Beyond the Release: Why Airway Freedom Demands More Than Tongue Mobility

There’s a common misconception in airway-focused care: that a tongue-tie release alone will restore function. But again and again, I see infants still panting, adults still mouth breathing, and fatigue that lingers long after the supposed “fix.” The truth is, airway health and oxygenation require more than a released tongue. They require a body that is ready to breathe—fully, reflexively, and in rhythm with itself. This article explores why the capacity for breath doesn’t start in the mouth, but in the integration of the entire system—especially the respiratory diaphragm, rib cage, and pelvic floor. Because breath is not a localized event. It’s a full-body conversation.

It’s become a common story: the tongue-tie is released, the latch improves—or doesn’t—and yet the infant is still panting, still exhausted, still unable to sustain a full feed. In adults, mouth breathing persists. Fatigue lingers. And everyone is wondering, “But the tongue was the problem… wasn’t it?”

Here’s the truth: The body doesn’t breathe with the tongue. It breathes with the ribs.

Yes, tongue mobility matters. It matters for suck-swallow-breathe coordination, for speech, for oral rest posture. But if the rib cage is collapsed, if the respiratory diaphragm is braced, if the pelvic floor is frozen, then the body cannot draw in air efficiently—regardless of what the tongue is doing.

The Suction System of Breath

The breath is not just an inhale. It’s a coordinated orchestration across diaphragms: the respiratory diaphragm at the base of the ribs, the thoracic inlet and brachial plexus diaphragm above the lungs, and the pelvic diaphragm below. These three diaphragms create a dynamic pressurization system. The rib cage must expand. The respiratory diaphragm must descend. The pelvic floor must respond in kind.

I remember in fourth grade, we made models of the lungs and diaphragm out of balloons, straws, and plastic cups. When you pulled on the bottom balloon—the “diaphragm”—the two inner balloons would inflate, mimicking breath. I played with mine for weeks. Something about it mesmerized me. Even then, before I had words for trauma, for tension, for the freeze that would later live in my own diaphragm, I was captivated by that gentle pull. That rising and falling. That suctioned breath of life.

I didn’t know then what I know now: how easily that mechanism gets locked down. How many bodies can’t make that balloon rise—not because they don’t want to breathe, but because their systems are bracing for survival. Because the diaphragm doesn’t descend in a state of threat. Because breath is one of the first things the body compromises in order to protect us.

The Missing Link Isn’t Always the Mouth

This is why airway work can’t begin and end in the mouth. I’ve seen infants with beautifully released tongues still pant through feeds. I’ve seen adults with perfectly “correct” tongue posture still reliant on mouth breathing. The tongue was never the whole story.

To breathe efficiently, the back body must be online. Spinal Gallant needs to integrate. Hands-pulling must be present. The fascial system around the brachial plexus needs to release. The respiratory diaphragm must be free—not braced in a freeze response. Only then can the body truly “switch on” its natural suction mechanism for air.

What I see in practice are infants whose hands are clenched into fists, unable to integrate Hands Pulling, Babkin or Hands Grasp reflexes. Their arms are locked in, and their bodies are holding so much that there’s no freedom to move into breath. There’s mottling in the hands and feet—a splotchiness that speaks to poor oxygenation and compromised blood flow. The body is surviving, not breathing.

It’s Not About the Right Spot. It’s About the Right System.

Everyone wants to know: is the tongue in the right spot? But I’d argue we’re asking the wrong question. The better question is: Is the body safe enough, integrated enough, stable enough to breathe on its own?

When breath is restored through system-wide integration—when the back body can support the front body, when reflexes organize movement rather than compensate for lack—only then does the airway begin to regulate.

The work doesn’t stop with the release. Sometimes, that’s where it begins.

Where I Begin: Signs, Somatics, and the Slow Path to Breath

I begin by listening—not just to the mouth, but to the movement beneath it. I look for signs the system is trying to do too much with too little: shallow breathing, clenched fists, mottled hands and feet, panting at rest, rapid fatigue during feeds.

I notice if the rib cage is moving. If the breath is rising in the chest or dropping into the belly. If the hands can open. If the feet are responsive. If the body has enough back to support the front.

Sometimes I release the fascial layers around the respiratory diaphragm. Sometimes I work with the brachial plexus or pelvic floor. Sometimes I begin with reflexes—like Spinal Galant or Hands-Pulling—because until there’s postural integrity, breath cannot organize.

Often, I support the nervous system in simply coming out of bracing. Out of withdrawal. Into just enough safety to let the next inhale come more freely.

This is slow work. But it is foundational. Because breath is the first movement toward life. And no release—no matter how skilled—can override a body still holding its breath.