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Let’s begin by making three radical assumptions. The first is that although the initial injury occurs to the tissue of the brain, the crippling motor problems that increase as the children develop are not only because of the brain injury but also because of other changes occurring in the muscular skeletal system especially the respiratory system including the diaphragm.

Despite its medically acknowledged pivotal position in the respiratory system most lay people have no idea what the diaphragm actually looks like. It is usually cut away in anatomy books to show the organs lying underneath and therefore represented merely as a thin membrane. In fact it is a huge umbrella-like organ, separating the thoracic from the abdominal cavity. When most people think of the act of breathing they think of it as a means of gas exchange but it is also pressure exchange.

The second radical assumption is that in fact the pressure changes in the thorax and abdomen created by the movement of the diaphragm have a profound effect on muscular skeletal and neurological development and maintenance.

The third radical assumption is that the brain’s outgoing signals are in fact entirely limited by the degree of electrical activity present in the body’s tissue.

So let’s put these assumptions together in reverse order and add a little more to the story to get at the Scotson strategy which is also called The Scotson Technique (TST). The approach is based on certain physiological facts: (1) blood supply carrying minerals across the cell membrane makes every cell a little battery. (2) Cells make up tissues; tissues make up organs and their connections. (3) Blood arrives at the cells through the capillaries. (4) The more capillaries there are the greater the cell growth and the stronger the tissue structures. (5) The blood flow through the capillaries is therefore a producer of varying levels of electrical activity which may be crucially necessary for nervous communication between the brain and the tissues making up the body’s physical systems.

When capillary blood flow is reduced by, for example local vasoconstriction, compression or damage, the tissue electrical activity falls and the brain has no idea where to send its outgoing signal. Does this really happen? Well, we have every day experiences when our fingers get numb or when an arm goes “dead” if we lie on it. Trying to get the sensation back by just using our brain simply isn’t possible.

Delicate capillaries are easily constricted and blood pressure through them is low. Every breath we take may act on the pre-capillary sphincter muscles and the capillaries, like compression and decompression on a sponge sucking water up into it. Thus the continuous pressure changes exerted on the surrounding tissue by breathing may not be inconsequential but could have a modifying effect on that tissue.

1. If this is so it is reasonable to propose that besides strengthening and maintaining skeletal muscle, the internal pressures that are the result of breathing gradually improve the strength of connective tissues between bones.

2. Strong thicker connective tissues open up the infant’s shoulder and pelvic girdle, and strengthen and develop the structure of the spine and the structures of the neck and so on.

3. This changes the alignment and rotational capacity of the limbs and increases blood flow and so electrical activity to the tissues of the limbs and their joints.

The Scotson therapeutic approach therefore sees the diaphragm as a key organ on which the development and maintenance of the body’s physical structure and both general and cerebral metabolic functions depends.

By focusing therapy on the diaphragm and upper respiratory muscles the technique is not merely addressing symptoms or supplying management or extensive training but building a deeply restorative treatment leading to functional change which all parents are capable of being taught.

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