Children with cerebral palsy are at higher risk of experiencing problems with joints, muscles and bones, also called the musculoskeletal system.

There are many possible reasons. A child may have difficulty with sitting posture, which has an impact on the spine. A child may have difficulty with muscle contracture or unwanted movement. One common problem is that children with CP often don’t weight bear and walk to the same extent as other kids, and so hip development is impaired.  

Doctors and allied health professionals will regularly monitor your child’s spine and hips, for signs of abnormality.

These issues can be very mild and easy to manage, or they may need more support or therapy as your child gets older.

Difficulties may include:

• muscle spasticity or tightness
• muscle laxity or floppiness
• asymmetrical muscles
• muscle spasms
• scoliosis, kyphosis or lordosis (related to spinal curvature)
• musculoskeletal pain.

It’s amazing how much of our bodies are controlled by muscles. Your child uses muscles not just to stand, walk or run, but to roll over, breathe, eat, speak and smile. Facial expressions are controlled by muscles. You might notice your child grimacing or drooling or having trouble eating and drinking. 

It’s also very common for young children with CP to experience muscle pain. It may be caused by contracture, abnormal postures, dystonia, hip ball and socket partial dislocation (also called subluxation), and gastro-oesophageal reflux. Understanding muscle pain can be difficult for parents, and obviously even difficult for children with CP.

There are ways to eliminate, reduce or alleviate muscle pain. If you know or suspect your child is in pain, talk to your GP, child and family health nurse, or paediatrician.

The best way to achieve a positive outcome is clinical evaluation.

An initial test used by many doctors is the Range of Motion (ROM) Assessment. It measures movement of the ankles, knees, hips, shoulders, elbows, wrists and fingers. ROM assessments can be performed on infants and across all levels of severity and types of cerebral palsy.

There are many surgical and non-surgical interventions which can help support healthy bones and joints in young children with CP.

There are also enormous benefits to be obtained from physical therapy. There are many different health professionals who specialise in the musculoskeletal system, for example, child physiotherapists. A tailored therapy plan can teach life-changing skills and improve strength and coordination.

It is widely recognised that the earlier children receive intervention the better the outcomes.

In the below section you will find information about child development, therapies and muscle strengthening exercises, and the importance of clinical management of postural care.