ABR Denmark Advanced Biomechanical Rehabilitation


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-The Greatest Paradox


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The Greatest Paradox – Breathing Against the Collapse

At the moment of a child’s birth, tremendous transformations take place in countless respects. One of the most obvious is the onset of independent breathing. The entire respiratory system must have reached the required developmental stage, in order to suddenly – literally from one minute to the next – be able to establish and maintain a sustaining functional system for the remainder of the life period.

Any attempt we make to observe our own natural breathing process, will necessarily fail, because, as soon as we focus our attention upon our own breathing, the "natural" rhythm changes. Nevertheless, we can notice some essential aspects:

- The trachea stays still during the respiration. It does not bulge in any direction – not forwards nor backwards nor sideways.

-The thorax expands during inhalation and contracts and relaxes during

-The movement of the upper thorax is a slow rising and falling along the vertical axis; the lower ribs expand only slightly to the sides and then recede.

-The spacing between the single ribs increases and decreases. The expansion and
contraction movement is smooth, gradual, soft, and gliding.

-We can even observe the rise and fall of the diaphragm within the lower to middle rib cage.

But how unrelated these described rhythmical movements are from the continuous breathing pattern that I observed on Gawain, is difficult to formulate and was a point of constant worry and concern. This problem seemed to me to be absolutely central to his development.

Sometimes I would try to breath as he did.

He would suck his solar plexus in when he inhaled and at the same time his abdomen would bulge out. The lower rib cage would widen dramatically to the sides. When exhaling, his rib cage would relax somewhat and the abdomen would reside.

It was only necessary to make one attempt at a cycle of breathing in this manner to make me feel light-headed, dizzy and nauseated as well. If I tried to perform any additional type of movement during executing these types of breathing motions, the feeling of unwellness was even stronger.

As the years went on, this "pulling in" of the rib cage worsened. Later, as his thorax stiffened and became more rigid, he would often simply not breath for longer periods. It was quite normal for him to inhale, and then hold his breath for 10 or 15 seconds whilst letting the strange pumping movement continue. Afterwards he would usually inhale again before allowing a short exhalation.

When he was sleeping, and apparently his muscle tone relaxed even further, he could only get air by throwing his head back and tearing his mouth wide open. He would gasp for breath two or three times and the pump without breathing for fifteen or twenty seconds without successfully inhaling. When he went through periods like this, we slept hardly at all in the night waiting - for the gasping and snorkelling sound of inhalation and often taking him up and shaking him to get him to wake up enough to breath.

"Why does he breath like that?" I would ask everyone who examined him. But none of his doctors – either specialists or otherwise could answer. "If his breathing situation cannot be improved, how can we expect him to develop further?"

I could not stop asking this question. It seemed so essential, so important. One doctor suggested that perhaps he did not require more oxygen than he was getting. Another ear, nose and throat specialist came somewhat closer to the reality when he observed that the nasal areas are undeveloped in a newborn baby, and usually develop further after birth. In Gawain’s case, he said, these cavities had not completed their development and had stayed at the stage of a newly born child's.

Not only was the functional act of breathing so abnormal, but also the entire respiratory cavities were unable to cleanse themselves in any way. Now I can say, that not only had the cavities failed to develop, but they had continuously collapsed in upon themselves, but then I could not understand his constant and worsening condition.

Gawain’s nose had been blocked since he was six months old. He began to suffer from a terrible sinusitis with 2 ½ years, which continued until he was 8 years old. The asthmatic bronchitis had been chronic since six months. With three years of age he had his first ear infection on both sides and was operated on for mastoiditis. This involved several operations. After that, the ear infections stayed chronic – often one of his ears ran for months. With six years he had to have another ear operation that resulted in a partial loss of hearing in that ear.

The above is an overall description of Gawain’s respiratory state when we first met the work of Leonid Blyum. Upon our first meeting he referred to Gawain’s "paradoxical breathing" and how we would have to address this problem initially. I was relieved to hear that a name existed for the breathing pattern that I had observed for seven years, but what exactly did that mean?

It was through observing hundreds of children with abnormal breathing patterns, that Leonid Blyum could formulate that which he came to describe as a collapse of the bodies internal hydrostatic pressure.

As a highly trained and practiced manual therapist, Leonid Blyum realised in his earliest work with C.P. patients, that, on the one hand, the structural deformities and abnormalities were much more extensive that normally is given notice to. Head shape, head-neck orientation, neck-shoulder connection, shape and size of the thorax and pelvis, positioning of the same, position of the legs in the pelvis – in short - the entire muscular skeletal system showed extreme deviations from that of the healthy individual. In addition, these individuals have a quite different "inner volume and pressure" within the bodily cavities. He found the response to an evenly applied hand pressure on the thorax, abdomen or even head to be weak, slow or rigid in contrast to the response of the healthy individual, revealing the weakened inner membranes and connective tissue quality of such affected persons.

Although all C.P. individuals and people with spinal injuries suffer from a collapse of the hydraulic system, this collapse manifests itself in surprising variety. Gawain’s particular version is what the ABR method describes as a collapse of the dorsal cavities – the spaces at the back of the body. This explains why, over the years, his entire vertebral column became visible immediately below the surface of the skin, as one by one - the spinal processes of each single vertebrae "popped out" - becoming palpable and readable on his dinosaur like back.

Instead of developing the differing curves for the neck, the upper back and the lumbar spine area, Gawain’s back became one rounded "C" shaped structure, with limited ability to upright itself. This meant that the frontal part of each vertebra came into a closer relation to the next one than normal, at the same time widening the distances between the spiny finger-like parts of the vertebrae (spinal processes) on the back. The tilt of each single vertebrae brought a tilt of each individual rib with it, which was further complicated, due to the weakening and ensuing rigidity of each respective joint. The ribs thus took an evermore rotating and downwards journey within the rib cage. The lower ribs protruded to the sides, whilst the upper ribs were compressed, lacking spacing and mobility. The overall appearance of his thorax was wide and extremely flat. In addition it was twisted and asymmetrical.

This gesture was repeated in his arms. The shoulders were rolled forwards and upwards; the clavicle was submerged to the level of the ribs. It was the position of these structures that determined the twist and tightness of his arms and hands.

It is surely not difficult to imagine that his breathing should have been tedious indeed. When one realises that weak muscles have the tendency to develop into stiff and rigid ones, it is clear why Gawain’s breathing became increasingly strenuous and decreasingly efficient over the years.

Since the onset of treatment with ABR we have observed immediate and continuous improvement in this area. The occurring structural changes in the thoracic region have also resulted in dramatic improvements in his day-to-day life.

Slowly, but step by step the rigid upper rib cage loosened, whilst the lower part strengthened. Volume capacity gained continuously. The overall shape has normalised. The breathing can be supported within the ribcage through the strengthening of the diaphragm muscle, so that the abdomen no longer bulges and partakes in the breathing process.

After ¾ of a years treatment, the chronic asthmatic bronchitis that had accompanied him for the last 6 years, had resided completely. Improvements with his ears and nose were gradual but the problems cleared up after 1-½ years of therapy.

When Gawain sleeps, his breathing is deep, rhythmical and continuous. There are no pauses – short or long.

In waking periods however his tendency to hold his breath can still be observed upon occasion, but in a much milder form than was previously evident. This is especially apparent when he is executing an activity that requires a greater physical effort. In this way we can see that his rib cage requires further strengthening, to be able to support the effort.

The relationship between an improved breathing process and countless other functions like movement, speech, song, and general health can easily be imagined, but will be described singularly in following articles.

August 2000  1/2 year before
beginning with ABR.












April 2005










March 2005

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