Neck and Core Exercises After TBI for Recovery

Gentle Neck & Core Exercises After Traumatic Brain Injury (TBI): Safe Movement, Integrative Chiropractic Care, and Nurse Practitioner Support

---

After a traumatic brain injury (TBI), many people are afraid to move because they do not want to make things worse. That fear makes sense. But gentle, guided movement is an important part of healing when done safely and with your doctor’s approval. Early exercises like light neck stretches, seated core work, and simple balance drills can reduce stiffness, lower neck tension, and slowly improve balance and confidence. Flint Rehab+1

This article explains:

• Why gentle movement matters after TBI

• How to perform simple neck, core, and trunk exercises

• Safety rules you should follow before and during exercise

• How integrative chiropractic care can support recovery

• How nurse practitioners help coordinate and monitor your whole care plan

Throughout, we will also highlight clinical observations from Dr. Alexander Jimenez, DC, APRN, FNP-BC, an El Paso–based chiropractor and nurse practitioner who uses a dual-scope, integrative model to support recovery from TBI and head injuries. El Paso Back Clinic+2El Paso, TX Doctor Of Chiropractic+2

Important: This article is educational and not personal medical advice. Always get clearance from your doctor or care team before starting or changing any exercise routine after a brain injury.

---

Why Gentle Movement Matters After TBI

After a TBI or concussion, many people experience:

• Neck pain and stiffness

• Headaches and dizziness

• Poor balance and fear of falling

• Tiredness, brain fog, and muscle tightness

The neck is often injured along with the brain, especially in car accidents, sports-related impacts, and falls. The U.S. Military Health System notes that neck pain often occurs with headaches after a concussion, and that gentle neck movements and posture changes can help reduce this discomfort. Military Health System+1

Gentle exercise supports recovery by:

• Promoting neuroplasticity – repeated, safe movements help the brain form new connections and relearn skills. Flint Rehab+1

• Improving blood flow to the brain, neck, and trunk muscles

• Reducing muscle stiffness from too much rest or guarding

• Improving balance and reducing the risk of falls through targeted exercises Flint Rehab+1

• Boosting mood and confidence, which are key for long-term recovery CDC

Programs like Flint Rehab’s home TBI exercises and balance drills, as well as state-sponsored TBI recovery guides, all encourage gentle, progressive movement as long as it is monitored and cleared by a clinician. Flint Rehab+2Flint Rehab+2

---

Safety First: Rules Before You Exercise After a TBI

Before starting neck, core, or balance exercises, safety must come first. Brain injuries are complex, and you may also have neck, spine, or other injuries that require special care. Mayo Clinic and CDC concussion guides, along with military TBI fact sheets, recommend clear limits and careful monitoring of symptoms. CDC+2Military Health System+2

Always:

• Get medical clearance from a doctor, nurse practitioner, or rehabilitation specialist.

• Tell your provider about any neck injuries, fractures, disc problems, or severe dizziness.

• Start low and go slow – fewer reps, smaller ranges of motion, and short sessions.

• Stop immediately if you notice:

  • Sharp or worsening headache

  • New or increasing dizziness or vertigo

  • Blurry vision, double vision, or ringing in the ears

  • Numbness, tingling, or weakness in arms or legs

  • Nausea, chest pain, or trouble breathing

• Use good support: a sturdy chair, armrests, and someone nearby if you feel unsteady.

• Avoid quick head movements until your clinician says it is okay.

Many concussion home-exercise guides recommend starting in sitting or lying positions and progressing gradually to standing and more dynamic movement, especially when balance and vestibular systems are affected. Sheltering Arms Institute+2Flint Rehab+2

---

Gentle Neck Stretches After TBI

Neck pain can make headaches, dizziness, and fatigue much worse. The “Neck Pain Following Concussion/mTBI” fact sheet from the Traumatic Brain Injury Center of Excellence teaches patients to use gentle stretching, posture changes, and relaxing positions to ease symptoms. Military Health System+1

Below are simple exercises often used early in recovery. Do them only if your provider has cleared your neck and you can sit safely.

Set up for All Neck Exercises

• Sit tall in a firm chair, feet flat on the floor

• Relax your shoulders away from your ears

• Move slowly, and stay in a comfortable, pain-free range

• Breathe in through your nose and out through your mouth

1. Chin Tucks (Neck Retraction)

This motion is often recommended for forward head posture, neck pain, and cervical stability. youtube.com+1

• Sit tall and look straight ahead.

• Gently draw your chin backward as if making a “double chin,” keeping your eyes level.

• Do not tilt your head up or down.

• Hold for 3–5 seconds, then relax.

• Repeat 5–10 times if it stays comfortable.

What it helps:

• Reduces forward head posture

• Helps unload tight joints at the base of the skull

• May reduce neck-driven headaches and help balance exercises feel more stable

2. Side Bends (Lateral Flexion)

• Sit tall and keep your nose pointing forward.

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

• Stop when you feel a light stretch on the left side of your neck.

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

• Repeat to the left side.

• Try 3–5 times on each side.

3. Gentle Neck Rotation

• Sit tall and look straight ahead.

• Slowly turn your head to look over your right shoulder within a comfortable range.

• Hold for 5–10 seconds, then return to center.

• Repeat to the left.

• Perform 5 times on each side if symptoms allow.

4. Shoulder Rolls

• Sit or stand tall.

• Gently lift both shoulders toward your ears.

• Roll them backward in a slow circle, then relax.

• Repeat 10 times, then roll forward 10 times.

These simple moves are similar to what many neck pain and concussion programs teach for early self-care, along with posture education and proper sleep positions. Military Health System+2LinkedIn+2

---

Core and Trunk Exercises: Building a Stable Center

Your “core” includes the muscles of your belly, back, and sides. After a TBI, these muscles can weaken or become poorly coordinated, which affects balance and walking. Rehab programs for TBI and stroke consistently show that core strengthening improves stability, gait, and daily task performance. Flint Rehab+2Flint Rehab+2

These exercises are performed while sitting to ensure safety. Always use a sturdy chair with a back and, ideally, armrests.

1. Seated Marching

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

• Tighten your stomach muscles gently (as if bracing before a cough).

• Lift your right knee a few inches, then lower it.

• Lift your left knee the same way.

• March slowly, 10–20 steps total, as tolerated.

What it helps:

• Activates core and hip muscles

• Begins to retrain walking patterns

• Can be progressed with small arm swings or light ankle weights (with supervision)

2. Lateral Trunk Flexion (Side-Leaning)

• Sit tall with feet flat.

• Place your hands on your thighs or lightly hold the chair.

• Gently lean your shoulders and ribcage toward the right side as if reaching toward your right hip, keeping your sit bones on the chair.

• Return to the center and repeat to the left.

• Try 10 slow leans side-to-side.

To make it harder, you may reach one hand toward the floor, but only if your balance is steady and your clinician approves.

3. Seated Trunk Extension

• Sit tall with your hands crossed over your chest or resting on your thighs.

• Breathe in and gently lift your chest upward, imagining a string pulling your breastbone toward the ceiling.

• Keep your head in line with your spine (do not throw it back).

• Hold for 3–5 seconds, then relax.

• Repeat 10 times.

This type of upright extension helps counteract slumped posture and thoracic kyphosis, which often worsen after injury and prolonged sitting. El Paso Injury Doctors

4. Simple Weight Shifts

Balance-focused TBI programs often use weight shifts to retrain the brain and body to control the center of gravity. Flint Rehab+1

Seated version (beginner):

• Sit tall with feet shoulder-width apart.

• Gently shift your weight toward your right hip while keeping both feet on the floor.

• Hold for 3–5 seconds, then shift to the left.

  Book Appointment 24/7

  Stop Suffering. There is NO need to remain in PAIN. Our Allied Back & Joint Specialists and Doctors are here to help you back to a pain-free life. Book an online appointment anytime at your convenience. Call Us Today: 915-850-0900

  Book Online Appointment

• Repeat 10–20 slow shifts.

Standing version (only with approval and support):

• Stand holding a counter or the back of a chair.

• Feet shoulder-width apart.

• Slowly shift weight to your right foot, lifting the left heel slightly.

• Then shift to the left foot.

• Stop if you feel unsteady or dizzy.

---

Adding Gentle Balance and Coordination Work

After TBI, many people struggle with dizziness, “uneven” walking, and fear of falling. Balance exercises, when supervised and progressed correctly, can reduce fall risk and improve independence. Flint Rehab+1

Examples of early-stage balance and coordination drills include:

• Seated balance holds

  • Sit near the front of the chair and cross your arms over your chest.

  • Gently tighten your core and hold your balance for 20–30 seconds.

• Heel-toe foot placement (in sitting)

  • Sit tall and place one foot slightly in front of the other, with the heel touching the toes of the opposite foot.

  • Hold for 20–30 seconds, then switch sides.

• Upper-body coordination while seated

  • Clap your hands slowly in front of you, then tap each thigh.

  • Add gentle head turns if your vestibular system can tolerate it (only with clearance).

Some programs also incorporate yoga-style poses, such as modified cat-cow or seated forward folds, which can help with flexibility and calming, as long as they do not trigger dizziness or headaches. Flint Rehab

---

How Integrative Chiropractic Care Supports This Process

Integrative chiropractic care focuses on the spine, nervous system, and whole-body function. After TBI, subtle misalignments and restricted joints in the neck and upper back can make headaches, dizziness, and postural problems worse. Pinnacle Health Chiropractic+1

Chiropractic offices that understand TBI recovery may offer:

• Gentle spinal and cervical adjustments to improve joint motion and reduce nerve irritation

• Soft tissue techniques for tight neck, shoulder, and jaw muscles (often stressed after concussion and whiplash) HML Functional Care+1

• Postural retraining, including forward-head and thoracic posture exercises

• Vestibular and gaze-stabilization drills, especially when dizziness comes from neck or inner-ear dysfunction

• Home exercise guidance, including neck stretches, core work, and safe progressions

Pinnacle Health Chiropractic describes several ways chiropractic care supports healing after TBI, including restoring spinal alignment, improving blood flow, and pairing adjustments with rehabilitative exercises to support the brain’s ability to reorganize and recover. Pinnacle Health Chiropractic+1

Dr. Alexander Jimenez’s Clinical Observations

Dr. Alexander Jimenez, DC, APRN, FNP-BC, in El Paso, Texas, offers a dual-scope model that blends chiropractic and nurse practitioner care for patients recovering from head injuries.LinkedIn+1 His clinical notes and articles on TBI recovery exercises emphasize: El Paso, TX Doctor Of Chiropractic+2El Paso Chiropractor Blog+2

• Using gentle cervical, thoracic, and rib adjustments to reduce neck-driven headaches and dizziness

• Combining spine work with vestibular training, posture, and breathing drills, and graded activity

• Building core and trunk strength through seated marching, trunk flexion/extension, and weight shifts

• Integrating functional medicine, such as nutrition and sleep support, to reduce inflammation and support nervous system healing

In his TBI exercise guides, Dr. Jimenez notes that many patients progress best when spinal alignment, balance training, and cognitive tasks are layered together in a step-by-step plan—always starting with safety screening and clear communication about symptoms. El Paso, TX Doctor Of Chiropractic+1

---

The Nurse Practitioner’s Role in TBI Exercise and Recovery

Nurse practitioners (NPs) play a central role in TBI care. Research in the Journal for Nurse Practitioners and other nursing guidelines shows that NPs are key in detecting TBI, recognizing the wide range of symptoms, and coordinating a rehabilitative team. ScienceDirect+2Rehab Nurse+2

In TBI recovery, a nurse practitioner can:

• Screen and diagnose

  • Recognize subtle symptoms like sleep problems, mood changes, or balance issues

  • Use standardized tools for concussion and mild TBI screening

• Monitor for complications

  • Watch for red flags like worsening headaches, seizures, or changes in behavior

  • Adjust medications that may affect balance, cognition, or sleep PubMed+1

• Coordinate care

  • Refer to and communicate with chiropractors, physical therapists, occupational therapists, and neurologists

  • Help design integrated plans that include neck stretches, core exercises, and balance work

• Teach and support

  • Educate patients and families about pacing, rest, safe activity levels, and symptom tracking

  • Provide written or digital exercise instructions and suggest tools like exercise videos or checklists CDC+1

Dr. Jimenez’s own practice demonstrates this dual role in action: he evaluates both the neuromusculoskeletal system and overall health, orders or interprets imaging as needed, and then helps patients follow an individualized, graded exercise plan tailored to their medical status. El Paso, TX Doctor Of Chiropractic+2El Paso Back Clinic+2

---

Putting It Together: A Simple, Sample Daily Routine

This is a general example only. It is not a prescription and must be cleared and adapted by your own provider.

Morning (5–10 minutes)

• 5–10 chin tucks

• 3–5 side bends on each side

• 10 shoulder rolls forward and backward

• 5–10 seated marches

Midday (5–10 minutes)

• 10 seated weight shifts side-to-side

• 10 lateral trunk leans (gentle range)

• 5 seated trunk extensions with breathing

• 1–2 short seated balance holds (20–30 seconds)

Evening (5–10 minutes)

• Review the gentle neck stretches that felt good earlier in the day

• Add a simple breathing or relaxation exercise (such as slow diaphragmatic breathing) to calm the nervous system and promote sleep. Flint Rehab+1

You and your care team can progress this routine by:

• Adding repetitions or sets

• Slowly increasing the range of motion

• Introducing standing weight shifts, heel-toe stance, or short walks when safe

• Pairing physical tasks with simple cognitive tasks (counting backward, naming categories)

Chiropractors and nurse practitioners working together can help decide when and how to progress these steps and when to rest or back off based on your symptoms day to day. Pinnacle Health Chiropractic+2ScienceDirect+2

---

When to Stop and Seek Medical Help

After a TBI, you should stop exercising and contact your provider if you notice:

• A headache that gets suddenly worse

• Repeated vomiting, severe dizziness, or fainting

• New vision problems or ringing in the ears

• Weakness, numbness, or burning sensations in arms or legs

• Confusion, unusual behavior, or trouble speaking

CDC discharge instructions and military health resources both stress that these symptoms can signal complications that need urgent medical evaluation. CDC+2ChiroMed+2

---

Final Thoughts

Gentle neck stretches and core/trunk exercises—like chin tucks, side bends, seated marching, lateral trunk flexion, and seated trunk extension—can support early recovery after TBI by easing neck tension, improving posture, and retraining balance. When these exercises are introduced carefully, watched closely, and combined with integrative chiropractic care and nurse practitioner oversight, many patients slowly regain confidence and function. Flint Rehab+2Flint Rehab+2

An integrated team, like the dual-scope model used by Dr. Alexander Jimenez in El Paso, can help you move safely from fragile early recovery to more active, independent living—one careful, well-supported step at a time. El Paso Back Clinic+2El Paso, TX Doctor Of Chiropractic+2

---

References

• Centers for Disease Control and Prevention. (2024). Recovering from a mild traumatic brain injury or concussion. [PDF].
  https://www.cdc.gov/traumatic-brain-injury/media/pdfs/2024/05/patient_discharge_instructions_ENG-508.pdf CDC

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

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

• Flint Rehab. (n.d.). Full body rehab exercises for brain injury patients (ebook).
  https://cdn.flintrehab.com/uploads/2019/04/Exercises-for-Brain-Injury-Recovery.pdf Flint Rehab

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

• Illinois Department of Central Management Services (BeWell Illinois). (n.d.). Traumatic brain injury recovery: Full-body & cognitive TBI exercises to try at home.
  https://cms.illinois.gov/benefits/stateemployee/bewell/getmoving/traumatic-brain-injury-recovery.html El Paso Back Clinic

• Military Health System – TBICoE. (2020, July 30). Neck pain following concussion/mTBI fact sheet.
  https://health.mil/Reference-Center/Fact-Sheets/2020/07/30/Neck-Pain-Following-ConcussionmTBI-Fact-Sheet Military Health System+1

• Pinnacle Health Chiropractic. (n.d.). Six ways chiropractic care supports healing after TBI.
  https://www.pinnaclehealthchiro.com/blog/six-ways-chiropractic-care-supports-healing-after-tbi Pinnacle Health Chiropractic+1

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

• Valente, S. M. (2011). Traumatic brain injury. Journal for Nurse Practitioners.
  https://www.sciencedirect.com/science/article/abs/pii/S155541551100482X ScienceDirect

• Wheeler, L. (n.d.). Veterans with co-morbid posttraumatic stress disorder and mild traumatic brain injury: The nurse practitioner’s role in facilitating treatment. Journal of Military and Veterans’ Health.
  https://jmvh.org/article/veterans-with-co-morbid-posttraumatic-stress-disorder-and-mild-traumatic-brain-injury-the-nurse-practitioners-role-in-facilitating-treatment/ JMVH

• Flint Rehab. (2024, June 3). Core exercises for stroke patients to help improve balance.
  https://www.flintrehab.com/core-exercises-for-stroke-patients/ Flint Rehab

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

• Jimenez, A. (2025, November 4). Rehabilitation exercises after head injuries—step-by-step plan.
  https://dralexjimenez.com/rehabilitation-exercises-after-head-injuries-step-by-step-plan/ El Paso, TX Doctor Of Chiropractic

• Jimenez, A. (2025, November 8). Traumatic brain injury recovery: Exercises and strategies.
  https://elpasobackclinic.com/traumatic-brain-injury-recovery-exercises-and-strategies/ El Paso Back Clinic+1

• Jimenez, A. (n.d.). Dr. Alexander Jimenez – El Paso chiropractor & nurse practitioner (integrative care portal).
  https://dralexjimenez.com/ El Paso Back Clinic

• Jimenez, A. (n.d.). Dr. Alex Jimenez LinkedIn profile.
  https://www.linkedin.com/in/dralexjimenez/ LinkedIn