The 12 Modern Postural Pain Patterns We See Every Week in Marylebone (and Why “Just Stretch” Usually Fails)

My Dear Reader,

If you work at a laptop, carry a bag on one shoulder, train hard on weekends, and sit like a folded deckchair on weekdays… welcome. You’re not broken. You’re just a modern human.

At JANMI Soft Tissue Therapy in Marylebone, we see the same postural pain patterns on repeat. Not because Londoners are fragile—because the body adapts brilliantly to whatever you do most. The problem is: it adapts with shortcuts.

And those shortcuts create what I call:

• Brakes: the muscles that grip, guard, overwork, and “do the job for everyone.”

• Sleepers: the muscles that go quiet, forget their role, and leave the brakes to run the show.

When brakes dominate and sleepers stay asleep, movement becomes messy. The body still moves—but it starts charging pain as a “service fee.”

Below are the 12 common modern postural pain conditions we see, what’s really happening anatomically, and what JANMI does differently to fix them.

The JANMI lens: pain is often a coordination problem, not a damage problem

A quick biomechanical truth:

• The shoulder blade (scapula) is not a decorative wing. It’s a moving base for the arm.

• The pelvis is not a bowl you “tilt”. It’s a load-transfer platform between legs and spine.

• The foot is not “flat” or “high-arched” by personality. It’s a spring + steering wheel.

When control changes, joints get overloaded and tissues complain.

At JANMI, we don’t chase symptoms. We chase the pattern.

12 patterns, in real clinic language

1) Tech Neck / Forward Head

What you feel: heavy head, tight skull base, tired mid-back.What’s happening: the head drifts forward, the upper cervical spine extends, and the mid-thoracic spine tends to stiffen into flexion. The body uses suboccipitals + SCM + upper traps as a neck “hanger.”

JANMI focus: release the neck “brakes,” then teach deep stabilisers to carry the head again.

2) Thoracic Outlet Syndrome (TOS pattern)

What you feel: heaviness/tingling, “crowded collarbone”, arm fatigue.What’s happening: the space around the first rib, clavicle, scalenes and pec minor gets crowded. Add forward shoulder posture and the nervous/vascular bundle can become irritated.

JANMI focus: calm the front-neck and pec minor tone, restore rib/scapular mechanics, then rebuild load tolerance carefully.

(Note: persistent neurological symptoms always deserve medical assessment.)

3) Rounded Shoulders / Scapular Protraction

What you feel: chest tight, blades slide forward, neck always “on.”What’s happening: a short pec minor tends to pull the scapula into anterior tilt and internal rotation. Serratus anterior and lower trap often underperform, so the scapula doesn’t upwardly rotate and posteriorly tilt well during arm movement.

JANMI focus: open the front line + wake up serratus/lower trap + re-train “quiet neck” posture.

4) Scapular Winging

What you see/feel: the shoulder blade lifts off ribs; pushing feels unstable.What’s happening: often reduced serratus anterior control (and sometimes lower trap timing). The scapula loses ribcage contact, so the arm loses a stable base.

JANMI focus: re-establish scapula-to-rib control first. Strength later. (Control beats ego.)

5) Anterior Shoulder “Impingement” (pinchy front shoulder)

What you feel: sharp/pinchy front shoulder with reaching or lifting.What’s happening: the rotator cuff and scapula should guide the humeral head smoothly. When scapular mechanics and cuff control are off, front-of-shoulder tissues (often biceps/rotator cuff/bursa area) get irritated—especially with repeated reaching.

JANMI focus: scapula position + rotator cuff loading + pec minor/lat release. And we stop forcing painful end-ranges.

6) Jaw Clench / TMJ–Neck Link

What you feel: jaw grip, neck tension, headaches, “busy face.”What’s happening: jaw muscles (masseter/temporalis) often co-contract with suboccipitals and SCM. Stress plus forward head posture creates a closed loop: tight jaw → tight neck → tighter jaw.

JANMI focus: downshift nervous system tone, release jaw/neck brakes, then retrain deep neck flexors + breathing mechanics.

7) Anterior Pelvic Tilt (APT)

What you see/feel: arched low back, tight front hips, glutes “missing.”What’s happening: hip flexors (iliopsoas/rectus femoris/TFL) shorten or dominate. Lumbar extensors overwork. Glutes and deep abdominals often under-contribute to controlling pelvis during walking and hinging.

JANMI focus: hip flexor tone management + glute/abdominal timing + hinge pattern retraining.

8) Posterior Pelvic Tilt (PPT)

What you see/feel: flat low back, hamstrings grip, ribs stiff.What’s happening: hamstrings and abs can become dominant stabilisers. Hip flexion mechanics get limited, and lumbar spine loses segmental extension capacity.

JANMI focus: restore rib mobility + hip flexor function + segmental spinal control. Less “brace”, more organised movement.

9) SI-Joint Irritation (load transfer problem)

What you feel: one-sided low back/buttock ache when standing/walking.What’s happening: often not the SI joint being “out”—more commonly poor load transfer between glute med/max, deep core, and hip mechanics. The body compensates via QL/piriformis/hamstrings.

JANMI focus: reduce protective tone, re-load glutes, and rebuild walking/standing endurance.

10) Knee Valgus (inward knee drift)

What you see/feel: knee collapses in squats/running; knee pain.What’s happening: the femur internally rotates/adducts while the foot collapses. Often glute med/max + deep hip external rotators underperform, while TFL/adductors dominate.

JANMI focus: hip control first, foot mechanics second, knee last. The knee is usually the messenger.

11) Foot Over-Pronation

What you feel: collapsed arch, tired calves, shin/hip chain overload.What’s happening: the arch is a spring. If intrinsic foot muscles and tibialis posterior underperform, pronation becomes uncontrolled. The calf complex often works overtime to stabilise.

JANMI focus: calf/plantar tissue tone + rebuild foot strength + connect it to hip control.

12) Plantar Fasciitis (non-acute)

What you feel: sore heel/arch, worst in the morning or after sitting.What’s happening: plantar fascia is part of the foot’s load system. When calves are tight and the arch is weak or overworked, the fascia becomes irritated. Often the problem isn’t “the fascia”—it’s the mechanics feeding it.

JANMI focus: calf/soleus + foot intrinsics + load progression. No aggressive smashing. Smart loading wins.

What makes JANMI different (and why it works)

Most people do one of two things:

1. Stretch the tight bits forever.

2. Strengthen randomly and hope.

JANMI is the third route:

• Assess the pattern (brakes vs sleepers)

• Release what’s overworking (myofascial release + trigger point therapy + precise soft tissue work)

• Rebuild control where it’s missing (targeted exercises, not generic “posture drills”)

• Progress load so results stick in real life (desk, gym, parenting, travel, London life)

You don’t need perfect posture. You need better options.

Quick note on safety

If your symptoms include constant numbness/tingling, progressive weakness, severe night pain, unexplained swelling, or symptoms after a significant trauma, get medical assessment alongside manual therapy.

Want this solved properly?

If you’re dealing with any of these patterns and you want a plan that’s specific to your body (not a random internet routine), book an assessment at:

JANMI Soft Tissue Therapy, Marylebone (Portman Square, London)

We’ll identify your brakes and sleepers, reset the pattern, and give you a short plan you’ll actually do.

Warmly,

Paulius Jurasius