Brain & nerves Paediatric Physiotherapy
Cerebral Palsy
- Delayed motor milestones
- Stiff or floppy muscle tone
- Difficulty with balance and coordination
- A preference for one side
Quick answer
Cerebral palsy is a permanent disorder of movement and posture caused by damage to the developing brain. The brain injury does not progress, but its effects on muscles and joints change as a child grows. Physiotherapy works towards functional goals and prevents contracture and deformity.
Typical recovery
Lifelong management with goal-based blocks
Cerebral palsy results from injury to the developing brain, before, during or shortly after birth. The injury itself does not worsen. What changes is its effect on a growing body: muscles that do not lengthen at the same rate as bones become tight, joints stiffen, and posture is affected.
That distinction shapes everything about treatment. The aim is not to fix the brain injury; it is to keep the body as functional and comfortable as possible as the child grows.
How it presents
Delayed motor milestones, altered muscle tone — usually stiff, sometimes floppy, sometimes fluctuating — poor balance and coordination, and often a strong preference for one side. It ranges enormously, from a child who walks with a slight limp to one who needs full support for every position.
Working to goals, not to a diagnosis
Treatment is built around goals that mean something to the family: sitting unsupported, crawling, walking to the bathroom alone, managing stairs at school, dressing independently. Those goals are agreed at the outset, worked towards in blocks, and honestly reviewed.
What physiotherapy does
- Preventing contracture — sustained stretching, positioning and splinting, because a joint that fixes is far harder to address than one kept mobile
- Strength and motor control, practised through play
- Postural management — seating, standing frames, sleep positioning
- Gait training and orthotic assessment
- Hip surveillance — children with more significant involvement are at real risk of hip displacement, and monitoring catches it early enough to act
- Supporting families with handling, equipment and daily routines
- Rehabilitation around surgery or botulinum toxin injections, where these form part of care
The role of the family
The hour with a physiotherapist matters far less than what happens in the other twenty-three. Parents are part of every session and leave knowing what to practise and why.
The long view
This is lifelong management delivered in blocks, with goals reset as the child grows. Growth spurts and adolescence are periods where tightness increases and input is typically needed most.
Medically reviewed by Nasir Mughees, BPT, MPT, Orthopaedic Physiotherapy · Last reviewed September 2026