Neck Pain, Finger Tingling and Vestibular Training in Perimenopause: The Connection Nobody Told You About

‍As you will know if you have been here a while, I am a movement nerd. I took P.E for GCSE much to my Mum’s horror, not because I was in any way sporty – I spent an inordinate amount of time trying to get out of the actual sport part – I took it because I wanted to do anatomy and physiology and half the P.E. curriculum was exactly this. Now we are going on a little life wander but stay with me. We ended up moving to New Zealand just after I started my GCSE’s. I thought I was going to get to learn Japanese instead. No such luck, after less than a year of what should have been a permeant move back to Mum’s family, we came back.

‍That meant I had to catch up on almost a year of GCSE work in about 6 weeks before our mock exams. Guess which subject I tackled first. And not only tackled, actively sought out and loved. I had my P.E. anatomy and physiology caught up in less than 2 weeks and bear in mind that I was at school and had new homework to do, that was no easy task. So, I am a human body nerd. It wasn’t on the cards for me to go to university until much later in my life and by then I was on the treadmill of ‘must be good at business and do business things’, so any kind of physical training was off. Then I was made redundant, got divorced, got into physical movement again and took myself off to Costa Rica to learn the ancient art of Yoga. And the bug was back. I picked the brain of our anatomy and physiology teacher to pieces. He was the physio for the Miami Dolphins so he had been around his share of athletes.

‍Since then I have studied biomechanics, nervous systems and systems that link into the internal workings of these fantastic creations we get to live in day in, day out.

‍I am not a physio. I do however watch a lot of content from physios, biomechanical experts and movement coaches, I do my own research when someone comes to me with a specific issue, and I try things on myself before I bring them into the room.

‍I started getting a sudden influx of ladies telling me that they had tingly fingers and they had or had just recovered from vertigo. So I went on a mission to learn as much as I could about what was going on and how it might be possible to prevent. What happened after I started adding vestibular and nerve release work into my yoga classes was significant enough that I needed to write about it.

‍I have had reports of chronic neck pain resolving. Finger tingling that had been present for years gone for days at a time, then longer and longer periods. Sleep that had been disrupted for as long as people could remember — restored.

‍Not magic. Science.

‍Here is what I think is happening. ‍

The vestibular system — and why yours might be undertrained

‍Your vestibular system lives in your inner ear. It is responsible for your sense of balance, spatial orientation and the coordination of your head and eye movements. It tells your brain where you are in space — whether you are upright, tilted, moving or still.

Most of us have a reasonably functional vestibular system for the movements we make every day. Walking. Sitting. Standing. The predictable, horizontal, feet-on-the-floor world we mostly inhabit. There was one thing that linked all of these women and it was glaringly obvious to me. Oestrogen. They were/ are all either perimenopausal or post menopause. Clinically, menopause is defined as a single day — twelve months after your last period. But the hormonal fluctuations of perimenopause can begin years before that and nobody can say with certainty when oestrogen levels stabilise, if indeed they ever fully do. What we do know if that our vestibular system has a LOT of oestrogen receptors so declines in oestrogen levels leave our inner ears extremely discombobulated. This also leads to the crystals in your ears (yes you’ve got your own treasure chest in your head, and it’s not just your brain), to shift, affecting your balance, making you feel like you are on the worst alcohol binge of your life when you are sober, at 3am and you simply rolled over in bed. Lastly, oestrogen regulates the elasticity of your blood vessels. When these become tense, your vestibular system has trouble responding quickly enough and you feel less stable.

‍The Good news is that now we know the issue, the vestibular system, like every other system in the body, responds to training. And most of us are not training it.

‍We sit in the same position for hours. We look at screens that are always at the same distance and the same height. We move our heads in the same limited range, in the same directions, dozens of times a day and almost never outside of that narrow corridor of motion.

‍ The result is a vestibular system that is competent within a very small range and progressively less confident outside of it.

‍ This matters more than most people realise. Especially in my mid 30s onward ladies because the vestibular system does not work in isolation. It is in constant conversation with your nervous system, your visual system, and — crucially — the muscles and nerves of your neck and upper back.

‍ Caveat – I put mid 30s here deliberately. Because no one really knows when oestrogen starts to decline, and I have had women describe symptoms of perimenopause surprisingly early, particularly after later-in-life childbirth. It is never too early to be informed. And the vestibular training in this post costs nothing, takes ten minutes and will feel really nice especially if you have had a stressful day. Starting now, before you need it, is exactly the kind of thing future you will be grateful for.

‍The cervicogenic connection — and the dinosaur muscle

The neck is one of the most underappreciated regions in the body from a neurological perspective.

‍ Running through and around it are some of the most important nerve pathways in the system — including the vagus nerve, which you may know as the primary pathway of the parasympathetic nervous system, the one responsible for rest, digestion, recovery and the feeling of being safe.

‍ Chronic neck tension does not just cause neck pain. It compresses. It restricts. It narrows the space that nerves need to move freely through. And when those nerves are compressed — particularly in the cervical spine and thoracic outlet — the result can be tingling in the fingers, numbness in the hands, disrupted sleep, headaches and a persistent low-level feeling of being wired and unrested.

‍There is a muscle I want to introduce you to.

‍It is called the sternocleidomastoid. I call it the dinosaur muscle because it sounds like one, I make names up for things all the time, and once you know it exists you will never stop finding it.

It runs from just behind your ear, down the side of your neck, to your collarbone. It is responsible for rotating and tilting your head. It is also, in most people who spend time at desks or looking at phones, chronically shortened, chronically tight, and almost never deliberately stretched.

‍When the dinosaur muscle is tight it pulls. It compresses. It contributes to the exact kind of cervicogenic tension that sends tingling down the arm and into the fingers.

‍Stretching it — properly, in combination with nerve mobilisation and vestibular input — begins to change things.

‍Sometimes quite quickly.

‍The practice — what I actually do in class

I want to give you two practices. The first is seated and accessible to almost everyone. The second is more active and can be woven into an existing movement practice.

Neither of these is a substitute for physiotherapy if you have a diagnosed condition. But both are safe, gentle, and based on established principles of nerve mobilisation and vestibular stimulation.

Practice 1 — The seated sequence

Sit comfortably. Cross your legs the opposite way to how you normally would. If crossing your legs is not possible, sit on a chair or place a sofa cushion under your pelvis on the floor to lift the hips.

Place your hands lightly on your knees.

Take an inhale and lift the crown of your head toward the ceiling — about five out of ten effort. Notice what wants to come with you. Knees lifting? Shoulders rising? You don't need to do anything about it. Just notice.

Exhale and soften — but keep the crown of the head where it is.

Inhale and lift the crown of the head to eight out of ten. Whatever wants to come with you, let it and add a little tension — squeeze the shoulders toward the ears or allow the knees to lift a little higher.

Exhale — keep the crown of the head where it is and let everything else fall away.

Now take your right hand and place it on your left shoulder. You will feel a ridge of muscle there. Take hold of it — firmly, like you are gripping something that matters.

Your next exhale takes your right ear toward your right shoulder.

Inhale back to centre.

Exhale ear to shoulder.

Inhale centre.

On your next exhale, as the ear moves toward the shoulder, turn your chin over your shoulder and then drop your chin down toward your shoulder. This is where you will find the dinosaur muscle. You will know because it will feel like you have discovered something that has been waiting to be found for a very long time.

Inhale — keep the ear over the shoulder as you turn the chin toward the sky.

Exhale — chin back to shoulder.

Inhale — chin to sky.

Exhale — chin to shoulder.

Then turn your chin to face the front of the room and take three breaths with your ear still toward your shoulder.

Inhale back to centre.

Keep your hand on the opposite shoulder.

Exhale and tuck your chin gently to your chest.

Inhale centre.

Exhale chin to chest.

Inhale centre.

Remove your hand.

Cross your legs the opposite way and repeat the entire sequence on the other side.

Take your time. There is no rush. The nervous system does not respond well to urgency.

Practice 2 — Upward dog with ear to shoulder

This one works beautifully woven into sun salutations or as a standalone active version of the neck release.

From upward dog — or a sphinx position if upward dog is not available to you today — the key is this: push the ground away. Not shoulders toward the ears. Ground away from you, crown of the head rising.

From there, take the right ear toward the right shoulder.

Hold for three to five breaths.

Return to centre.

Left ear to left shoulder.

Three to five breaths.

Return to centre.

The ground-pushing detail is not optional. It is the difference between compressing the neck and decompressing it. One makes things worse. The other begins to create the space the nerves need.

Where this goes next — rings and inversions

The seated sequence and the upward dog variation are the beginning of the conversation between your nervous system and your vestibular system.

But the conversation gets richer when you start to move into positions that genuinely challenge your sense of where you are in space.

Rings training does this in a way that almost nothing else does. The instability of the rings means your vestibular system, your proprioceptive system and your visual system are all being asked to communicate simultaneously and in real time. Every adjustment your body makes on the rings is a vestibular training moment.

And handstands — which I appreciate sound alarming if you have never tried one — are perhaps the most complete vestibular training tool available without specialist equipment. Being upside down completely disrupts the visual field and forces the body to find stability from within. The inner ear recalibrates. The nervous system learns that this unfamiliar position is survivable. The proprioceptive feedback from the hands and wrists begins to replace the visual information that is no longer reliable.

For women who have been living with chronic neck tension, nerve compression or that persistent feeling of being slightly unmoored in their own body — inversion work, approached carefully and progressively, can be genuinely transformative.

I have a programme for this. It is called Highway to Handstand and it starts exactly where you are — standing upright, possibly sceptical, definitely curious — and takes you somewhere you probably did not think your body could go.

What the outcomes tell us

Two women sleeping through the night after one session.

Chronic neck pain resolving over weeks of consistent practice.

Finger tingling — present for years — stopping.

I want to be clear again: I did not treat these women. I gave them movements. Their bodies did the rest.

But the movements were not random. They were chosen because of what we know about the vestibular system, the cervicogenic nerve pathways, the role of the dinosaur muscle in chronic tension, and the relationship between movement variety and nervous system regulation.

The body wants to regulate. It is always looking for the opportunity to do so.

Sometimes all it needs is someone to show it a movement it has never tried before.

And occasionally to name a muscle after a dinosaur.

If you want the story of what happened when I got upside down the morning after a flood — and why it was the most normal I had felt in 24 hours — that's Letter from the Trail Issue 6. The science in this post is the explanation for what happened in that newsletter.

And if you want to start your own vestibular training journey — from ear to shoulder all the way to freestanding handstand — Highway to Handstand is where we begin.

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