What is SDR?
Children with cerebral palsy often experience muscle spasticity — increased muscle tightness that can lead to shortening of muscles and tendons, joint contractures, bone deformities and pain. A selective dorsal rhizotomy (SDR) is a neurosurgical procedure where a surgeon carefully cuts some of the sensory nerve roots in the lower spinal cord.
The aim is to:* Reduce spasticity
* Decrease discomfort
* Increase independence and function
When spasticity is reduced, underlying muscle weakness often becomes more visible. However, this creates the opportunity to build strength and control through physiotherapy and exercise.
How physiotherapy can help
Physiotherapy is essential both before and after SDR surgery.
It can:
* Strengthen trunk and leg muscles to prepare for surgery
* Support early recovery by improving posture and movement control
* Help build strength in weakened muscles after spasticity is reduced
* Improve walking patterns and functional mobility
* Provide clear home and school programmes for ongoing progress
Our approach at StarPhysio
We have extensive experience supporting children before and after SDR.
Our approach includes:
* Pre-operative physiotherapy to strengthen muscles and optimise surgical outcomes
* Post-operative rehabilitation, both on land and in the pool
* Aquatic therapy to provide supported movement, reduce effort, and encourage strength-building
* Close collaboration with international SDR centres, regional hospitals and local NHS teams
* Family coaching and discharge planning, ensuring children have the right support at home and school
* Long-term therapy to help children reach their potential over months and years
What to expect
* Careful goal-setting before surgery to prepare your child
* A clear therapy plan immediately after discharge
* Regular reviews and therapy sessions to build progress step by step
* Ongoing support for as long as your child needs it
FAQ’s
Is SDR suitable for every child with cerebral palsy?
No, it depends on the type and pattern of spasticity. Suitability is decided by specialist neurosurgical centres.
Why is physiotherapy so important after SDR?
Once spasticity is reduced, muscles may feel weaker. Therapy helps rebuild strength, develop new movement patterns and prevent secondary issues.
Can aquatic therapy really help?
Yes. We use the pool both before and after SDR to build strength and confidence, support safe movement, and accelerate recovery.