• The Forgotten Muscle of the Shoulder: Serratus Anterior

    November 23, 2017 | By Tony Yong

    While there’s a lot of focus and attention placed on strengthening the rotator cuff to maintain healthy shoulders, there is a muscle that is often forgotten on the path to healthy shoulders. That forgotten muscle is the serratus anterior.

    What is the Serratus Anterior?

    The Serratus Anterior is a muscle that originates from the side/front of the chest wall and attaches to the front of your shoulder blade. The muscle is supplied by the lower nerves of the neck (C5-C7).

    As you can see from the picture to the right, the serratus anterior has a serrated knife-like appearance and is noticeable in muscle-defined individuals.

    The serratus anterior has a few different functions:

    1. It helps anchor the shoulder blade against the rib cage. This gives the shoulder blade a good foundation for stability and control of the shoulder joint.

    2. It helps rotate the shoulder blades upwards when lifting the arms overhead.

    3. It helps with breathing given its attachments to the rib cage.


    Why is the Serratus Anterior Important?

    First off, the serratus anterior provides some of the necessary support for your shoulder blades to stay in a neutral position with your arms by your side. If your serratus anterior muscle is weak and lengthened, it can contribute to an increased rounding of the shoulders and your shoulder blades may sit further away from your spine.

    Second, your serratus anterior helps to bring your arms overhead. When you lift your arm overhead, a majority of that movement comes from the shoulder joint, but there is a portion of the movement that is coming from the shoulder blade. When the shoulder blade doesn’t rotate enough through overhead movements, it ends up putting more strain on the shoulder joint. This can result in excess stress being placed on the AC joint (where your collarbone and shoulder blade connect), and on the tendons of the rotator cuff.

    The most common sign of serratus anterior dysfunction is winging of the scapula. This can come  from an issue with the nerve supplying the muscle, or from a weak or lengthened serratus anterior muscle.

    Signs That Your Serratus Anterior May Have Challenges

    Here are a few tell tale signs that tell you that your serratus anterior may be struggling:

    1. You may notice when you look at yourself in the mirror (side view) that you see a fair amount of your shoulder blades

    2. You may find it a struggle getting your arms overhead easily and effortlessly

    3. You may have someone observe that your shoulder blades are winging in standing or when doing exercises such as a forward plank or a push-up.

    4. You may experience tenderness of your AC joint or may have chronic “rotator cuff tendinitis” that doesn’t seem to go away.

    If you answer yes to any of these tell-tale signs, you would be well served to book an appointment with one of Innovation Physical Therapy’s experienced physiotherapists. Given that the shoulder blades are visually out of sight for us, it can be a challenge to understand how well they’re functioning with different movements and exercises.

    Exercises for Your Serratus Anterior

    To get you started with engaging your serratus anterior we wanted to provide you with two exercises:

    1. The Punch Out

    Lying on your back, straighten your arm with a small weight (1-5 pounds) and punch your fist towards the sky. Slowly lower the arm while keeping the elbow straight. Make sure to avoid using your neck or chest muscles and focus on punching out from the shoulder blade. Repeat 10-15x.





    2. The Push-up Plus

    In the push-up position, perform a push-up and on the way back up give an extra little push through your shoulder blades. Avoid rounding your mid back or lifting up your hips when doing this.


    What Now?

    If you answered “yes” to any of the tell-tale signs mentioned above, or are experiencing shoulder pain with activities or with sleeping, you’ll want to have a thorough assessment. Physiotherapists are movement experts and are trained to diagnose and treat movement related problems of the shoulders and the body.

    To book an appointment with one of Innovation Physical Therapy’s experienced physiotherapists call one of our 5 clinics located throughout Edmonton & Sherwood Park including Riverbend, Meadowlark, Belvedere, Namao, or Sherwood Park.