recommending an exercise program, a therapist will check your limb. He or she will look at strength and pain, measure swelling and range of motion, and look at your skin and any scars.
The therapist will give you one or two simple exercises to start with. If these go well, the therapist will gradually add other exercises.
Therapy also can include massage and using hot and cold packs to help keep any swelling down. Both of these also increase circulation, which helps healing.
When Can I Play Sports Again?
Every situation is different, but a general rule of thumb is that you should avoid strenuous activities for as long as your limb was in the cast. You'll be able to go back to doing most hobbies and light activity earlier, but sports will have to wait a little longer.
People usually can return to playing non-contact sports after about 4 to 6 weeks. Going back to full contact sports may take 8 to 12 weeks or more. It's all about when the doctor decides a bone is fully healed and is strong enough for the demands of a particular sport.
What If Something Seems Wrong?
Your doctor will probably schedule a follow-up visit for a few days or weeks after you get the cast off. This is to check that your bones are healing as they should. When and how often you go for follow-up exams depends on your injury and whether you had surgery.
If your skin doesn't seem to be healing properly after a couple of days or if you have any pain, call your doctor's office.
In the coming weeks, follow your doctor's or therapist's instructions to ensure that your skin, bones, and muscles heal the way they should.
Finally, be careful not to fall on the injured limb while it's healing. You're about to get out of a cast. You don't want to end up right back in one.
Reviewed by: Joseph Basante, MA, MS, CHT
Date reviewed: June 2011
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