JANMI Journal: The Lateral Elbow Pain That Was Borrowed From a Shoulder Blade… and an Opposite Knee

Dear reader,

A client came in with that classic complaint:

“Paulius, it’s the outside of my elbow. It’s weird. Gripping hurts. Lifting a bag feels wrong. Sometimes even shaking hands feels like I’m negotiating with a stapler.”

Outer elbow pain (lateral elbow) is usually blamed on the forearm — and fair enough, the forearm is often screaming. But in a JANMI Full Chain Reset, I always ask a different question:

Why is the elbow working so hard that it needs to complain?

The assessment surprise

Two things stood out:

1. Scapulas were misaligned

   One shoulder blade was sitting differently — slightly more forward, tilted, rotated, or unstable compared to the other.

2. The opposite-side knee was off

   Subtle collapse/rotation in the knee mechanics (often linked to foot control and hip stability), but on the other side to the painful elbow.

So now the puzzle became clear:

This wasn’t just an elbow problem. It was an efficiency problem.

Why lateral elbow pain happens

The main tissues that usually get overloaded are the wrist/finger extensors — especially a famous little worker called:

• Extensor carpi radialis brevis (ECRB)

These muscles stabilise your wrist when you grip, type, lift, carry, train, scroll, and generally live as a modern person.

But here’s the JANMI twist:

When the scapula loses control, the forearm becomes the stabiliser

If the shoulder blade isn’t giving a stable base, the body looks for stability elsewhere.

And the nearest “honest worker” is the forearm.

So the elbow becomes a backup stabiliser — gripping harder, bracing more, tightening sooner — until the tendon area starts to feel irritated and reactive.

That’s when you get:

• pain with gripping

• pain lifting with palm down

• tenderness on the outer elbow

• that “angry tendon” feeling the next morning

How the opposite-side knee connects (the spiral logic)

This is the part that feels mystical, but it’s just the body being one continuous system.

If the opposite knee collapses or rotates, it usually means the whole lower chain is subtly twisting:

foot → knee → hip → pelvis → ribcage → scapula

When the pelvis and ribcage rotate even slightly, the scapula on the other side often loses its clean resting position.

So the shoulder blade becomes:

• a bit more protracted (forward)

• a bit less stable

• less able to share load through the shoulder

And then the arm says:

“Fine. I’ll grip and stabilise from the elbow.”

Boom: lateral elbow pain.

A common pattern I see

Opposite knee instability → pelvic rotation → ribcage shift → scapula misalignment → shoulder loses “base” → forearm extensors overwork → lateral elbow pain.

Not always identical, but the theme is consistent:

lower-body asymmetry often creates upper-body overuse.

What we did in the JANMI Full Chain Reset

Instead of “treat the sore spot and hope,” we rebuilt the chain.

1) Give the scapula its job back

• down-train overactive pec minor / upper traps / levator (common culprits)

• restore glide and positioning around scapula and ribs

• re-activate serratus anterior + mid/lower trapezius patterns (so the blade stabilises during arm use)

2) Calm the elbow without making it the whole story

• precise soft tissue work to the extensor compartment (especially ECRB region)

• reduce protective tone around the lateral elbow

• grip mechanics: wrist position + forearm rotation habits

3) Fix the opposite knee mechanics (the quiet architect)

• foot and ankle control (often pronation/instability theme)

• glute med / deep hip rotators engagement

• pelvic stacking so the trunk stops pulling the scapula into a crooked position

In simple terms:

we removed the reason the elbow was overworking.

A quick self-check (non-diagnostic)

If someone has lateral elbow pain, I often try this simple experiment:

1. Stand tall.

2. Gently set the shoulder blade “back and down” (not forced, just organised).

3. Keep wrist neutral.

4. Lightly grip or lift something.

If pain reduces even a little: it’s a hint the elbow is reacting to poor upstream stability, not just local tissue weakness.

Disclaimer

This is educational and not a diagnosis. Lateral elbow pain can have different causes (tendon irritation, nerve sensitivity, neck referral, joint issues). If symptoms are severe, persistent, worsening, or include numbness/tingling/weakness, seek assessment from an appropriate healthcare professional.

Until next time,

Paulius