Serratus who? The often forgotten culprit causing shoulder pain
Updated: Mar 2, 2020
Our member and physiotherapist, Shae Martello, tells us about the lesser known shoulder muscle, Serratus Anterior, and how important it is for proper shoulder mechanics.
As a physiotherapist, I have an innate admiration for the muscular system. Most of you reading this will know what a bicep muscle is and that the ‘quads’ are a group of 4 muscles at the front of your thigh. However, it is often the little guy that goes unnoticed who can be causing the most problems.
If you experience shoulder pain, particularly with reaching or overhead activities, it could be due to a weak Serratus Anterior. The Serratus Anterior is an important muscle that acts on the shoulder blade (scapula), attaching the scapula to the first 8 ribs. It is also sometimes referred to the “Boxers muscle” as when it contracts, it draws the scapula against the rib cage and towards the front of the body (seen when a boxer delivers a perfect punch). If you look at pictures of Calvin Klein models, the Serratus Anterior muscle is “those finger thingy’s” under the arm that attaches onto the rib cage. The action of Serratus Anterior increases the freedom of movement allowed at the shoulder joint.
If your Serratus Anterior is weak, its action will be ineffective, resulting in restricted shoulder movement. Repeatedly trying to move a restricted shoulder can irritate and squash structures within the shoulder joint (known as impingement) which can result in shoulder pain. One way to tell if you have a weak Serratus Anterior is if the border of your scapula sticks out, or ‘wings’ when you move your arm. You may also have a ‘rounded shoulders’ posture. People with a strong Serratus Anterior will be able to maintain a flat scapula against their rib cage throughout full range of motion. Strengthening your Serratus Anterior will improve your posture and can help relieve or prevent shoulder injuries.
A simple yet effective exercise for strengthening your Serratus Anterior is the “push-up plus” against a wall. Start by standing just short of arm’s length away from the wall. Assume a push-up position with your arms straight, elbows slightly bent and your hands placed slightly wider than shoulder-width apart. Your body should form a straight line from your ankles to your head.
Lower your body until your chest nearly touches the wall. Pause, and then push back up.
When your arms are back to the start position, push your chest further away from the wall, feeling your shoulder blades slide forwards along your rib cage. This extra movement is called shoulder protraction and it activates your Serratus Anterior. Pause for a one count, then lower your chest and slide your shoulder blades back to the starting position. Repeat x10. For strength gains, this exercise is best performed 3 times per week, 3-4 sets of 10 to 12 repetitions.
If you cannot achieve this push-up correctly and are doing gym or strength training, or if you have shoulder pain, you should speak to your physiotherapist or healthcare professional for further advice.
Shae Martello is a physiotherapist at Healthfocus Physiotherapy in Albury, NSW. Shae has an interest in researching how nutrition affects recovery in adjunct to physical activity, and also safe resistance training for adolescents to improve performance. Shae promotes physical activity to her clients by brainstorming how it can fit into their daily routine and helping them explore other options if they do not have an interest in conventional activities. Shae's personal favourite form of physical activity is resistance training and she attempts to educate all clients on the benefits, especially adolescents. Call (02) 6041 5744 to make a booking to see her today!