Total contact casting (TCC)

A total contact cast (TCC) is a treatment for foot conditions, such as a diabetic foot ulcer or Charcot foot. The cast reduces pressure on your foot.

Applying a total contact cast

It takes about 1 hour to apply the cast to your foot. After it’s applied you need to stay sat down or lying down for 20 minutes. You can walk on the cast after 20 minutes, but try to reduce walking as much as possible while you have the cast on. Speak to the podiatrist if you need crutches or a walking aid to help you move around.

Depending on your foot condition, you may need to have your cast reapplied every week.

You might need to have a TCC for months, or in some cases more than a year. 

You will be given a shoe to wear over your cast. Wear this all the time when you’re walking.

Risks of having a total contact cast

A possible, but rare, serious complication when wearing a cast is the development of a deep vein thrombosis (DVT).

Symptoms include:

  • increased or new pain in your leg
  • struggling to breathe
  • a sharp pain in your chest which is worse when you breathe in
  • swelling in your leg

When you have a total contact cast

Rest and raise (elevate) your leg as much as possible.


  • check your cast every day for any damage, such as it getting wet or stained
  • check the skin on the other foot and leg for rubbing, you can use a large sock or pillow case to cover your cast in bed
  • let your healthcare team know if your cast is rubbing against your leg
  • check your blood sugar levels regularly

Do not

  • do not put anything down the cast as you could damage the skin under the cast and cause infection or sores
  • do not get your cast wet, you can get a plastic cover for the cast which will keep it dry while you shower

It’s important that you do not remove your cast yourself. Speak to your healthcare team if you want to remove your cast.

Daily activities and work

You may need to take time off work while you’re in the cast.

You should check with your insurance company to make sure you are covered to drive.

We recommend not travelling abroad while you have a cast on. You should also speak to the airline if you’re planning to fly, as they might not allow you to fly with a cast.

Speak to your healthcare team if you’re unsure about any daily activities while wearing your cast.

Contact your healthcare team or 111 if:

  • your cast is worrying you
  • your cast is rubbing or has made your foot or leg bleed
  • you feel unwell, more tired than usual, hot or shivery with flu-like symptoms, as this could mean that you are developing an infection
  • your cast gets wet, damaged or starts to smell
  • you have pain or discomfort in your foot or leg
  • your cast becomes too loose or too tight
  • you are diabetic and your blood sugars are not stable

Resource number: 4755/VER2
Last reviewed: May 2023
Next review due: May 2026

Contact us

If you have any questions or concerns, please contact the foot clinic.

St Thomas’ Hospital
Phone 020 7188 9195, Monday to Friday, 8am to 4pm

Guy’s Hospital
Phone 020 7188 2449, Monday to Friday, 8am to 3pm

If you need help outside these hours, please go to your nearest emergency department (A&E) and ask them to take the cast off. Please contact the foot clinic the next working day.

Do you have any comments or concerns about your care?

Contact our Patient Advice and Liaison Service (PALS)

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