Table of ContentsView AllTable of ContentsAnatomyFunctionAssociated ConditionsTestingSymptomsRehabilitation
Table of ContentsView All
View All
Table of Contents
Anatomy
Function
Associated Conditions
Testing
Symptoms
Rehabilitation
Theserratus anterioris a fan-shaped muscle that attaches your shoulder blade, known as yourscapula, to your rib cage. The muscle helps to move your scapula in various directions and is essential for proper shoulder function. Injury to the serratus anterior is rare, but if it happens, you may require rehabilitation to get your shoulder moving and functioning normally again.
This article will cover the important role the serratus anterior muscle plays in the body, as well as conditions that are associated with this muscle.
Ekaterina Goncharova / Getty Images
The serratus anterior originates via eight muscular “slips” that attach to the side of your ribs. It then courses around the side of your rib cage and underneath your scapula. There, it inserts along the medial border of your scapula.
This muscle lies between the back of your rib cage and your shoulder blade near the subscapularis (one of thefour rotator cuff muscles). A small fluid-filled sac called abursalies between the subscapularis and serratus anterior that allows the scapula to glide and slide normally during movement.
There are three divisions of the serratus anterior:
Each of the divisions of the muscle functions together to move your scapula in various directions.
You have two serratus anterior muscles, one on each side of your body.
What Do the Serratus Anterior Muscles Do?
The serratus anterior muscle protracts the shoulder blades. This means that they pull them forward around your rib cage. Think of a boxer throwing a punch; as his arm comes forward, the serratus anterior contracts to pull the shoulder blade around the ribs and forward.
The inferior and superior aspect of the serratus also helps to stabilize your shoulder blade against your rib cage. When they contract together, they work with therhomboid musclesto pull your scapula tight against the back of your ribs.
When your arm and shoulder are in a fixed and stable position, the serratus anterior helps to elevate your ribs. This occurs during normal breathing. Thus, the serratus anterior muscles are considered secondary muscles of respiration.
Common causes of serratus muscle pain include:
Muscle pain is common in sports with repetitive motions such as tennis, swimming, and weightlifting.
Although rare, serratus anterior myofascial pain syndrome (SAMPS) is another potential cause. It presents with pain over the fifth to seventh ribs, which can radiate to other parts of the upper body.
Injury to the serratus can result in a condition called a winged scapula. This manifests as a visual bump in your back where your shoulder blade resides.
One common cause of a serratus anterior injury is a problem with the long thoracic nerve.This nerve resides near your armpit, and it may be damaged during surgical procedures involving your shoulder.
Injury to the long thoracic nerve may occur during lymph node resection in patients with breast cancer.The nerve can also be overstretched during athletic activity.
Since the serratus anterior attaches to the side of your rib cage, an injury to your ribs may also cause damage to the muscle. A rib fracture can cause the muscle tissue of the serratus to pull away, resulting in anavulsion fracture. This can be a painful injury and limits the function of the serratus anterior.
Shoulder Blade Pain Symptoms and Causes
Sometimes, serratus anterior weakness and winging of the scapula can occur for no apparent reason. A condition known asParsonage-Turner Syndromemay affect your brachial plexus and the long thoracic nerve. This brachial neuritis may cause weakness in your serratus and manifest as the telltale scapular winging.
An injury to your shoulder or rotator cuff may also cause scapular winging. Conditions like rotator cuff tear or ashoulder separationmay cause pain and inhibition of the muscles that support your shoulder. If the serratus anterior becomes inhibited, it may fail to adequately hold your shoulder blade to your ribs, leading to scapular winging.
Testing the Serratus Anterior
The serratus wall test is often performed to assess the function of the serratus anterior. To do this test:
Have someone watch the position of your shoulder blades. If one shoulder blade wings out, there may be weakness in your serratus anterior on that side.
If you suspect you have an injury to your serratus or find that your shoulder blade is winging, you should visit your healthcare provider for a full assessment. Your healthcare provider can determine the cause of your problem and refer you to the right professional to help regain function of your serratus muscle.
What Are the Symptoms of Serratus Anterior Pain?
Pain associated with the serratus anterior muscle may occur in the chest, back, and arm. It may be perceived as burning or stabbing in nature. In some cases, the pain may radiate down to the fingers.
An injury to your serratus anterior may cause scapular winging, shoulder motion limitations, and difficulty with normal upper extremity function. Working with a physical therapist can help you recover after an injury to your serratus.
Treatments that you may encounter during rehab for your serratus anterior may include:
These treatments are designed to improve the way your shoulder moves and functions.
Exercises
Exercises that may be done toimprove the strength and function of your serratus anteriormay include:
Supine punches
Pushups with a plus
Serratus wall slide
Plank
Band chest press
Check with your healthcare provider before starting this or any other exercise program for your shoulders or serratus anterior. If any exercise causes pain, stop and visit your healthcare provider
Summary
Your serratus anterior is a major scapular stabilizer that essentially holds your shoulder blades to your rib cage. An injury here can cause pain, limited motion, scapular winging, and difficulty using your arm normally. Understanding the anatomy and function of your serratus anterior can help you properly rehab it after an injury.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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