Intramuscular injections of botulinum toxin A (Btx-A) and exercise are used in the treatment of muscle spasticity in children with cerebral palsy. However, little is known about the biological changes within muscle subsequent to Btx-A-induced paralysis and how the combination of Btx-A and exercise might affect the growing muscle. The wet mass, myosin heavy chain (MHC) composition, and titin content of the juvenile rat gastrocnemius muscle were determined 3 weeks after Btx-A injections and subsequent voluntary wheel-running exercise. Btx-A increased the proportion of type IIa (+121%) and IIx (+65%) MHC while decreasing the proportion of type IIb MHC (-51%) and reducing the titin content (-18%). Exercise did not amplify or reduce the changes induced by Btx-A. Thus, we conclude that although the sarcomeric stability of paralyzed muscle might be impaired, moderate mechanical loading does not seem to affect paralyzed muscle protein composition.