Traumatic Brain Injuries Posture and Balance Recovery

How Traumatic Brain Injuries Affect Posture and Balance: From Subtle Changes to Severe Posturing and Chiropractic Help

Traumatic brain injuries, or TBIs, happen when a sudden blow or jolt to the head damages the brain. These injuries can range from mild, like a concussion, to severe, where the brain suffers major harm. One key way TBIs show up is through changes in posture and balance. Posture is how we hold our bodies upright, and balance helps us stay steady without falling. When the brain is injured, it can affect these abilities in subtle, ongoing ways or cause extreme, rigid positions that signal significant problems.

In mild cases, people may experience dizziness or unsteadiness for an extended period after the injury. Such symptoms can make everyday tasks, such as walking or standing still, difficult. Severe TBIs can lead to abnormal posturing, where the body locks into rigid poses because of brain damage. These poses, known as decorticate or decerebrate posturing, are signs that someone requires immediate assistance. TBIs can also cause issues in the spine, such as misalignments in the neck or upper back, which can exacerbate symptoms like headaches and vertigo—a sensation of spinning.

Chiropractic care offers a way to help. It focuses on addressing spinal problems to enhance the nervous system’s function, which can aid in brain healing. This article explains these effects and treatments in simple terms, using reliable sources.

Mild TBIs and Long-Term Balance Problems

Mild traumatic brain injuries, often called concussions, don’t always knock someone out, but they can shake up the brain enough to cause lasting issues with balance and posture. Balance is our ability to maintain the body’s center of gravity while sitting, standing, or moving. It relies on the brain processing signals from the eyes, inner ears, and body sensors. When a TBI happens, even a mild one, it can disrupt this process.

Studies show that people with a history of mild TBI may have subtle changes in how they control their posture. For example, their body sway might be different when standing with eyes closed or on uneven surfaces. One study found that those with past mild TBIs had altered postural dynamics, meaning their balance adjustments weren’t as smooth as those of people without injuries. This was measured using tools such as the Sensory Organization Test, which assesses an individual’s ability to remain steady under various conditions. These changes can persist long after the injury appears to have healed, affecting daily life.

About 30% to 65% of people with brain injuries face balance problems. This comes from damage to systems that handle vision, inner ear function, and body position sensing. Weak muscles, dizziness, or even anxiety can make it worse. For instance, if the vestibular system in the inner ear is damaged, a person may feel off-balance or have trouble walking straight. Past studies note that older people or those with more severe injuries have bigger balance issues, but even young adults can struggle.

Imagine trying to stand on one foot after a bump to the head— it might feel wobbly for weeks or months. This chronic disturbance can lead to falls, reduced mobility, and a decline in confidence in mobility. Rehabilitation often includes exercises to rebuild strength and coordination; however, understanding the brain’s role is crucial for effective recovery.

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Severe TBIs and Abnormal Posturing

In more severe TBIs, the brain damage can cause the body to assume rigid, unnatural positions, known as abnormal posturing. This happens because the injury disrupts normal brain signals, letting primitive reflexes take over. The two main types are decorticate and decerebrate posturing, both of which are signs of severe problems that require urgent care.

Decorticate posturing looks like this: arms bent in toward the chest, wrists curled, fists clenched, and legs straight out. The person is usually unconscious and doesn’t respond to attempts to wake them. It’s caused by damage to the cerebral cortex or midbrain areas that control movement. TBIs from falls or accidents are common triggers, as they can harm nerve pathways.

Decerebrate posturing is even more serious. Here, arms and legs stretch straight out, toes point down, and the head and neck arch back. Muscles are tight and rigid. This suggests more severe brain damage, such as in the brainstem. Survival rates are lower for this type, around 10%, compared to 37% for decorticate.

These postures can happen on one side or both and might switch. They’re reflexes to pain or brain pressure, not voluntary moves. If someone shows this after a head injury, call emergency services immediately. Treatment starts with stabilizing breathing and may involve intensive care.

Abnormal posturing affects equilibrium because the body can’t adjust normally. In recovery, therapists may position patients to reduce rigidity, such as having them sit up instead of lying flat.

How TBIs Impair Sensory, Visual, and Vestibular Systems

TBIs mess with posture by damaging key brain systems. The sensory system senses body position through skin, muscles, and joints. The visual system uses the eyes to see the surroundings. Head movement and gravity are sensed by the inner ear’s vestibular system.

When a traumatic brain injury (TBI) occurs, it can impair the nervous system’s functions. For example, visual problems make it challenging to judge distances, which can lead to poor balance and coordination. Vestibular damage causes vertigo or dizziness, making standing feel like spinning. Sensory issues mean the brain doesn’t get accurate signals from the body, causing unsteadiness.

In severe cases, this results in rigid posturing because the brain is unable to properly coordinate the muscles. Mild cases exhibit chronic changes, such as irregular sway patterns. Factors such as age or injury severity can exacerbate it.

These impairments reduce a person’s ability to maintain equilibrium. Daily activities become more risky, increasing the chances of falls. Therapy targets rebuilding these systems through exercises.

TBIs and Spinal Misalignments

TBIs often come with neck or back injuries, especially from whiplash in accidents. This can misalign the cervical (neck) and upper thoracic (mid-back) spine. Misalignments, or subluxations, disrupt nerve signals and cause poor posture.

Symptoms include headaches due to tension and vertigo resulting from affected balance nerves. The spine protects the spinal cord, which connects to the brain. When misaligned, it can worsen TBI effects like pain and dizziness.

Studies show TBIs are linked to musculoskeletal pain, including spine issues. Poor posture, resulting from stiffness or weakness, exacerbates the problem.

Chiropractic Care for TBIs

Chiropractic care helps by fixing spine misalignments through adjustments. This improves nervous system function, blood flow, and cerebrospinal fluid circulation to the brain.

For mild TBIs, it reduces headaches and vertigo by aligning the neck. It also includes sensory and motor therapies, like balance exercises and coordination drills, to help regain control.

Chiropractic neurology utilizes neuroplasticity—the brain’s ability to rewire itself—to support healing. Adjustments boost brain activity and reduce inflammation. Other methods include improving circulation to enhance oxygen delivery to the brain and addressing lifestyle factors such as nutrition. In hospitals, chiropractic helps with pain and stiffness in TBI patients.

Insights from Dr. Alexander Jimenez

Dr. Alexander Jimenez, DC, APRN, FNP-BC, has over 30 years in chiropractic and integrative care. He focuses on natural healing for injuries, including spinal issues from accidents. His practice utilizes adjustments, functional medicine, and rehabilitation to address root causes, such as misalignments, that affect posture and balance. His research on pain and whiplash supports the use of chiropractic care to treat brain-related symptoms, even though it is not specifically related to TBIs.

Conclusion

TBIs impact posture, ranging from mild balance shifts to severe posturing, and affect quality of life. Chiropractic care provides non-invasive support by addressing spinal issues and promoting overall well-being. Always seek professional advice for TBIs.

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References

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Jimenez, A. (n.d.). Injury Specialists.

Jimenez, A. (n.d.). Dr. Alexander Jimenez DC, APRN, FNP-BC, IFMCP, CFMP, ATN ?.

Mount Sinai. (2025a). Decorticate Posture.

Mount Sinai. (2025b). Decerebrate Posture.

Northwest Florida Physicians Group. (n.d.a). Using Chiropractic Care to Treat Traumatic Brain Injuries.

Northwest Florida Physicians Group. (n.d.b). Using Chiropractic Care to Treat Traumatic Brain Injuries.

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UF Health. (2025). Decerebrate Posture.

Vida Integrated Health. (n.d.). Treating Concussions with Chiropractic Care.

Vining, R. D., Salsbury, S. A., Cooley, W. C., Gosselin, D., Corber, L., & Goertz, C. M. (2018). Patients receiving chiropractic care in a neurorehabilitation hospital: a descriptive study.