Posture Exercises After TBI: Integrative Chiropractic Care

Improving Posture With Chiropractic Care After TBI: Safe Neck, Core, and Chiropractic Support

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Traumatic brain injuries (TBIs) do much more than affect thinking and memory. Many people also struggle with poor posture, tight neck muscles, and balance problems for weeks or months after the injury. These changes can make it harder to sit upright, walk safely, or look straight ahead without pain. Military Health System+1

The good news is that gentle posture exercises, combined with integrative chiropractic care and support from a nurse practitioner, can help you move more comfortably and safely as you heal. This article explains:

• Why posture often gets worse after a TBI

• Safe, simple neck stretches like chin tucks and side bends

• Core and trunk exercises, such as seated marching and trunk extension

• Balance exercises to support upright posture

• How integrative chiropractic care supports the brain and spine

• How nurse practitioners coordinate care, education, and monitoring

Important: Always get medical approval before starting new exercises after a TBI, and stop right away if symptoms get worse.

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Why Posture Suffers After a Traumatic Brain Injury

After a TBI or concussion, several things can change at the same time:

• Neck muscles can be strained or injured during the same event that hurt the head, such as a car crash or fall. Military Health System+1

• Balance, vision, and inner-ear (vestibular) systems can be affected, making it harder to know where your body is in space. ARN Learning Center+1

• Pain and fatigue can cause you to slouch or hold your head forward to “protect” the injured area.

Over time, this can lead to:

• Forward head posture, where the head juts out in front of the shoulders, increases strain on neck muscles. Military Health System

• Rounded shoulders and upper back (kyphotic posture), which can tighten chest muscles and weaken the upper back. Military Health System

• More headaches, neck pain, and dizziness because the muscles and joints in the neck are under extra stress. Military Health System+1

Gentle posture exercises help retrain your body to sit and stand in a healthier position while also calming overworked muscles and waking up weak ones.

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Safety First: How to Exercise After a TBI

Before diving into specific exercises, safety needs to come first. Brain injuries are complex, and pushing too hard can make symptoms worse. CDC+1

Get Medical Clearance

Talk with your:

• Primary care provider or neurologist

• Rehabilitation specialist or physical therapist

• A nurse practitioner who follows your TBI recovery

They can help you decide which exercises are safe, how often to do them, and what warning signs to watch for. Mayo Clinic+1

General Safety Rules

When starting posture exercises after a TBI:

• Start low and go slow. Begin with small movements and few repetitions.

• Stop if symptoms spike. If you get more dizzy, nauseated, confused, or develop sharp pain, stop and rest. CDC

• Avoid sudden head turns at first if you are prone to dizziness.

• Use support (a sturdy chair, wall, or another person) to stay safe, especially during standing exercises. Flint Rehab+1

• Work in short sessions—for example, 5–10 minutes a few times per day, rather than one long session.

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Gentle Neck Stretches for Early TBI Recovery

Neck pain is very common after a concussion or mild TBI. The neck muscles may tighten to protect the head, worsening headaches and limiting motion. Military Health System+1

The goal of early neck exercises is not to force a big stretch but to move slowly and comfortably within a pain-free range.

Chin Tucks (Seated)

Chin tucks help bring the head back over the shoulders and reduce forward head posture.

How to do it: Military Health System+1

• Sit tall in a chair with your feet flat on the floor.

• Look straight ahead.

• Gently draw your chin straight back, as if making a “double chin.”

• Keep your eyes level; do not tilt your head up or down.

• Hold for 3–5 seconds, then relax.

Try:

• 5–10 gentle repetitions

• 1–2 times per day to start

Tips:

• Move slowly and avoid jerking.

• Stop if you feel sharp pain, dizziness, or numbness.

Side Neck Bends

Side bends can ease tension along the sides of your neck and upper shoulder muscles. Military Health System+1

How to do it:

• Sit or stand tall.

• Gently tilt your right ear toward your right shoulder (do not shrug the shoulder).

• Hold for 10–15 seconds, breathing slowly.

• Return to neutral, then repeat to the left side.

Try:

• 3–5 repetitions per side

• Once or twice daily

Extra Gentle Neck Moves

If your provider approves, you may also try:

• Shoulder rolls (slow circles forward and backward)

• Upper trapezius stretch (ear to shoulder with gentle hand support)

• Small head turns (turning right and left within a comfortable range) Military Health System+1

These movements should feel like mild stretching, not like a strong pull or pain.

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Core and Trunk Exercises to Support Upright Posture

Your core and trunk muscles (abs, back, and side muscles) are the foundation that support your spine. After a TBI, these muscles may become weaker or harder to control, especially if you have been resting more or avoiding movement. Flint Rehab+1

Strengthening these muscles in a safe, seated position is a good way to start.

Seated Marching

Seated marching gently activates your hip flexors, core, and lower trunk muscles. It is well-suited for early recovery, especially if standing exercises feel unsafe. Flint Rehab+2Zao Rehab+2

How to do it:

• Sit near the front of a sturdy chair with your feet flat on the floor.

• Sit tall with your shoulders relaxed.

• Slowly lift one knee toward your chest as if you are marching.

• Lower it back down and repeat with the other leg.

Try:

• 10–20 marches total

• 1–3 sets, depending on how you feel

Make it easier: Use your hands to lightly help lift your leg.

Make it harder:

• Sit without leaning on the backrest.

• Hold each knee up for a couple of seconds.

Seated Trunk Extension

Seated trunk extension strengthens the muscles that help you sit tall and prevent slouching.

How to do it: Flint Rehab+1

• Sit tall in a chair with arms crossed over your chest or resting in your lap.

• Gently lean your upper body forward a little, keeping your back straight.

• Then, slowly return to an upright position, focusing on using your back and core muscles to “lift” yourself tall.

Try:

• 8–12 repetitions

• 1–2 sets, as tolerated

Lateral Trunk Flexion (Side Bends in Sitting)

This exercise targets the side muscles of the trunk, helping you stay centered and balanced. Flint Rehab+1

How to do it:

• Sit tall with your hands on your thighs.

• Gently slide your right hand down toward your right knee, letting your trunk bend slightly to the side.

• Keep both sit bones on the chair; do not twist.

• Return to the center and repeat to the left.

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Try:

• 8–10 bends on each side

• Once per day to start

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Balance and Posture Exercises for Later Stages

Once you can comfortably do seated exercises and your provider agrees, you may slowly move into simple standing balance activities that help align posture from head to toe.

Weight Shifts (Standing)

Weight shifts train your body to maintain good posture as you shift your weight from side to side—important for walking and preventing falls. Flint Rehab+1

How to do it:

• Stand with feet shoulder-width apart, near a counter or sturdy surface.

• Stand tall and look straight ahead.

• Gently shift your weight onto your right foot while lifting your left heel or toes slightly.

• Hold for up to 10–30 seconds if safe.

• Return to the center and repeat on the left side.

Try:

• 5 repetitions per side

• 1–2 sets each day

Safety tips:

• Keep a hand close to a counter or chair for support.

• Have a helper nearby if you are very unsteady.

Simple Yoga-Inspired Movements

Some individuals with TBI benefit from modified yoga poses that combine gentle stretches with breath control and body awareness. For example, a modified cat–cow pose can help mobilize the spine and improve posture when performed slowly and safely. Flint Rehab+1

Always use:

• Stable surfaces (like a sturdy chair)

• Slow breathing

• Small ranges of motion

If traditional yoga classes feel too challenging, a therapist or integrative provider can offer modified versions tailored to your stage of recovery. Flint Rehab+1

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How Integrative Chiropractic Care Supports Posture After TBI

Integrative chiropractic care focuses on the relationship between the spine, nervous system, and whole-body health. For people with TBI, the goal is not to “fix the brain injury” but to support spinal alignment, nerve communication, and overall function so the body can heal better. Calibration Brain & Body+2HML Functional Care+2

Key Ways Chiropractic May Help

Chiropractors trained in integrative or functional approaches may:

• Assess spinal alignment, especially in the cervical spine (neck) and upper back, where posture changes often show up after TBI. Calibration Brain & Body+1

• Use precise, gentle adjustments to correct joint restrictions and improve spinal and rib movement. Calibration Brain & Body+1

• Apply soft-tissue techniques to relax tight muscles and reduce trigger points that cause head and neck pain. Calibration Brain & Body+1

• Coordinate rehabilitation exercises that match the patient’s tolerance, including posture drills, balance work, and breathing exercises. El Paso Back Clinic+1

Evidence and clinical reports suggest that improving spinal mobility and posture can help some TBI patients experience less pain, better balance, and improved cognitive clarity, likely by enhancing nervous system function and blood flow. El Paso Injury Doctors+4Calibration Brain & Body+4HML Functional Care+4

Clinical Observations from Dr. Alexander Jimenez, DC, APRN, FNP-BC

Dr. Alexander Jimenez’s integrative practice in El Paso focuses on functional medicine, spinal alignment, and personalized rehabilitation for patients recovering from injuries, including TBIs. El Paso, TX Doctor Of Chiropractic+2El Paso, TX Doctor Of Chiropractic+2

In his clinical work, he emphasizes:

• Whole-person assessments that consider posture, movement patterns, gut health, sleep, and stress levels. El Paso, TX Doctor Of Chiropractic+1

• Dual-scope care as both a chiropractor and nurse practitioner, allowing him to understand imaging, medications, and rehabilitation together.El Paso, TX Doctor Of Chiropractic+1

• Targeted spinal adjustments and rehab exercises aim to restore head and neck alignment, reduce muscle guarding, and support better balance and coordination. Synergy Chiropractic+2El Paso Injury Doctors+2

Clinically, patients often report that when their posture improves and neck tension decreases, they can better tolerate daily activities, exercise, and cognitive tasks.

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The Nurse Practitioner’s Role in TBI Posture Rehabilitation

Nurse practitioners (NPs) play a central role in both acute and long-term care for TBI. They are often the “connecting thread” who coordinate services, monitor progress, and educate patients and families. Regency Health Care+5NursingCenter+5PMC+5

How NPs Support Safe Exercise and Posture Care

A nurse practitioner involved in TBI rehabilitation may:

• Review your full medical history and current symptoms to decide when it is safe to begin neck and posture exercises. Mayo Clinic+1

• Coordinate referrals to physical therapists, occupational therapists, chiropractic providers, and neuropsychologists. ARN Learning Center+1

• Monitor red flag symptoms, such as worsening headaches, new weakness, vision changes, or mental status changes, and adjust the plan quickly if needed. AANN+1

• Educate patients and families about safe activity levels, home exercise routines, sleep, and stress management. NursingCenter+2PMC+2

They also help ensure continuity of care as patients move from the hospital to rehabilitation and then back into home and community life. PMC+2Regency Health Care+2

In integrated practices like Dr. Jimenez’s, nurse practitioners and chiropractors often work side by side, combining medical evaluation, imaging interpretation, medication management, and manual therapies into a unified plan. El Paso, TX Doctor Of Chiropractic+2El Paso, TX Doctor Of Chiropractic+2

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Putting It Together: A Sample Gentle Daily Routine

Every person with a TBI is different, so your plan should be customized with your healthcare team. The sample below shows how gentle posture care might look after you have medical clearance.

Morning (5–10 Minutes)

• Deep breathing in a comfortable sitting position

• 5–10 chin tucks

• 3–5 side neck bends on each side

• 10–20 seated marches

Midday (5–10 Minutes)

• Short walk (indoors or outdoors) if tolerated

• 1 set of seated trunk extensions

• 1 set of lateral trunk bends on each side

• Light hydration and a rest break

Evening (5–10 Minutes)

• Gentle weight shifts (holding onto a counter if needed)

• Simple neck and shoulder stretches

• Relaxation exercises such as slow breathing or guided imagery

Always listen to your body and adjust your routine with your providers’ help. If you feel wiped out the next day, cut back and progress more slowly. Flint Rehab+1

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When to Stop and Call Your Provider

Stop exercising and contact your healthcare provider or seek urgent care if you notice:

• Strong or sudden headache increase

• New or worsening dizziness, nausea, or vomiting

• New weakness, numbness, or trouble moving an arm or leg

• Blurred or double vision

• Confusion, slurred speech, or behavior changes

• Chest pain or shortness of breath

These signs may indicate that your brain or spine is under excessive stress or that another medical problem is developing. Mayo Clinic+1

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Working With a Team for Better Posture and Recovery

Recovering from a traumatic brain injury is rarely a solo journey. The best outcomes usually happen when:

• You, as the patient, participate actively but safely in your exercises.

• Integrative chiropractic providers correct spinal misalignments, address muscle tension, and guide posture drills that match your ability level. El Paso Injury Doctors+5Calibration Brain & Body+5El Paso Back Clinic+5

• Nurse practitioners coordinate care, monitor warning signs, and adjust the plan as your brain and body heal. ARN Learning Center+3NursingCenter+3PMC+3

• Rehabilitation therapists provide detailed exercise programs for strength, balance, vision, and coordination. Flint Rehab+2Flint Rehab+2

Gentle posture exercises—like chin tucks, side bends, seated marching, lateral trunk flexion, and trunk extension—become powerful tools when they are used slowly, safely, and consistently, and when the whole care team supports you. With time, many people notice better posture, less neck tension, more stable balance, and greater confidence in daily life.

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References

Flint Rehab. (2022, September 21). Traumatic brain injury recovery exercises: 20 best TBI exercises. Flint Rehab. https://www.flintrehab.com/exercises-for-brain-injury-recovery/ Flint Rehab+2Flint Rehab+2

Flint Rehab. (2023, November 14). Balance exercises for brain injury patients of all levels. Flint Rehab. https://www.flintrehab.com/balance-exercises-for-brain-injury-patients/ Flint Rehab

Health.mil – Traumatic Brain Injury Center of Excellence (TBICoE). (2020, July 30). Neck pain following concussion/mTBI fact sheet. Military Health System. https://health.mil/Reference-Center/Fact-Sheets/2020/07/30/Neck-Pain-Following-ConcussionmTBI-Fact-Sheet Military Health System+2Military Health System+2

Mayo Clinic. (n.d.). Traumatic brain injury: Diagnosis & treatment. Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/diagnosis-treatment/drc-20378561 Mayo Clinic

Oyesanya, T. O., Thomas, M. A., & Brown, R. L. (2017). Caring for patients with traumatic brain injury: A survey of nurses’ perceptions. Rehabilitation Nursing, 42(1), 10–17. https://pmc.ncbi.nlm.nih.gov/articles/PMC5192003/ PMC+1

TBICoE & Centers for Disease Control and Prevention. (2024). Recovering from a mild traumatic brain injury or concussion: Patient discharge instructions [PDF]. U.S. Department of Defense. https://www.cdc.gov/traumatic-brain-injury/media/pdfs/2024/05/patient_discharge_instructions_ENG-508.pdf CDC

Zrelak, P. A., et al. (2020). Nursing care of adults with severe traumatic brain injury [Clinical practice guideline]. American Association of Neuroscience Nurses. https://aann.org/uploads/Publications/CPGs/AANN20_sTBI_EBR.pdf AANN+1

Calibration Chiropractic and Functional Health. (2024, August 21). How can integrative chiropractic care help with traumatic brain injuries? Calibration Mansfield. https://calibrationmansfield.com/how-can-integrative-chiropractic-care-help-with-traumatic-brain-injuries/ Calibration Brain & Body

HML Functional Care. (2025, July 22). How chiropractic neurology supports brain healing. HML Functional Care. https://hmlfunctionalcare.com/how-chiropractic-neurology-supports-brain-healing/ HML Functional Care

El Paso Back Clinic. (2025). Integrative chiropractic care benefits in El Paso. El Paso Back Clinic. https://elpasobackclinic.com/integrative-chiropractic-care-benefits-in-el-paso/ El Paso Back Clinic

Dr. Alexander Jimenez, DC, APRN, FNP-BC. (n.d.). Doctor of Chiropractic – Functional & integrative medicine in El Paso, TX. DrAlexJimenez.com. https://dralexjimenez.com/ El Paso, TX Doctor Of Chiropractic

Jimenez, A. (2025, November 6). Chiropractic care for long-term relief from TBI and tinnitus. Injury Medical & Chiropractic Clinic. https://personalinjurydoctorgroup.com/2025/11/06/chiropractic-care-for-long-term-relief-from-tbi-and-tinnitus/ El Paso Injury Doctors

Jimenez, A. (2025, November). Stress and traumatic brain injury: Understanding the effects. DrAlexJimenez.com. https://dralexjimenez.com/stress-and-traumatic-brain-injury-understanding-the-effects/ El Paso, TX Doctor Of Chiropractic

Regency Healthcare System. (2025, March 19). How care coordination enhances the quality of life for TBI patients. RegencyHCS.com. https://www.regencyhcs.com/blog/how-care-coordination-enhances-the-quality-of-life-for-tbi-patients Regency Health Care

Flint Rehab. (2025, July 9). Home exercise program for traumatic brain injury survivors. Flint Rehab. https://www.flintrehab.com/home-exercise-program-for-traumatic-brain-injury/ Flint Rehab

Zaor Rehabilitation. (2023, January 6). A step-by-step guide to walking after brain injury: Exercises & rehabilitation methods. ZAO Rehab. https://zaorehab.com/2023/01/06/a-step-by-step-guide-to-walking-after-brain-injury-exercises-rehabilitation-methods/ Zao Rehab