Cerebral Palsy and Foot Drop
People with cerebral palsy may experience toe catching, reduced foot clearance, ankle instability, stiffness or a walking pattern that looks like foot drop. Support usually needs to consider tone, growth, footwear, fatigue and daily function.
Written and reviewed by qualified physiotherapists across the Mobile Physiotherapist network. Last updated: 1 June 2026.
Is it always true foot drop?
In cerebral palsy, toe catching may be caused by weakness in the muscles that lift the foot, but it can also be affected by spasticity, calf tightness, altered selective control, hip or knee movement, balance, fatigue, foot posture or shoe fit. That means "foot drop" is sometimes used as a simple description, while the clinical picture is more complex.
A good assessment looks at the whole walking pattern, not only the ankle. It should consider whether the foot is flexible, whether the ankle can reach a neutral position, whether the toes catch more when tired, and whether support is needed for school, work, sport, stairs or outdoor walking.
Common signs
- Toes catching on the floor, carpets or kerbs.
- Walking on the toes or forefoot.
- The foot turning inwards or outwards during swing or stance.
- Reduced ankle control when tired.
- Trips, falls or loss of confidence outdoors.
- Shoe wear on the toe area or one side of the sole.
- Difficulty keeping up with peers or managing uneven ground.
Splints and AFOs in cerebral palsy
Orthotic support is common in cerebral palsy. An AFO can help position the foot and ankle, improve stability, support a weakened muscle group and reduce falls risk. Some people need a custom AFO or more controlling support; others may suit a lighter option for specific activities.
The CPFT NHS orthotics service describes AFOs as custom splints designed to control movement in the foot and ankle and to help make walking easier, keep the foot or ankle in a better position, support weakened muscles and reduce falls risk. The right prescription should be made by clinicians who understand the person's tone, range of movement, skin, footwear and goals.
Physiotherapy priorities
Range and comfort
Maintaining calf length and ankle range can help comfort, standing and splint tolerance.
Strength and control
Exercises may target ankle lift, hip control, knee control, balance and endurance.
Walking practice
Practice should reflect real goals: stairs, pavements, school corridors, playgrounds, work or community walking.
Equipment review
Shoes, insoles, AFOs, splints and walking aids may need review as needs change.
Children, growth and review
Children's walking can change as they grow. A splint that once fitted well may become uncomfortable, too short, too tight or no longer suitable. Regular review is important if there is pain, red skin marks, new toe catching, increased falls, rapid growth, changes in school activity or reduced confidence.
Parents and carers can help by noting when toe catching happens, which shoes work best, whether fatigue changes walking, whether the child removes the splint, and whether there are skin marks after wear.
Where OrthoPed may fit
The OrthoPed Foot Drop Splint is a lighter shoe-compatible foot drop splint. It may be relevant for some suitable users, but cerebral palsy can involve tone, contracture, rotational changes and complex gait patterns. Children and adults with cerebral palsy should usually have orthotic or physiotherapy advice before relying on any single support.