THE 12 JANMI MODERN PAIN CONDITIONS - Why Even Strong, Fit Bodies Are Struggling

My dear reader,

If I had a pound for every time a healthy, fit, hard-working Londoner lay on my couch and said:

“Paulius, I do my steps, I lift, I stretch, I eat well… so why does my body still feel broken?”

…I’d probably be writing this from my JANMI chateau in the Alps.

You are not lazy.

You are not weak.

You are not “getting old at 35”.

You are simply a Stone Age body trying to survive in a Wi-Fi world.

For more than 15 years, I’ve had my hands on the muscles and fascia of busy professionals, athletes, yoga lovers, cyclists, desk-bound CEOs and burnt-out therapists. Different lives, different stories – but the same pain patterns, over and over again.

Eventually I stopped calling them “random injuries” and started calling them what they are in my head:

The 12 JANMI Modern Pain Conditions.

They are the twelve postural and movement patterns that keep returning to my Marylebone clinic, no matter how fit or educated the person is.

Today I want to talk to you personally about them – not as a lecturer, but as someone who has spent a lot of time with other people’s hamstrings – and explain why they are not a personal failure, but a predictable result of our disconnection from natural movement.

How We Got Here: Ancient Biology, Modern Furniture

Your body was sculpted over millions of years for:

• Walking long distances on uneven ground

• Squatting, climbing, carrying, throwing

• Breathing deeply in fresh air

• Sleeping and waking with light and darkness

• Responding to short bursts of danger – and then resting

Your actual day probably looks more like this:

• Chair → car → chair → sofa

• Screens at arm’s length and head’s tilt

• Tight shoes on flat pavements

• Chronic low-grade stress rather than short sharp danger

• Exercise squeezed into a 45-minute slot between meetings

It’s not that you don’t move.

It’s that you move in ways your body was never designed to be the only movement.

And so the body does what it always does: it adapts.

Tissues stiffen where the load is constant.

Other muscles fall asleep from underuse.

Fascia thickens along certain lines like footpaths in a field.

The result is a quiet pandemic of pain and stiffness – especially among people who “do everything right”.

These are the twelve JANMI modern pain conditions I specialise in.

1. Tech Neck – The Digital Head Drift

The head moves a few centimetres forward.

The neck muscles go on strike.

Your neck was designed to scan horizons for predators and opportunities, not emails and Instagram. For every bit the head drifts forward, the load on your neck increases dramatically. Imagine carrying a bowling ball on a stick – now lean it forward and see what your shoulders say.

What I feel under my hands:

• Suboccipitals like steel cables

• Tender SCM and levator scapulae

• Tired upper traps

• Weak deep neck flexors

• Often a jaw that has joined the complaint

From an evolutionary point of view:

We used to spend more time looking far away than close-up. Now our world is mostly at 30–40cm from our face. The neck has quietly become an endurance athlete with no training.

2. Thoracic Stiffness – The Locked Ribcage

This is the “I feel like a brick between my shoulder blades” condition.

Hours of sitting, shallow breathing, stress and lack of rotation gradually turn your upper back from a beautiful mobile column into something that resembles a piece of architecture.

Everyday example:

Cyclist with strong legs, big lungs, but can’t rotate enough to look over the shoulder without the whole body turning. Or the office worker who feels like their spine is made of one solid bone from T4 to T10.

Evolutionary story:

The thoracic spine was built for rotation – throwing, twisting, reaching, climbing trees. Modern life offers: typing, driving and staring. The spine responds by reducing movement in directions we never use.

3. Anterior Pelvic Tilt (APT) – The Modern Warrior Pose

APT is that classic “Instagram posture”: chest out, bottom out, lower back in a permanent arch. Looks strong in photos, feels less glamorous in real life.

Why it shows up:

• Tight hip flexors from sitting

• Overactive lumbar erectors

• Glutes doing less than they signed up for

• Training patterns that strengthen the big muscles but ignore the stabilisers

Result:

Lower back compression, hamstring overload, knees grumbling, hips pinching.

In evolutionary terms, we used our hips through large ranges every day: walking, squatting, running, climbing. Now we spend long hours folded at 90 degrees, then suddenly ask the body for heavy squats at 7pm.

The iliopsoas, once a dynamic prime mover, has become a short, sulky office worker.

4. Posterior Pelvic Tilt (PPT) – The Flat-Back Paradox

PPT is the cousin of APT – the pelvis tucked under, glutes and hamstrings locked short, lower back flattened out.

You see it in people who sit a lot, brace too much, or protect a sensitive lower back by permanently “tucking” the pelvis.

Effects:

• Limited hip extension

• Difficulty generating power in running or lifting

• Lower back that feels stiff but not strong

• That classic “I can’t find my glutes” feeling

Our ancestors needed a pelvis that could move like a well-oiled hinge. Modern life offers one main position: tucked under on a chair. The body adapts and gradually forgets what neutral even feels like.

5. Knee Valgus – When the Knees Kiss In

Knee valgus is when the knees drift inward – often during squats, running, or simply standing.

Most people blame the knee.

The knee, poor thing, is usually innocent.

Usual suspects:

• Weak or sleepy glute medius

• Tight IT Band and Tensor Fascia Latae

• Shortened Vastus Lateralis

• Lack of awareness of where the leg is in space

On natural uneven ground, your hips, knees and ankles constantly negotiate alignment. On flat floors and in stiff shoes, that negotiation ends. The knee becomes a compliant middle child caught between a confused hip and a collapsing foot.

6. Foot Overpronation – The Collapsing Arch

Overpronation is what happens when the arch drops and the weight rolls inwards. Sometimes gently, sometimes dramatically, like a slow-motion building collapse.

Modern ingredients:

• Hard, flat floors

• Cushioned, supportive shoes that do the job of your foot muscles

• Little barefoot time

• Tight calves and lack of ankle mobility

From an evolutionary angle, feet were designed to be active, intelligent sensors. Each step over stones, roots and uneven soil trained the intrinsic muscles. Your plantar fascia was meant to be a dynamic spring.

Now we live on polished slabs and call it progress.

Overpronation feeds straight up into knee valgus, hip instability and eventually – our final character: plantar fasciitis.

7. Jaw Clenching – Stress in the Chewing Muscles

Jaw clenching is the modern “fight or flight” stuck in permanent “hold”.

You may wake with a sore jaw, headaches, or that feeling that your teeth have had an argument all night. Often it’s married to tech neck and upper-back tension.

Why it happens:

• Chronic low-grade stress

• Poor sleep

• Forward head posture

• Shallow breathing

• Nervous system that never really switches off

Our ancestors’ stress was intense but brief: a predator, a fight, a storm. Your stress is emails, deadlines, money, traffic – and none of them has a clear end point. The jaw becomes your personal pressure valve.

8. Shoulder Impingement – The Pinch at the Top

You raise your arm and somewhere between 60° and 120° the shoulder says, “Absolutely not.”

Impingement happens when the space in the shoulder joint becomes crowded – often because the shoulder blade isn’t moving properly.

Common ingredients:

• Rounded shoulders

• Tight pec minor pulling everything forward

• Weak serratus anterior and lower traps

• Thoracic stiffness blocking upward rotation

Evolutionary comparison: our shoulders were climbing tools. Hanging, reaching overhead, throwing spears – all day, every day. Now we mostly reach to the keyboard and occasionally to the top cupboard. Overhead movement has become exotic.

9. Tennis Elbow – Not Just for Wimbledon

Lateral epicondylitis is the fancy name; “why does my elbow hate me when I lift the kettle?” is the lived experience.

You don’t need to play tennis. You only need:

• Lots of mouse and keyboard time

• Repetitive gripping in the gym

• Poor shoulder control so the forearm does extra stabilising

• Stiff neck and thoracic spine changing arm mechanics

We used our hands historically for varied tasks – pulling, climbing, carrying, crafting. Now they mostly hold small rectangles and click things.

The forearm extensors become the unsung heroes of modern civilization. Eventually, they protest.

10. Golfer’s Elbow – The Flexor’s Revenge

Same joint, opposite side.

Inner elbow pain, often worse with gripping, lifting a bag, or doing pull-ups.

Again, you don’t need to play golf. A smartphone and a barbell are more than enough.

Flexor tendons evolved for powerful, intermittent work – grabbing branches, lifting stones, handling tools. They weren’t designed for endless typing combined with sporadic heroic gym sessions.

11. Piriformis Pain – The Small Muscle with a Huge Job

The piriformis is a deep hip rotator that was never meant to be the star of the show. That role belongs to the glutes.

But in the modern sitting-and-sprinting lifestyle, the glutes often go quiet. The piriformis steps in to stabilise the hip… and then doesn’t get to clock out.

Everyday pattern:

• Long day of sitting

• Quick change into running shoes

• 5–10 km run “to be healthy”

• Hip says: excuse me?

Deep buttache, sometimes with sciatic-type symptoms, follows.

Our ancestors’ glutes were constantly active: walking, climbing, squatting, carrying. Now they spend most of the day as padding for a chair.

12. Plantar Fasciitis – Morning Pain, Modern Foot

Plantar fasciitis is one of the clearest examples of evolutionary mismatch.

You get that first-step-out-of-bed stabbing heel pain… and your day hasn’t even started.

Typical contributors:

• Tight calves and Achilles

• Overpronation

• Lots of standing or walking on hard floors

• Weak intrinsic foot muscles

• Sudden spikes in running volume

The plantar fascia evolved to store and release elastic energy on forgiving ground. Now it’s asked to behave like a shock absorber for concrete and office tiles.

How These 12 Patterns Led to JANMI

When I started, I treated what I saw: a neck, a shoulder, a hip. But over time patterns emerged. Tech neck travelled with jaw clenching. Thoracic stiffness with shoulder impingement. Overpronation with knee valgus and plantar fasciitis. APT with piriformis pain.

It stopped looking like 12 separate problems and started looking like one large modern story told in twelve chapters.

That realisation shaped JANMI Soft Tissue Therapy and later JANMI Integrated Therapy:

• I release what is overloaded

• I wake what is under-working

• I help the nervous system calm down

• I try to remind your body how it once moved, before furniture and phones arrived

It is not simply “massage”. It is a conversation with your evolutionary design, delivered through hands, breath and movement.

A Serious Note – And a Gentle Smile

We are living through a quiet pain pandemic. Not the dramatic kind you see in films, but the slow erosion of comfort: stiff backs at 30, sore feet at 40, shoulders that can’t reach overhead, jaws that never quite relax.

This is serious.

It affects sleep, mood, relationships, performance, and the way we age.

At the same time, I prefer to hold it with a little humour. Because if we can smile while talking about piriformis spasms and over-enthusiastic forearm extensors, we are already less afraid of them.

You are not broken.

You are simply modern.

And with the right touch, the right understanding, and a little return to nature’s logic, the body responds beautifully. I see it every week in Marylebone.

Warm wishes,

Paulius Jurasius