With over 30 years of clinical experience spanning three countries, Pippa Windsor brings specialised expertise in Breathing Pattern Disorders and dysfunctional breathing. Her career began with an interest in respiratory care and musculoskeletal physiotherapy. Her special focus emerged in 1997 when she first encountered patients with Breathing Pattern Disorders at Waitakere Hospital in New Zealand. This discovery led to eight years contributing to the development of the UK's Breathing Pattern Disorders special interest group, before establishing Australia's first dedicated breathing disorders clinic in Perth.
Pippa understands how breathing dysfunction often amplifies autonomic symptoms through complex physiological mechanisms. When cerebral blood flow is compromised due to orthostatic intolerance, the brain triggers a compensatory hyperventilation response to increase oxygen delivery. However, this strategy backfires—chronic hyperventilation creates hypocapnia (low CO2 levels), which actually reduces cerebral blood flow through vasoconstriction, worsening the very problem it attempts to solve.
This creates a vicious cycle: reduced cerebral perfusion triggers hyperventilation, which lowers CO2, which further reduces brain blood flow, which triggers more hyperventilation. Patients become trapped in this maladaptive pattern, experiencing worsened orthostatic intolerance, increased tachycardia, and persistent sympathetic overdrive.
Pippa's systematic approach breaks this cycle by restoring normal CO2 levels through controlled breathing retraining. As patients learn to maintain optimal breathing patterns despite orthostatic challenges, cerebral blood flow improves, reducing the drive to hyperventilate. This breathing work becomes a foundational support for other POTS interventions within Biio's dysautonomia pathway.
Pippa's work with ME/CFS patients focuses on breathing efficiency to support energy conservation and reduce post-exertional malaise (PEM). Patients with ME/CFS often develop inefficient breathing patterns that increase metabolic demand—something their already compromised energy systems cannot sustain.
Her approach emphasizes gentle breathing optimization that works within energy limits rather than demanding increased effort. She teaches techniques to maximize oxygen delivery efficiency and reduce the energetic cost of breathing itself. For severe ME/CFS patients, even small improvements in breathing efficiency can translate to meaningful functional gains while respecting the crucial principle of staying within energy envelopes.
Long COVID patients present unique challenges, often experiencing persistent dyspnea, exercise intolerance, and breathing pattern disruption that outlasts the acute infection. Pippa's assessment differentiates between ongoing tissue damage and developed compensatory breathing patterns that perpetuate symptoms.
Many Long COVID patients develop anxiety-driven hyperventilation or compensatory breathing patterns that maintains breathlessness long after lung function normalizes. Her systematic approach addresses both the physical and neurological components of breathing dysfunction, helping patients rebuild confidence in their breathing capacity while optimizing respiratory mechanics for symptom reduction.
ADHD presents unique breathing challenges that often go unrecognized. Pippa identifies and treats both hyperventilation patterns in hyperactive presentations and hypoventilation patterns in inattentive presentations. ADHD patients frequently develop compensatory breathing strategies that either overstimulate or understimulate their nervous systems.
Hyperactive ADHD patients often hyperventilate during periods of intense focus or stress, leading to symptoms that can be misattributed to anxiety. Conversely, inattentive ADHD patients may develop chronic hypoventilation—shallow, insufficient breathing that contributes to brain fog and fatigue. Pippa's assessment determines which pattern predominates and develops targeted interventions.
Her work with neurodivergent patients recognizes that breathing retraining must account for executive function differences, sensory sensitivities, and the unique ways neurodivergent individuals process interoceptive signals. Treatment approaches are adapted to work with, rather than against, neurodivergent nervous systems.
In patients with hypermobility disorders, Pippa addresses a crucial but often overlooked component: how joint instability creates compensatory muscle bracing patterns that fundamentally alter breathing mechanics. When patients unconsciously brace their core, shoulders, and neck to compensate for joint laxity, the diaphragm can't function optimally.
This compensation creates a cascade: poor breathing leads to increased sympathetic activation, which increases muscle tension, which further restricts breathing—a vicious cycle that amplifies both pain and autonomic symptoms. Hypermobile patients often present with chronic upper chest breathing, accessory muscle overuse, and diaphragmatic dysfunction.
Her treatment addresses both the breathing dysfunction and the underlying compensation patterns. By improving breathing efficiency, patients often find they require less muscular bracing for stability, reducing overall tension and pain. This work is particularly valuable for hypermobile patients who also have POTS, as improved breathing can support both postural control and autonomic regulation.
As the founder of Western Australia's first clinic dedicated exclusively to breathing disorders, Physio2Breathe, Pippa established a new standard of care for conditions that are common but poorly recognized.
The Bradcliff® Method she employs isn't simply breathing exercises—it's a systematic, evidence-based approach to breathing retraining that treats dysfunctional breathing as a faulty movement pattern that can be corrected through structured physiotherapy principles. This methodology is supported by Grade-A evidence in major international guidelines including GINA, BTS, and SIGN.
Pippa's patients often arrive after years of being told their breathlessness is anxiety, deconditioning, or "all in their head." Her thorough assessment process validates their experience while providing concrete explanations for symptoms. She empowers patients with tools for self-management, teaching them to recognize and modify their own breathing patterns.
Treatment is highly individualized, progressing from basic pattern correction in supportive positions to complex integration during challenging activities. Recovery timelines are realistic, acknowledging that breathing pattern changes require consistent practice and gradual progression.