Thursday, December 18, 2014

Respiration and Neurodevelopmental Disorders: Part 2

This second installment comes after a solid 3 months after the first one...intentional simply because there is always a certain amount of time needed to take in, "chew", and digest information when it involves important and otherwise complex topics. 

Although each part will essentially stand on it's own, I recommend that everyone read / re-read part 1 so that the information within this brief post will have more impact and relevance. 

In the previous installment, I went into some small detail with respect to certain key mechanical realities regarding respiration.  This particular dialogue will simply attempt to highlight some additional elements that provide some added insight into the importance of the respiratory mechanism...not only within the relatively specific topic of neurodevelopmental disorders (NDD's) but within the entire human experience context as well.  With this objective in mind, I will identify 2 fundamental realities that should amplify the relevance respiration has on BOTH systemic and mechanical development. 

1.  Respiration / Breathing is the earliest critical biomechanical action that takes place following birth. 

In order to understand this statement more clearly, we need to ask a fundamental question:  "what does every human organism do as soon as they are born?"  That's not too difficult to answer...drink, eat, breathe, and evacuate.  Nothing more.  The systemic necessities are relatively simple and straightforward...these are things that are essential for survival. The MECHANICAL relevance of respiration is not so obvious, but it is none-the-less equally important. 

The above video extract is simply a demonstration of the  fundamental phenomenon of "hydraulic brassage" or hydraulic pumping.  In short, the breathing action generates what can be considered as a "hydraulic massage and pumping" that is directed upwards towards the upper chest and downwards into the pelvis and into the pelvic floor.  Why is this important? 

It is the direct action of this hydraulic brassage that drives the further development and architecture of the pelvis (pelvic girdle) and the upper chest (shoulder girdle). 

Basic observation will demonstrate that every child is born with a comparatively small pelvis and upper thorax (chest) in relation to the rest of the body...and this essential respiratory action of breathing within a gravitational field (under the weight of their own body) that is THE key catalyst for pelvic and shoulder development.  If we extrapolate this reality further, we come to the nex tlevel of practical question:  Why is the development of the pelvic and shoulder girdle so fundamental and relevant? 

The pelvis (and the health thereof) determines and regulates EVERYTHING biomechanically relevant to the legs.  Likewise, the shoulder girdle (and the health thereof) is critically relevant to the function and performance of the arms. 

This sheds some valuable light into the otherwsie complex world of NDD's.  In other words, one of the most dominant characteristics of any neurodevelopmental disorder is the presence of a comparatively small pelvis and upper chest.  Therefore, it is not unusual that they also manifest common challenges with gross and motor performance of the arms and legs.  This identifies the developmental importance of addressing respiration as a fundamental objective within any and all treatment strategies. 

2. Respiration is one of the most powerful catalysts / stimulus for biomechanical symmetry

Given that it is the most primitive and earliest mechanical stimulus, as well as the fact that it is present during the most "plastic" stages of life, respiration is one of the main drivers in the establishment of symmetry and homogenous development.  Many of the structural distortions (particularly in the chest / thorax) have their roots in a deficient / inefficient respiratory mechanism during early stages of life. 

In summary, the main message is as follows:  EVERY neurodevelopmental disorder, whether mild or severe, will manifest some deficit in respiratory mechanics.  Therefore a careful and comprehensive assessment of breathing patterns and underlying challenges will always ultimately generate a high "rate of return" with respect to progress and long-term rehabilitation strategy.  

More to come...




  1. This is very well explained. We have a 1 year old with CP and he does have a tiny pelvis and a bulging belly, though he does show some pretty good movement in his thorax when breathing. I'm concerned that his belly shows that his breathing pushing his belly out to the sides instead of down into his pelvis. Is there anything we can do to aid this hydraulic pump? I'm thinking of a compressional bandage around his waist to prevent the bulging. We have been to an ABR session where they taught us to roll him with supersoft balls, but he will not stay still long enough (or gets too upset) for us to do a full session at home. In terms of function, he is commando crawling, but has very stiff legs and pretty tight arms. Thank you for any insights you can offer!

    1. Greetings! I would be happy to share some insight and perspective with you...however it will likely involve some "back and forth" and therefore is best served via a private communication via e-mail (or other modality if necessary). You can reach me directly at and we can proceed from there...sending some additional info and history will be helpful in providing you with useful and productive feedback. Cheers!