Document Type

Handbook, Guide or Manual (Third Edition)

Publication Date (Third Edition)




Spinal cord injury can affect normal breathing. The level of your injury will determine the effect it will have. It can be different for everyone. For example, the higher the level of your injury, the more complications you may face. Good pulmonary care can assist in keeping you healthy after your spinal cord injury.


The process of breathing (or respiration) is a two-step process: taking in air (inspiration) and exhaling the waste products. The process of taking in air (inhalation) is an active process, requiring the use of many muscles, while the process of exhaling is a passive process, which occurs when the muscles relax. The muscles of respiration include the diaphragm, and a group of muscles called the accessory muscles. The muscles included in the “accessory group” include your neck muscles, your chest wall muscles and your abdominal muscles. These muscles are the ones that are used when you run or are stressed and assist the diaphragm in taking in larger amounts of air. If your injury is high enough, the neck accessory muscles may become the primary muscles of respiration. By themselves, these muscles are unable to bring in enough air to maintain life on a daily basis. When this occurs, assisted ventilation is used. This assistance can be in the form of a ventilator, phrenic (a nerve that helps make the muscle of breathing work properly) pacers or other non-invasive methods of breathing. Assisted ventilation is used along with other therapies and treatments to try to maintain good pulmonary condition. Without this assistance, the person could suffer severe tissue damage, brain damage or death.

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