JANMI Soft Tissue Therapy

29/03/2026

A young client in his early twenties came to see me with pain on the lateral side of his right knee a few days after playing tennis.

But as often happens, the knee was not telling the whole story.

On assessment I found a flat overpronated foot and significant tightness through the posterior chain. In this kind of pattern, I often suspect that the foot intrinsic muscles are not doing enough of their quiet but essential work.

These small muscles under the foot are rarely discussed, yet they help support the arch, guide balance, improve load sharing, and give the whole lower limb a better mechanical foundation. When they become inhibited, the foot can collapse too easily, the chain above starts compensating, and the knee may end up receiving forces it was never meant to manage alone.

So sometimes lateral knee pain after tennis is not just a knee story.
Sometimes it is a foot to knee to hip story.

This is why I always look at the body as a connected chain rather than a collection of separate complaints. The painful area is not always the place where the trouble began.

Paulius Jurasius
JANMI Soft Tissue Therapy
Marylebone, London

This post is for educational purposes only and does not replace an individual assessment by a qualified professional.

27/03/2026

Shoulder pain during golf is not always just a shoulder story.

This week I saw a 56 year old female client who plays golf a few times a week and came with one shoulder struggling in external rotation, with pain radiating into the anterior deltoid. At the same time, the opposite gluteus medius was aching during play. Strange combination? Not really. The body loves compensation more than we do.

On assessment, the pattern made sense. Forward head posture, shoulders drifting forwards, tight pectorals, a restricted diaphragm, and a very sensitive short head of biceps brachii tendon were all influencing the mechanics of the shoulder. When the front of the body becomes too dominant, the scapula loses some of its clean support, the shoulder joint loses some elegance, and external rotation starts feeling more like a negotiation than a movement.

Then golf enters the scene and asks the body to rotate with precision, transfer load well, and stay balanced through the swing. If the shoulder and ribcage are not sharing the work properly, the opposite side gluteus medius often has to do extra stabilising work. That is why one painful shoulder and one aching opposite hip can belong to the same chain pattern.

This is what I look for at JANMI Specialised Postural Pain Clinic in Marylebone. Not just the sore spot, but the full logic behind it. The shoulder may complain loudly, but the ribcage, diaphragm, pelvis, and lateral hip often have their fingerprints all over the case.

Modern life prepares these patterns beautifully. Sitting, stress, shallow breathing, screens, and repetitive movement habits quietly pull us away from natural mechanics. Then a sport like golf politely reveals the bill.

At JANMI, I see these kinds of postural pain patterns every week, and once the chain is understood properly, the body usually starts making much more sense.

JANMI Soft Tissue Therapy
Marylebone, London

Disclaimer. This post is for educational purposes only and reflects the perspective of a soft tissue therapist. It is not medical advice, diagnosis, or treatment.

27/03/2026

27/03/2026

Recently I saw a 35 year old female client with a sedentary job whose main complaint was uncomfortable pain in the upper glute area after longer periods of sitting.

On assessment, the pattern was very clear. Posterior pelvic tilt, overcontracted hamstrings, and a lot of tightness around the ischial tuberosity attachment. In simple words, the body had started borrowing stability from the wrong places.

This is something I often see in modern office life. When the deep core is not doing enough to support the trunk and pelvis, the hamstrings often step in and start gripping for stability. They pull on the sitting bone, the pelvis stays tucked under, and the upper glute area starts paying the price after too many hours on a chair.

So this is not really just a glute problem. It is a lumbopelvic load sharing pattern.

The hamstrings overwork.
The deep core underperforms.
The gluteal area becomes compressed and irritated.
And sitting keeps repeating the same message every day.

That is why improving deep core strength can make a lot of sense in this type of pattern. The goal is not just to chase the painful spot, but to improve how the body organises support from the inside.

At JANMI Specialised Postural Pain Clinic Marylebone, I always try to help patients understand the logic behind their pain pattern, because once the body makes sense, the process becomes calmer and more effective.

Disclaimer. This post is for educational purposes only and does not replace individual medical advice or assessment.

24/03/2026

SI joint pain is very rarely just about the SI joint.

A few days ago I saw a male client with pain on both sides of the lumbopelvic area, irritation around the SI joint, tight hip flexors, a very overworked quadratus lumborum, rib discomfort, protracted shoulders, neck tension and even a blocked jaw. On paper it may look like several different problems. In reality, it was one connected postural chain asking for help.

This is what I see again and again at JANMI Specialised Postural Pain Clinic in Marylebone. The body does not suffer in isolated little boxes. It compensates through links.

In this case, an old knee ligament rupture likely changed gait mechanics years ago. Since then, the body had been building a clever but expensive compensation strategy. Soleus, re**us femoris, iliopsoas, gluteus medius, quadratus lumborum, thoracic extensors, pectorals, upper trapezius, neck extensors and occipitals were all pulling their weight a bit too heroically.

The result was a pelvis tipped forward, SI joint irritation during walking, overloaded hamstring origin, rib tension around the rhomboid minor area, stiff chest, tight neck and a jaw that looked like it had been attending business meetings on its own.

This is why I do not look only where it hurts. I look at the full chain. Foot, knee, hip, ribcage, scapula, neck. When load sharing breaks down through the chain, pain often appears where the body finally runs out of polite ways to cope.

Modern office work, frequent travel, sitting, stress, lack of varied movement and old unresolved injuries create these patterns every day. The body adapts brilliantly, but not always comfortably.

At JANMI, my focus is to understand the logic of the pattern, not just chase the symptom.

JANMI Soft Tissue Therapy
Marylebone, London

Disclaimer
This post is for educational purposes only and does not replace individual assessment or medical advice.

23/03/2026

Stress can quietly reshape the whole pectoral girdle and neck pattern.

Today I saw a female client with a stressful job who came in with chronic tightness around the chest and neck, limited shoulder movement, very tight scalenes, a shortened pec minor, and almost no real diaphragmatic breathing. This is such a common modern pattern that I could probably give it its own waiting room chair.

When stress becomes chronic, breathing often moves upwards into the chest. The diaphragm does less, while the scalenes and other accessory breathing muscles start working far too much. At the same time, a tight pec minor can pull the shoulder girdle forward and down, changing scapula mechanics and making shoulder movement feel restricted, heavy, and stiff.

So the problem is often not just the neck and not just the shoulders. It is a full ribcage scapula neck pattern, shaped by posture, breathing habits, and long periods of tension.

At JANMI Specialised Postural Pain Clinic Marylebone, I look at these patterns as connected chains, not isolated sore spots. When the logic of the pattern is understood properly, the body starts making much more sense.
Postural pain clinic
Neck and shoulder tightness treatment

Disclaimer This post is for educational purposes only and does not replace individual assessment or medical advice.

21/03/2026

Lower back pain after a skiing weekend is often not just about one unlucky bend or one dramatic morning getting out of bed. Sometimes the slope simply exposes a chain that has already been struggling for years.

Today I saw a woman in her fifties with severe lower back pain that began during a skiing trip. The pain was especially intense in the mornings and very sharp when bending down. The reassuring part was that no neurological signs or red flags were observed. But her posture told an important story. Pronounced anterior pelvic tilt, flat feet, and a forward head position had already set the stage for the lumbar area to become overloaded.

This is what I see again and again at JANMI Specialised Postural Pain Clinic in Marylebone. The body is one connected chain. If the feet collapse, the pelvis often loses support. If the pelvis tips forward, the lower back starts working overtime. If the head moves forward, the whole trunk stacks less efficiently. Then one active weekend comes along and the lower back says enough.

Flat feet are often one little sign of this modern forgetting. Hard flat surfaces, narrow shoes, and repetitive two directional movement patterns can gradually reduce the natural spring and support of the foot. Then the body compensates upward. The lower back often pays the bill.

Skiing is interesting because it suddenly demands something more primal from the body again. Balance, adaptation, shock absorption, constant postural correction. A body that has spent too long on flat predictable ground can find that conversation with gravity a bit too expensive.

This is why at JANMI I do not just look at where it hurts. I look at why the chain chose that exact place to complain.

Paulius Jurasius
JANMI Specialised Postural Pain Clinic
Marylebone, London

Disclaimer
This post is for educational purposes only and does not replace medical assessment diagnosis or treatment.

20/03/2026

Scalenes are small muscles, but when they get chronically overcontracted they can make the whole neck feel as if it has been glued onto the shoulders.

Yesterday I saw a young male client in his late twenties after a few brutal weeks of desk work, long sitting hours, deadline pressure, forward head posture, poor breathing, and severe stiffness around the base of the neck. He could barely move his head in the morning without pain. What stood out most was how overworked the scalene muscles had become.

This is important because the scalenes do not only help with neck movement. They also assist breathing by lifting the upper ribs. When stress is high and diaphragmatic breathing disappears, these muscles often start working overtime. Add a forward head, lifted chest, and long hours at the desk, and the neck can become painfully stiff very quickly.

In this kind of pattern, the neck is not the whole story. The thoracic spine gets tight, the lumbar extensors start overworking, the ribcage becomes rigid, and the body loses its natural sharing of load. The result is a system that feels stuck, tired, and irritated.

This is why at JANMI Specialised Postural Pain Clinic Marylebone I always look deeper than the pain itself. A stiff neck is often also a breathing pattern problem, a posture problem, and a stress pattern hiding in soft tissue.

Modern life is very good at deadlines, but not always very good at necks.

Disclaimer: This post is for educational purposes only and does not replace individual assessment or medical advice.

20/03/2026

Yesterday I saw a male client with a history of lumbar pain, and once again the body reminded me of something I see very often in clinic.

When the gluteus maximus underperforms, the lower back often starts doing extra work to stabilise the lumbopelvic area. The person keeps moving, yes, but not in the most efficient way. Over time this can lead to recurring lumbar tightness, stiffness after sitting, a feeling of compression, and that frustrating pattern where the pain settles for a while and then returns again.

This is why I do not look at lower back pain in isolation.

At JANMI Postural Pain Clinic Marylebone, I always look at the wider chain. Foot, knee, hip, pelvis, ribcage, scapula. If the glutes are not giving enough support, the pelvis may lose some control and the lumbar muscles may begin gripping too much to compensate.

Very often the sore area is not the whole story. The lower back may be the one complaining, but the real issue can be poor force transfer and weak support from the hip.

The gluteus maximus is not there just for appearance. It is one of the main muscles responsible for hip extension and an important supporter of pelvic control. When it is not doing its share, the lower back may quietly become the overworked substitute.

That is one reason why some people keep chasing lower back tightness, while the deeper mechanical problem remains unchanged.

At JANMI, I look for who is underworking, who is overworking, and how the whole chain is sharing load. That is often where the real answer begins.

For education only. Soft tissue therapy does not replace medical diagnosis or treatment.

18/03/2026

Base of neck pain that suddenly appears after a more intense week at the office is often not just a neck problem.

A few days ago I saw a female patient with tightness and pain at the base of the neck, forward head posture, very tight lumbar extensors, and mild pins and needles travelling into both little fingers. This kind of pattern often reflects a deeper chain overload involving the scalenes, levator scapulae, upper trapezius, ribcage tension, stress breathing, and poor postural support through the trunk.

When stress rises, many people start breathing higher into the chest, lifting the upper ribs and tightening the side of the neck. Add long desk hours and forward head posture, and the base of the neck can become overloaded very quickly. The body then starts compensating elsewhere too, often with the lower back becoming rigid and overworked.

At JANMI Specialised Postural Pain Clinic Marylebone, I always look at these cases as a full postural chain puzzle, not just a sore spot to rub for ten minutes and hope for the best. The neck, ribcage, shoulders and lumbar spine often work together in these modern office pain patterns.

If your neck feels tight, heavy or stuck after stressful office work, it may be worth looking deeper than the place that hurts.

Paulius
JANMI Specialised Postural Pain Clinic Marylebone

Disclaimer
This post is for educational purposes only and does not replace medical assessment, especially if tingling, numbness or weakness is persistent or worsening.

17/03/2026

A strong bodybuilder can have a very good squat technique and still end up with one sided knee pain when the chain stops sharing load properly.

This week I was working with the client where the knee looked almost like one tight locked block. The patella was not gliding well. The medial hamstring attachment was very tight. The adductors were gripping. The gluteus medius was also overworking. On the surface it looks like a knee problem. In reality, very often it is a load sharing problem through the whole lower chain.

In these cases the knee is not always the true troublemaker. Sometimes it becomes the meeting point of tension coming from the foot, hip and pelvis. The body chooses stiffness to create control. Useful for survival perhaps, but not very friendly for squats and lunges.

This is why at JANMI Specialised Postural Pain Clinic Marylebone I do not like to look only at the painful spot. I look at the pattern. Which tissues are overworking. Which links are not doing their job. Why the patella is not moving freely. Why the medial side of the knee is becoming overprotected.

Very often the pain is just the final protest. The real story starts earlier in the chain.

This is the JANMI way. Not just chasing pain, but understanding the logic behind it.

This post shares soft tissue and postural reasoning only and is not a medical diagnosis or a substitute for assessment by a qualified medical professional.

16/03/2026

Old injuries do not always stay in the old chapter.

This week I was reflecting on a female client who had a major fracture in the upper part of the tibia three years ago. The bone had healed, of course. Life had moved on. But the body was still telling the story.

On the same side, the hamstrings and quadratus lumborum were working far too hard. Gluteus medius was full of trigger points. On the opposite side, infraspinatus and upper trapezius had joined the compensation party as well. Quite a clever party, but not a comfortable one.

This is the interesting part of postural pain. The body does not think in separate muscles. It thinks in survival and load sharing. If one leg stops feeling fully trustworthy, the pelvis adapts. Then the ribcage adapts. Then the shoulder girdle adapts. Suddenly the client wonders why the opposite shoulder feels tight when the original drama happened years ago near the knee.

At JANMI Specialised Postural Pain Clinic Marylebone, I always look for this deeper chain logic. Foot, knee, hip, pelvis, ribcage, scapula. Because pain is often not where the problem started. It is simply where the compensation became loud enough to complain.

Disclaimer. This post is for educational purposes only and does not replace medical diagnosis or treatment by a qualified healthcare professional.