TBI, Mobility, and Flexibility: How Movement Changes After a Brain Injury—and How Chiropractic-Integrated Care Can Help Skip to main content

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Chiropractic Podcast

TBI, Mobility, and Flexibility: How Movement Changes After a Brain Injury—and How Chiropractic-Integrated Care Can Help

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Summary: Traumatic brain injuries (TBIs) can change how you move by causing muscle weakness, poor coordination, and balance problems. These issues can make walking, moving your arms or legs, and maintaining good posture more challenging. Pain, fatigue, and dizziness can make mobility even tougher. Inactivity can then lead to muscle shortening (contractures) and less flexibility. A whole-person plan—combining medical care, physical therapy, and chiropractic-integrative support—can help restore alignment, reduce muscle tension, retrain balance, and improve range of motion. This approach also aims to support blood and cerebrospinal fluid (CSF) flow, as well as the nervous system’s ability to heal and adapt. (Headway, n.d.; MSKTC, n.d.; Brain Injury Canada, n.d.; Moon et al., 2022; BIAUSA, n.d.)

What Mobility and Flexibility Mean After a TBI

Mobility is your ability to move—walking, turning, getting up from a chair, and using your arms and hands for daily tasks. Flexibility is how easily your joints and soft tissues move through their range. After a TBI, both can change:

  • Movement may slow down, and balance often worsens. People may need a cane, walker, or wheelchair for safety and energy conservation (Headway, n.d.).

  • Coordination and gait can be affected, from mild sway to obvious stumbling or, in severe cases, paralysis (MSKTC, n.d.; BIAUSA, n.d.).

  • Fatigue and pain can make even short walks challenging and increase the risk of falls (Headway, n.d.; Irvine, 2018).

  • Vestibular and sensory changes (including those affecting the inner ear, vision, and body position senses) can disrupt balance and posture (MSKTC, 2023; n.d.; Row et al., 2019).

  • Abnormal tone (too tight/spastic or too loose/flaccid) may limit range and control (BRITE/Brain Injury Canada, n.d.).

  • Over time, immobility can cause contractures—shortened muscles and tight joints that reduce flexibility (Physio-Pedia, n.d.; Harvey, 2017).

These changes vary from person to person. Some are mild and frustrating; others are severe and disabling. Even “slight” changes in walking and balance can be meaningful in real life and need attention (BIAUSA, n.d.).

Key takeaway: TBI can affect your movement system from many angles—muscles, joints, nerves, and the inner ear. A thoughtful plan can help you regain safe movement and prevent stiffness. (Headway, n.d.; MSKTC, n.d.; Brain Injury Canada, n.d.; BIAUSA, n.d.)

Why TBI Changes Movement

1) Muscle weakness and coordination loss

Injury to motor pathways in the brain reduces muscle activation and timing. This leads to slower movement, reduced strength, and less precise limb control (MSKTC, n.d.; Headway, n.d.).

2) Balance system disruption

The brain blends information from your vision, inner ear (vestibular system), and body sensors. TBI can disrupt this teamwork, leading to sway, missteps, and dizziness (MSKTC, 2023; n.d.; Row et al., 2019).

3) Muscle tone changes and joint stiffness

Spasticity (excessive tension) or flaccidity (insufficient tension) can make movement awkward and tight. When joints and muscles don’t move fully, they get stiffer (Brain Injury Canada, n.d.; Physio-Pedia, n.d.).

4) Pain and fatigue

Chronic pain is common after TBI and can reduce activity, which then worsens weakness and stiffness. Fatigue lowers your willingness and ability to move, creating a loop of inactivity (Irvine, 2018; Headway, n.d.).

5) Nerve signal interference

Head and neck trauma can irritate or compress nerves and disturb how signals travel from your brain through your spine to your body. This may be characterized bya  poor control, heaviness, or clumsiness (MSKTC, n.d.; Cognitive FX, 2025).

6) Secondary complications from immobility

Without regular motion, contractures can develop; shortened muscles limit joint motion and cause discomfort. Prevention through early stretching and positioning matters (Physio-Pedia, n.d.; Harvey, 2017).

Common Signs You Might Notice

  • Feeling unsteady, wobbly, or tilted when you stand or turn (MSKTC, 2023/ n.d.).

  • A short, guarded gait or foot scuffing; trouble turning quickly or stepping over obstacles (Headway, n.d.; BIAUSA, n.d.).

  • Tight calves, hamstrings, or hip flexors; difficulty fully straightening joints (Physio-Pedia, n.d.).

  • Neck or shoulder tension, headaches, and posture changes after a concussion or whiplash (Cognitive FX, 2024, 2025; Headway, n.d.).

  • Brain “lag”—your body reacts late or overreacts to balance challenges (MSKTC, n.d.; Row et al., 2019).

Even if imaging looks “normal,” slight balance and walking changes can still be present and limit daily life (BIAUSA, n.d.).

Symptom Questionnaire:

How Inactivity Leads to Contractures and Less Flexibility

When you move less, muscles and connective tissues adapt to shorter lengths. Over weeks to months, this becomes a contracture—a fixed reduction in joint range. Contractures are harder to reverse than to prevent. Early and regular stretching, positioning, and range-of-motion routines help keep tissues long and joints free (Physio-Pedia, n.d.; Harvey, 2017).

Helpful principles

  • Move each major joint daily through its comfortable range.

  • Hold gentle, pain-free stretches (Harvey, 2017).

  • Use braces or splints only as prescribed to keep safe alignment.

  • Practice active movement often—muscles stay longer when they work.

How Chiropractic and Integrative Care Fit In

Your care should be team-based. Core rehabilitation typically involves medical oversight, physical therapy, occupational therapy, and vestibular therapy, as needed. Chiropractic-integrated care incorporates strategies that target the spine, soft tissues, and sensorimotor systems to support mobility and flexibility, while coordinating with your medical and therapy teams.

What chiropractic-integrative care may include:

  1. Gentle spinal and rib adjustments to improve joint motion and posture, with special caution in acute and complex cases. Better alignment may reduce nerve irritation, improve movement patterns, and help balance strategies (Dr. Jimenez Clinical Observations; Impact Medical Group, 2024; Northwest Florida Physicians Group, 2025; Pinnacle Health Chiropractic, n.d.). pinnaclehealthchiro.com+3El Paso, TX Doctor Of Chiropractic+3Impact Medical Group+3

  2. Soft-tissue therapy (myofascial release, neuromuscular massage) to reduce muscle guarding and trigger points, especially in the neck and shoulders, which often tighten after concussion (Cognitive FX, 2025, 2023). Cognitive FX+1

  3. Targeted exercises to restore range of motion, flexibility, and coordination, and to retrain balance and gait mechanics (BIAUSA, n.d.; MSKTC, n.d.; NR Times, 2023). Brain Injury Association of America+2MSKTC+2

  4. Vestibular and ocular motor drills help the brain process motion and visual input more clearly, thereby easing dizziness and improving stability (Row et al., 2019; Cognitive FX, 2024). PMC+1

  5. Posture and ergonomic coaching to keep the head, neck, and torso in safer positions that reduce headaches and muscle tension (Dr. Jimenez Clinical Observations). El Paso, TX Doctor Of Chiropractic+1

  6. Lifestyle guidance for sleep, pacing, hydration, and anti-inflammatory habits that support tissue healing and reduce pain (Irvine, 2018; Cognitive FX, 2024). OUP Academic+1

Note on CSF and blood flow: Some chiropractic clinics report improved cerebrospinal fluid (CSF) dynamics and circulation following gentle spinal manipulation. Evidence is evolving and should be interpreted with caution; techniques must be individualized and safety-screened (Pinnacle Health Chiropractic, n.d.; Dr. Jimenez Clinical Observations). pinnaclehealthchiro.com+2El Paso, TX Doctor Of Chiropractic+2

A Simple, Step-By-Step Care Framework

Step 1: Medical screening & red-flag check

  • Rule out urgent issues (worsening headache, repeated vomiting, new weakness, seizures).

  • Review medications, imaging, and other treatments. (MSKTC, n.d.)

Step 2: Baseline movement and balance tests

  • Comfortable walking speed, timed up-and-go, single-leg stance, tandem stance, and gentle range-of-motion checks.

  • Balance testing can reveal subtle deficits even when routine tests are normal (BIAUSA, n.d.; Row et al., 2019). Brain Injury Association of America+1

Step 3: Early mobility & flexibility plan

  • Daily gentle ROM for neck, shoulders, hips, knees, and ankles.

  • Stretch tight areas (calves, hamstrings, hip flexors, chest) with short, frequent holds (Harvey, 2017). PMC

Step 4: Balance & gait retraining

  • Begin with wide-stance weight shifts, then narrow your base, and finally adopt a tandem stance near the support.

  • Add head-turning drills and stepping patterns as tolerated (MSKTC, 2023/ n.d.; BIAUSA, n.d.). MSKTC+1

Step 5: Strength and posture restoration

  • Gentle core work, hip-thigh strengthening, scapular retraction, and chin-tuck variations.

  • Posture cues for sitting, standing, and walking (Dr. Jimenez Clinical Observations). El Paso, TX Doctor Of Chiropractic

Step 6: Integrative chiropractic support (if appropriate)

  • Consider low-force adjustments and soft-tissue therapy to relieve stiffness, reduce guarding, and improve alignment for easier movement (Cognitive FX, 2025; Impact Medical Group, 2024; Northwest Florida Physicians Group, 2025). Cognitive FX+2Impact Medical Group+2

Step 7: Progress and protect

  • Increase walking distance and speed slowly.

  • Use pacing to avoid “push-crash” cycles; add rest breaks.

  • Re-check balance and range every 2–4 weeks to adjust the plan (BIAUSA, n.d.). Brain Injury Association of America

Practical Home Strategies (Easy Wins)

  • Daily motion snacks: Move your neck, shoulders, hips, knees, and ankles through gentle ranges 2–3 times per day.

  • Short holds, many reps: Stretch 20–30 seconds, 3–5 reps, staying pain-free (Harvey, 2017). PMC

  • Balance near support: Practice standing with feet together, then heel-to-toe, holding a counter lightly.

  • Walk often: Several short walks beat one long, exhausting walk (MSKTC, n.d.). MSKTC

  • Neck care: Heat before soft tissue work and light mobility; ice if irritated later (Cognitive FX, 2024). Cognitive FX

  • Posture cues: Ears over shoulders, ribcage stacked over hips, eyes level.

  • Hydrate and fuel: Dehydration and poor meals worsen fatigue and pain.

  • Track symptoms: Note dizziness, headaches, or flare-ups after activities and share with your clinicians.

Example 8-Week Mobility-Flexibility Plan (General Template)

Always follow your clinician’s advice and adapt the plan to your needs.

Weeks 1–2 (Calm the system, restore gentle motion)

  • Daily ROM for all major joints.

  • Seated and supported standing balance; wide-base weight shifts.

  • 5–10-minute easy walks, 2–3x/day.

  • Gentle soft-tissue work and, if cleared, low-force spinal mobilization/adjustments. (Cognitive FX, 2025; Dr. Jimenez Clinical Observations) Cognitive FX+1

Weeks 3–4 (Build consistency)

  • Add light band work for the hips and shoulders.

  • Tandem stance, head turns, and gentle step-overs.

  • Walks up to 15–20 minutes as tolerated.

  • Continue posture retraining and flexibility (Harvey, 2017; MSKTC, 2023/ n.d.). PMC+1

Weeks 5–6 (Challenge balance and gait)

  • Uneven-surface practice (grass or foam) with a helper.

  • Timed up-and-go practice; gait drills (longer steps, arm swing).

  • Strength: Chair squats, rows, bridges.

  • Progress vestibular/oculomotor work if needed (Row et al., 2019). PMC

Weeks 7–8 (Real-life skills)

  • Carry light objects while walking, turn, and stop on cue.

  • Add stairs (with rails) and a community walking path.

  • Re-test balance and range; set your next goals (BIAUSA, n.d.). Brain Injury Association of America

When to Seek Care Urgently

  • New or worsening severe headache, repeated vomiting, slurred speech, seizures, new weakness or numbness, or major change in thinking or behavior needs immediate medical attention (MSKTC, n.d.). MSKTC

What the Research and Rehab Guides Say

  • Mobility becomes slower and balance suffers after a TBI; assistance or aids may be needed, especially in the early stages (Headway, n.d.). headway.org.uk

  • Coordination, strength, and balance can remain reduced for months; many people still walk independently by 3 months but with lingering issues (MSKTC, n.d.). MSKTC

  • Even subtle balance and gait changes affect quality of life; specialized testing helps identify them (BIAUSA, n.d.). Brain Injury Association of America

  • Contractures are a preventable complication of immobility; early stretch and ROM are key (Physio-Pedia, n.d.; Harvey, 2017). physio-pedia.com+1

  • Movement disorders such as tremor and dystonia can follow TBI and affect posture and daily function (Moon et al., 2022). PMC

  • Chronic pain is common after TBI and requires a plan that blends activity, desensitization, and supportive therapies (Irvine, 2018). OUP Academic

Where chiropractic-integrated care fits: While high-quality research on chiropractic for TBI is growing, but still limited, clinics commonly integrate gentle spinal work, soft-tissue therapy, and sensorimotor drills with standard rehab. The goal is to reduce mechanical stress, improve posture and movement efficiency, and support neuroplastic change—always coordinated with medical and physical therapy care (Cognitive FX, 2023–2025; Impact Medical Group, 2024; Northwest Florida Physicians Group, 2025; Dr. Jimenez Clinical Observations). El Paso, TX Doctor Of Chiropractic+3Cognitive FX+3Impact Medical Group+3

Dr. Alexander Jimenez’s Clinical Perspective (El Paso)

Dr. Alexander Jimenez, DC, APRN, FNP-BC, emphasizes a dual-scope, integrative approach for TBI-related mobility problems:

  • Cervical and upper-thoracic alignment can influence headaches, dizziness, and posture; gentle corrections and soft-tissue care often make exercise and vestibular rehab easier.

  • Team-based care—chiropractic, nurse-practitioner oversight, physical and vestibular therapy—helps patients progress safely.

  • Objective re-testing (balance, gait, ROM) guides step-wise loading to avoid flare-ups.
    These points align with his recent articles on TBI posture and integrative recovery for El Paso patients (Jimenez, 2025). El Paso, TX Doctor Of Chiropractic+2El Paso, TX Doctor Of Chiropractic+2

Putting It All Together

  1. TBI can disrupt movement by weakening muscles, changing balance systems, and stiffening joints.

  2. Pain and fatigue exacerbate the condition, resulting in reduced activity and increased stiffness.

  3. Early, steady motion prevents contractures and keeps flexibility.

  4. Chiropractic-integrative care, when coordinated with your medical and therapy team, can reduce tension, improve alignment, and support posture and balance training.

  5. Progress slowly and test often, celebrating small wins and adjusting the plan as your brain and body adapt.

You don’t have to accept “stuck” movement. With a patient, whole-person plan, most people improve—sometimes slowly, but in a meaningful way.


References

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The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, and physical medicine, as well as wellness, sensitive health issues, and functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and the jurisdiction in which they are licensed to practice. We utilize functional health and wellness protocols to treat and support care for musculoskeletal injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters and issues that directly or indirectly support our clinical scope of practice. Our office has made a reasonable effort to provide supportive citations and to identify relevant research studies that support our posts. We provide copies of supporting research studies upon request to regulatory boards and the public.

We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol. To discuss the subject matter above further, please contact Dr. Alex Jimenez or us at 915-50-0900.

Dr. Alex Jimenez, DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

Email: coach@elpasofunctionalmedicine.com

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Professional Scope of Practice * The information on this blog site is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Blog Information & Scope Discussions Welcome to El Paso's Premier Wellness and Injury Care Clinic & wellness blog, where Dr. Alex Jimenez, DC, FNP-C, a board-certified Family Practice Nurse Practitioner (FNP-BC) and Chiropractor (DC), presents insights on how our team is dedicated to holistic healing and personalized care. Our practice aligns with evidence-based treatment protocols inspired by integrative medicine principles, similar to those found on dralexjimenez.com, focusing on restoring health naturally for patients of all ages. Our areas of chiropractic practice include Wellness and nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, severe sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. Our information scope is limited to Chiropractic, musculoskeletal, physical medicine, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, please feel free to ask Dr. Alex Jimenez, DC, APRN, FNP-BC, or contact us at 915-850-0900. We are here to help you and your family. Blessings Dr. Alex Jimenez DC, MSACP, APRN, FNP-BC*, CCST, IFMCP*, CFMP*, ATN* email: coach@elpasofunctionalmedicine.com Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico* Texas DC License # TX5807 New Mexico DC License # NM-DC2182 Licensed as a Registered Nurse (RN*) in Texas & Multistate  Texas RN License # 1191402  Compact Status: Multi-State License: Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP*, IFMCP*, ATN*, CCST