Posture Exercises for Traumatic Brain Injury Recovery

Integrative Chiropractic and Posture Exercises for Traumatic Brain Injury

 

Recommended post-traumatic brain injury (TBI) posture exercises focus on gentle neck stretches and simple core and trunk movements that are safe, slow, and carefully monitored. When used with integrative chiropractic care and support from a nurse practitioner, these exercises can help improve posture, reduce neck tension, and support early brain recovery. (Flint Rehab, 2024; Mayo Clinic, 2024) Flint Rehab+1

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Why posture matters after a traumatic brain injury

After a TBI or concussion, many people develop:

• Stiff neck and upper back muscles

• Forward head posture

• Poor balance and trunk control

• Headaches, dizziness, or “heavy” head feeling

Changes in muscle tone, vision, balance, and body awareness make it hard for the brain to manage posture the way it used to. This often leads to slumped posture, rounded shoulders, or a head jutting forward over the chest. (Healthline, 2023) Healthline

Good posture after TBI is important because it can:

• Reduce strain on the neck and shoulders

• Improve breathing and blood flow

• Support better balance and walking

• Decrease the risk of chronic pain and forward head posture (Healthline, 2023) Healthline

Early, safe movement—especially gentle neck and trunk exercises—can help the nervous system “re-learn” how to hold the body upright. (Flint Rehab, 2024) Flint Rehab

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Safety first: rules before starting posture exercises

Posture exercises after TBI must always be done carefully. Before trying anything new, make sure:

• A medical professional has cleared you for exercise.

• Your neck is stable (no unstable fractures or fresh surgery).

• Your dizziness, headaches, and vision changes are reasonably controlled.

Always follow these basic safety rules:

• Start slowly. Begin with small movements and low repetitions.

• Stop if symptoms worsen. If you notice increased headache, dizziness, nausea, double vision, or sharp pain, stop and rest.

• Avoid quick, jerky motions. Move smoothly and in control.

• Use support. Sit in a stable chair with a back; use armrests or another person as needed.

• Breathe normally. Never hold your breath during exercises.

Many TBI rehabilitation programs recommend supervised exercises at first, then gradual progression at home as the brain and body recover. (Illinois CMS, 2022; Flint Rehab, 2024) Illinois CMS+1

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Gentle neck stretches to reduce tension and improve alignment

Neck stretches are often the first step in a posture program after a concussion or TBI. They help loosen stiff muscles, ease pain, and prepare the body for core and balance work. Achieve Brain & Spine, for example, recommends gentle flexion, extension, rotation, and side-bending exercises performed slowly and only within a comfortable range. achievebrainandspine.com

Chin tuck (or chin glide)

The chin tuck is one of the most important posture exercises because it trains the head to sit over the shoulders instead of forward.

How to do it (seated):

1. Sit tall with your back supported and feet flat on the floor.

2. Look straight ahead.

3. Gently draw your chin straight back, as if making a “double chin,” without tipping your head up or down.

4. Hold for 3–5 seconds, then relax.

5. Repeat 5–10 times, if comfortable.

This movement strengthens the deep neck flexors, which are often weak in forward head posture and after neck strain. (Achieve Brain & Spine, n.d.; Healthline, 2023) achievebrainandspine.com+1

Side-bend stretch

Side-bend stretches help release tight muscles that pull the head to one side.

• Sit tall with shoulders relaxed.

• Slowly tilt your head toward one shoulder (the ear toward the shoulder), without rotating your head.

• Hold for 10–20 seconds, then return to center.

• Repeat on the other side.

• Try 3–5 times on each side, as tolerated.

Do not pull on your head with your hand. The stretch should feel gentle, not sharp or burning.

Forward and backward nods (flexion and extension)

These movements keep your neck from becoming stiff and help maintain the normal curve.

• Drop your chin gently toward your chest. Hold a few seconds, then return to center.

• Slowly look up toward the ceiling, only as far as is comfortable, then return to center.

Some clinics recommend doing these seated to avoid losing balance. (Achieve Brain & Spine, n.d.) achievebrainandspine.com

Shoulder blade squeeze

Posture is not just about the neck; the upper back is just as important.

• Sit tall, and bend your elbows to about 90 degrees with palms facing forward.

• Gently squeeze your shoulder blades together, as if pinching a pencil between them.

• Hold for 3–5 seconds, then relax.

• Repeat 10 times, if tolerated.

This exercise helps open the chest, reduce rounded shoulders, and support the neck. (Achieve Brain & Spine, n.d.) achievebrainandspine.com

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Core and trunk exercises to support upright posture

Once basic neck stretches are comfortable, simple seated core and trunk exercises can help stabilize the spine. Strong core muscles are key to balance and preventing slouching. (Flint Rehab, 2024) Flint Rehab

Seated marching

Seated marching builds trunk stability and hip control without standing.

How to do it:

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

• Gently tighten your abdominal muscles (think “brace your belly”).

• Lift one knee a few inches off the floor, then lower it.

• Alternate legs in a marching pattern.

• Start with 10–20 marches total (5–10 per side), resting as needed.

Seated marching helps the brain coordinate leg movement and core control, which carries over to walking.

Seated trunk extension

This movement teaches your body to come out of a slouched posture.

• Sit at the front of the chair with feet flat.

• Fold your arms across your chest or place your hands on your thighs.

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

• Then slowly straighten up and gently “grow tall,” lifting your chest.

• Repeat 8–10 times.

The goal is a smooth, controlled motion—no fast “sit-ups.” If you feel dizzy, stop and rest. (Flint Rehab, 2024) Flint Rehab

Lateral trunk flexion (side bending)

Side-bending strengthens the muscles that keep you from leaning too far to one side.

• Sit tall with your hands resting on your thighs.

• Slide one hand down toward the side of the chair, letting your trunk bend slightly to that side.

• Keep your head in line with your trunk; don’t twist.

• Return to the upright and repeat on the other side.

• Try 5–8 times each way.

These motions are especially helpful for people whose posture tends to drift to one side after a brain injury.

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Balance and whole-body posture training

After TBI, balance is often affected, altering posture and increasing fall risk. Simple balance exercises help the brain reconnect with the body and improve stability. (NEOFECT, 2021; Flint Rehab, 2024) Flint Rehab

Weight shifts (sitting or standing)

Weight shifts are a gentle way to retrain your balance system.

Seated version:

• Sit tall, feet flat on the ground.

• Slowly shift your weight to your right hip, then to your left, without lifting your feet.

• Then shift your weight slightly forward and back.

• Keep the movements small and controlled.

Standing version (only with medical clearance and support):

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

• Gently shift weight from one foot to the other, then forward and back.

• Hold onto support as needed.

Start with 10–20 gentle shifts. Stop if dizziness, headache, or nausea increases. (Flint Rehab, 2024) Flint Rehab

Seated or supported “yoga-style” posture work

Modified yoga poses, such as a seated version of cat-cow, can mobilize the spine while focusing on breathing and relaxation. (Flint Rehab, 2022) Flint Rehab

For example:

• Sit tall with your hands on your thighs.

• As you breathe in, gently arch your back and open your chest (“cow”).

• As you breathe out, gently round your upper back and let your head come slightly forward (“cat”).

• Repeat 5–10 times, moving slowly with your breath.

These slow, mindful movements can calm the nervous system and improve body awareness.

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Addressing forward head posture and rounded shoulders

After TBI and neck pain, many people develop forward head posture and rounded shoulders, which increase stress on the cervical spine and can worsen headaches. (Healthline, 2023) Healthline

Forward head posture:

• Increases compressive forces on the neck

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• Strains muscles and ligaments

• Can compress nerves and contribute to numbness or tingling

Programs that combine chin tucks, shoulder blade squeezes, and education on workstation setup (monitor at eye level, supportive chair, breaks from screens) have been shown to reduce forward head posture and neck pain. (Achieve Brain & Spine, n.d.; Healthline, 2023) achievebrainandspine.com+1

Daily posture tips:

• Keep screens at eye level.

• Use a chair that supports your lower back and allows your feet to rest flat on the floor.

• Take short movement breaks every 30–60 minutes.

• Avoid long periods of looking down at phones or tablets.

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How integrative chiropractic care supports posture after TBI

Integrative chiropractic care can be an important part of recovery when used alongside medical and rehabilitation services.

Chiropractors trained in neurologically informed approaches:

• Assess spinal alignment, joint motion, and muscle balance

• Look for areas of restricted movement in the cervical and thoracic spine

• Use gentle, precise adjustments and soft tissue therapy to restore motion and reduce pain

Some clinics report that correcting misaligned vertebrae can help relieve nerve irritation, reduce headaches, and improve mobility and cognitive clarity after TBI when care is carefully coordinated with the overall medical team. Northwest Florida Physicians Group+1

Dr. Alexander Jimenez, DC, APRN, FNP-BC, in El Paso, emphasizes combining spinal adjustments, posture corrective care, neurology-informed assessment, and rehabilitative exercise to address both musculoskeletal and nervous system changes after trauma. His clinic integrates advanced imaging, posture analysis, and functional neurology concepts to guide safe, progressive care for head, neck, and spine injuries. El Paso, TX Doctor Of Chiropractic

Potential benefits of integrative chiropractic care after TBI:

• Reduced neck pain and muscle tension

• Improved joint motion and spinal alignment

• Support for better posture and balance

• Relief of some headache and dizziness symptoms when appropriate

• Education on safe movement, ergonomics, and home exercises

Chiropractic care must be customized for each person, especially after a brain injury. High-velocity techniques may not be appropriate for all patients; many providers use lower-force methods, instrument-assisted techniques, or mobilization when needed. (Calibration Mansfield, 2023; Northwest Florida Physicians Group, 2022) Northwest Florida Physicians Group+1

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The nurse practitioner’s role in posture-focused TBI recovery

A nurse practitioner (NP) with trauma, neurology, or rehabilitation experience is often the “consistent thread” in the TBI team, helping to coordinate care across emergency, inpatient, and outpatient settings. (Freeborn, 2004) Nursing Center

Key ways a nurse practitioner supports posture and TBI care:

• Comprehensive assessment:

  • Screens for TBI-related symptoms, including headaches, dizziness, vision changes, and mood or sleep problems.

  • Evaluates neck pain, range of motion, and posture.

• Care coordination:

  • Refers to physical therapy, chiropractic, neurology, neuropsychology, and vestibular rehab as needed.

  • Ensures all providers share information and follow consistent safety guidelines.

• Patient and family education:

  • Explains which exercises are safe, how often to do them, and warning signs that require medical attention.

  • Provides written instructions and visual aids, especially helpful when memory or concentration is affected.

• Monitoring for complications:

  • Watches for signs of worsening intracranial pressure, seizures, depression, or cognitive decline.

  • Adjusts the care plan if symptoms flare with certain movements or activities.

In integrative settings, an NP may also address sleep, nutrition, medications, and coexisting medical issues that influence healing, such as blood pressure, blood sugar, and pain management. (Mayo Clinic, 2024) Mayo Clinic

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Building a simple daily posture routine after TBI

Every person’s TBI recovery plan is different, so this is just an example that must be adjusted with your healthcare team’s guidance. A simple daily posture routine might include:

Warm-up (3–5 minutes):

• Deep, relaxed breathing

• Gentle neck flexion/extension

• Slow side-bend stretches

Core and posture (5–10 minutes):

• Chin tucks: 5–10 repetitions

• Shoulder blade squeezes: 10 repetitions

• Seated marching: 10–20 marches

• Seated trunk extension: 8–10 repetitions

• Lateral trunk flexion: 5–8 each side

Balance and body awareness (5–10 minutes):

• Seated or standing weight shifts: 10–20 shifts

• Simple seated “cat-cow” spine movements

• Short, supported standing practice with proper head and shoulder alignment

Cool-down (2–3 minutes):

• Gentle neck stretches

• Relaxed breathing with focus on posture and body awareness

Always check in with your symptoms during and after exercise. If you feel worse, scale back and talk with your NP, physical therapist, or chiropractor.

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When to pause exercises and call your provider

Stop exercising and contact your nurse practitioner, chiropractor, or medical provider if you notice:

• Sudden severe headache

• New or worsening dizziness or vertigo

• Nausea or vomiting that does not settle with rest

• Double vision or sudden vision changes

• Numbness, weakness, or loss of coordination

• Strong neck pain or a feeling of instability

These signs may mean your brain or cervical spine needs a new evaluation or imaging before continuing. (Mayo Clinic, 2024) Mayo Clinic

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How Dr. Jimenez’s integrative team might support someone with TBI and posture problems

Clinically, Dr. Alexander Jimenez’s dual training as a chiropractor and board-certified family nurse practitioner allows him to:

• Evaluate the brain–spine connection using neurological and musculoskeletal exams

• Order and interpret imaging when needed (X-ray, MRI, CT)

• Design phased care plans that blend chiropractic adjustments, posture corrective care, and rehabilitative exercises

• Coordinate with physical therapists, neurologists, and other specialists in complex injury cases

• Educate patients and families about safe home exercises, ergonomics, sleep, and nutrition that support brain healing

This type of integrative model can be especially helpful for individuals recovering from motor vehicle accidents, sports injuries, or falls who are dealing with both head injury and spinal dysfunction. El Paso, TX Doctor Of Chiropractic

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Final thoughts

Posture exercises after a traumatic brain injury are not about pushing hard; they are about helping the brain and body reconnect safely. Gentle neck stretches, such as chin tucks and side bends, along with core and trunk exercises like seated marching, lateral trunk flexion, and seated trunk extension, can help relieve neck tension, improve balance, and support long-term spinal health when performed under medical guidance. (Flint Rehab, 2024; Achieve Brain & Spine, n.d.) Flint Rehab+1

When these exercises are combined with integrative chiropractic care and coordinated by a knowledgeable nurse practitioner, patients receive support for both their nervous and musculoskeletal systems. Over time, this team-based approach can improve posture, reduce pain, and help individuals move more confidently as they continue their TBI recovery journey.

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References

Achieve Brain & Spine. (n.d.). Patient exercises. https://www.achievebrainandspine.com/resources/patient-exercises/

Flint Rehab. (2024). Traumatic brain injury recovery exercises: 20 best TBI exercises. https://www.flintrehab.com/exercises-for-brain-injury-recovery/

Freeborn, K. (2004). Neurotrauma—The role of the nurse practitioner in traumatic brain injury. Topics in Emergency Medicine, 26(3), 225–230. https://www.nursingcenter.com/journalarticle?Article_ID=527301&Journal_ID=420955&Issue_ID=527288

Healthline. (2023). Forward head posture: Exercises and stretches to try. https://www.healthline.com/health/bone-health/forward-head-posture

Illinois Department of Central Management Services. (2022). Traumatic brain injury recovery. https://cms.illinois.gov/benefits/stateemployee/bewell/getmoving/traumatic-brain-injury-recovery.html

Mayo Clinic. (2024). Traumatic brain injury – Diagnosis & treatment. https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/diagnosis-treatment/drc-20378561

Northwest Florida Physicians Group. (2022). Using chiropractic care to treat traumatic brain injuries. https://northwestfloridaphysiciansgroup.com/using-chiropractic-care-to-treat-traumatic-brain-injuries/

Calibration Mansfield. (2023). How can integrative chiropractic care help with traumatic brain injuries? https://calibrationmansfield.com/how-can-integrative-chiropractic-care-help-with-traumatic-brain-injuries/

NEOFECT. (2021). Balance exercise after brain injury. https://www.neofect.com/blog/balance-exercise-after-brain-injury

Sheltering Arms Institute. (2023). Concussion treatment: Exercises you can do at home. https://shelteringarmsinstitute.com/rehablogs/concussion-treatment-exercises-you-can-do-at-home/

Flint Rehab. (2022). Yoga poses for brain injury. https://www.flintrehab.com/yoga-poses-for-brain-injury/

Healthline. (2022). Kyphosis exercises. https://www.healthline.com/health/exercise-fitness/kyphosis-exercises

Back Intelligence. (n.d.). How to fix forward head posture. https://backintelligence.com/how-to-fix-forward-head-posture/

Back Intelligence. (n.d.). Cervical herniated disc exercises. https://backintelligence.com/cervical-herniated-disc-exercises/

PhysioTattva. (2023). Exploring effective concussion treatment and recovery strategies. https://www.physiotattva.com/blog/exploring-effective-concussion-treatment-and-recovery-strategies

Healix Therapy. (2023). Neck exercises for TMJ pain relief. https://healixtherapy.com/neck-exercises-tmj-pain-relief/

Tigard Chiropractic & Auto Injury. (2023). Navigating recovery: Exercise plans after chiropractic care. https://www.tigardchiropracticautoinjury.com/navigating-recovery-exercise-plans-after-chiropractic-care

HML Functional Care. (2023). How chiropractic neurology supports brain healing. https://hmlfunctionalcare.com/how-chiropractic-neurology-supports-brain-healing/

Aurora Chiropractic. (2023). Chiropractic care for head injuries. https://aurora-chiropractic.com/chiropractic-care-for-head-injuries/

Pinnacle Health Chiropractic. (2023). Six ways chiropractic care supports healing after TBI. https://www.pinnaclehealthchiro.com/blog/six-ways-chiropractic-care-supports-healing-after-tbi

Jimenez, A. (2025). El Paso’s premier chiropractic clinic – Injury Medical Pain Treatment Clinic. https://dralexjimenez.com/