The serratus anterior attaches to the outside edge of the shoulder blade and then connects to the ribs. The serratus anterior originates at the side of the first through eight ribs. Attachment of Serratus Anterior Origin: Upper nine ribs at the side of the chest Insertion: Costal aspect (side articulating with the ribs) of […] The serratus anterior slow our descent from High Plank into Chaturanga. Serratus anterior muscle origins and insertion. Serratus Anterior Weakness. Serratus anterior weakness was highlighted as detrimental, with the model unable to fully solve the loadsharing redundancy in its absence, and forces at the elbow and glenohumeral joint and in other muscles were found to be profoundly increased. So, the reader is thinking at this point, if my serratus anterior is weak then my right hook isn’t what it used to be, and I have a funny looking shoulder blade. Today I want to discuss one of the biggest contributors in shoulder impingement injuries, weakness of the serratus anterior. The serratus anterior is a muscle that originates on the surface of the 1st to 8th ribs at the side of the chest and inserts along the entire anterior length of the medial border of the scapula.The serratus anterior acts to pull the scapula forward around the thorax. Injury to the long thoracic nerve causing paralysis or weakness of the serratus anterior muscle can be disabling. A condition known as Parsonage-Turner Syndrome may affect your brachial plexus and the long thoracic nerve. Serratus Anterior: The Serratus Anterior muscle is utilized in activities which draw the scapula forwards. Picture 1. • Patients with serratus anterior weakness, patient is able to fully flex the shoulder but exhibit a degree of scapular winging. Step1. Step2. Sometimes, serratus anterior weakness and winging of the scapula can occur for no apparent reason. In many cases, serratus anterior muscle pain treatment is similar to other muscle pain treatments. Talk about a full circle powerhouse of muscle!! Winged scapula is a designator having a weak Serratus Anterior muscle. Here are a few tell tale signs that tell you that your serratus anterior may be struggling: 1. The serratus anterior is the most important muscle that facilitates an upward rotation of the shoulder blade. (This whole blog post will be going through a range of different Serratus Anterior Exercises) Serratus Anterior Muscle Pain Treatment. It is the upward rotation force that we are wanting to test, however. Thanks to my lack of progress with pressing overhead, I will … In such a case, scapulothoracic fusion might be the preferred surgical process . The most common sign of serratus anterior dysfunction is winging of the scapula. Although an unappreciated muscle, the serratus anterior plays a significant role in stabilizing the shoulder joint and shoulder blade. Step3. The rhomboids are shortened and contracted. EXAMINATION Muscle Function: Origin Fixed: • Abduction (protraction) of the scapula. The second commonly thought of function for the serratus anterior is ‘protraction’ of the shoulder blade, pushing it forward relative to the body in a punching motion. It is utilized vigorously in push-ups and bench presses. Many of the following techniques can even be done at home. However true scapular winging as a result of nerve damage to the long thoracic nerve innervating the serratus anterior muscle or other nerve palsy’s are both more disabling and fortunately not as common. When you reach overhead, this cooperative muscle forms a force couple with the upper and lower trapezius allowing for maximal upward rotation of the glenohumeral joint. “When the serratus anterior muscles are weak, they contribute to neck problems, rotator cuff issues and scapular winging (damage to the long thoracic nerve of the shoulder),” Carnevale says. Next, practice Activation exercises to strengthen and facilitate proper firing sequences of the following underactive muscles: Rhomboids (Upper Back Muscle), Mid and Lower Trapezius (Upper Back Muscles), Serratus Anterior (Shoulder Girdle Muscle), and the Cervical Flexors (Anterior Neck Muscles). The serratus anterior muscle is capable of providing both a protraction and upward rotation force. The Serratus Anterior is the primary muscle that anchors the scapula flat onto the rib cage.. During the summer of 2015, I decided to really find the culprit behind my lacking overhead press performance, and eventually I found it: weak upward rotation and weak serratus anterior muscles. This can come from an issue with the nerve supplying the muscle, or from a weak or lengthened serratus anterior muscle. It runs laterally around the rib cage, passes underneath the scapula to insert on its medial border. Serratus anterior dysfunction is just one of many reasons for shoulder dysfunction in breast cancer patients. • Upward rotation of the scapula and rotates the glenoid cavity cranially. When the serratus anterior contracts, upward rotation, abduction, and weak elevation of the scapula occurs, allowing the arm to be raised above the head. Weak Serratus Anterior Muscles Can Lead To Various Dysfunctions. Step4. Patients with serratus palsy may present with pain, weakness, limitation of shoulder elevation, and scapular winging with medial translation of the scapula, rotation of the inferior angle toward the midline, and prominence of the vertebral border. Ask the patient forward flexing of arm 90 degree. Actions. Fig.  The second is the shoulder abduction test, the therapist applies a downwards resisting force against the scapular plane abduction of the shoulder at about 120–130° and against upward rotation of the scapula. By protracting the shoulder blade the bone is in a more supportive position to allow the rotator cuff to do its job. Weak serratus anterior muscle would result in winging of the scapula medial border. Serratus anterior (SA) holds the scapula to the wall of the thorax. With the serratus anterior muscle, overuse injuries can lead to stress fractures of the ribs.The serratus anterior is a scapulothoracic muscle that is responsible for laterally rotating and elevating the scapula, and when weak due to LTN injury, it results in scapular winging. Therapist apply backward pressure to the arm. The muscle is named from Latin: serrare = to saw, referring to the shape, anterior = on the front side of the body. A weak serratus anterior and subsequently some mild winging of the scapula is a common feature with abnormal scapulohumeral rhythm. These interfascial injections were developed as alternatives to thoracic epidural, paravertebral, intercostal, and intrapleural blocks, primarily for analgesia after surgery on the hemithorax. When these muscles are weak, we come crashing down. Visualize the serratus anterior expanding the chest. Signs That Your Serratus Anterior May Have Challenges. Instead of allowing this muscle to become weak through neglect, consider make it stronger by the following 8 serratus anterior exercises. The serratus anterior is broad and flat; it arises in the form of multiple Its purpose is to protract or pull around the shoulder blade as we reach forward. When one talks about winging of the scapula, true winging is due to serratus anterior muscle dysfunction. From a systemic perspective, the serratus plays a major role in shoulder positioning which can enhance lymphatic drainage. That’s where the serratus anterior comes in. Therefore, damage to this muscle can result in … 1, a: Normal position of the scapula at rest, b: In serratus weakness the inferior angle of the scapula rotates backward and upward, stretching the lower fibers of the trapezius. For one, it prevents winged scapula, a condition that can occur when your serratus anterior muscle is weak or dysfunctional. In my clinical practice thus far, I have seen several different ways of testing the serratus anterior, but it is … Shoulder impingement occurs as a result of repeated irritation or pinching of long head… The long thoracic nerve innervates the serratus anterior; therefore, damage to or impingement of this nerve can result in … A weak or fatigued Serratus Anterior may not allow for adequate Scapulohumeral Rhythm compromising proper shoulder mechanics. Namaste' Ray and Chris Learn more about anatomy and yoga by subscribing to our Newsletter. One of the most common injuries seen in any overhead activities such as welding, painting, weightlifting, swimming and baseball/softball is shoulder impingement. I've trained gymnastics for years now and have a reasonable level of upper body strength, in fact I can hold a straddle planche but I'd hate to imagine what my scapula looks like then. Serratus Anterior Strength Test or Push Out Test is used to examine the serratus anterior muscle weakness and scapula winging. Multiple papers (here, here) have shown is that when this muscle becomes weakened or fails to properly activate, it can lead to unwanted movement within the shoulder joint and the shoulder blades.And this then creates various dysfunctions, such as: A forward rounded posture (Read my previous article: How To Fix Rounded … Your lymphatic system helps to … This last issue is a particular concern as it can lead to a backlog of toxins in the breast tissue and lymph nodes. 8 Great Exercises You Should Try If your serratus anterior muscles become weak, this can lead to rotator cuff issues, neck problems, lymphatic return in the armpits, poor circulation and numbness down your arm. 1. Exercises to strengthen serratus anterior are important for those who wish to remain fit, who are involved in sports and athletics, those who have injuries causing weak serratus anterior or those with joint and muscle conditions. Luckily, there are a number of ways you can treat serratus anterior muscle pain, most of which can be done in your own home, simply and safely. Romero and Gerber reported poorer outcomes in the presence of an more serratus anterior palsy or weak rhomboid muscle. If you do not have strength and/or control of this very important muscle, it can lead to scapular winging. The serratus anterior a muscle that originates on the top surface of the eight or nine upper ribs. A winged scapula , also called scapular winging is when one of your shoulder blades sticks out; it makes performing everyday movement like picking up your child or carrying groceries difficult.