Serratus Anterior Activation


Serratus Anterior Activation (Upper-Body Dysfunction):

By Brent Brookbush MS, PES, CES, CSCS, ACSM H/FS


Serratus Anterior Activation (Functional Anatomy Article Coming Soon)

  • Origin: Outer surface and superior borders of the upper eight or nine ribs
  • Insertion: Costal surface of the medial border of the scapula.
  • Nerve: Long thoracic (C5 – C7 and somtimes C8)
  • Action: Protraction and upward rotation of the scapula.  The scapula also acts to approximate the scapula and ribs – stabilizing the shoulder girdle

Information above from Muscles: Testing and Function with Posture and Pain by Kendall, McCreary, Provance, Rodgers, and Romani


Signs of under-activity and a maladaptive increase in length:

Carefully assess dysfunction in every individual before suggesting corrective techniques.


Overhead Squat Assessment:

  • Arms Adduct (Long/Under-active)
  • Arms Fall Forward (Long/Under-active)


Manual Muscle Testing MMT:

  • Serratus Anterior MMT and Modifications:
    • A common result indicating dysfunction is compensation (as pressure is applied the patient pulls into anterior tipping of the scapula indicating pectoralis minor dominance, adduction may indicate pectoralis major and subscapularis dominance).
    • Provocative testing – In my humble opinion the MMT traditionally used, even the “Preferred Test” by Kendall et. al, in not a particularly provocative exam.  The inability to upwardly rotate with optimal shoulder girdle mechanics is lost well before an individual would test “weak” (4/5 or lower) or “with


Serratus Anterior Activation — 12 Comments

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  2. I am an athletic trainer and have a patient with severe scapular winging and serratus anterior weakness on one side. I am searching for specific activities that can strengthen to help him be able to complete a push up. Any suggestions are greatly appreciated.

    • Hey Chelsea,
      Did you clear the cervical and thoracic spine? You will also want to check pec minor, levator scapulae and upper trap tonicity. Potentially AC and SC joint mobility… and then… Serratus Anterior and Trapezius Activation.
      Let me know how this goes,

      • Admin,

        Hello, as Chelsea stated above I have the same problem. I’m experiencing the condition for the second time now. Last time was in 2011. I don’t know exactly what causes the condition to occur but it does for whatever reason. I’m a federal law enforcement officer and do lots of physical work on top of staying in shape working out. When I mentioned my shoulder recovered once I meant it only in the sense that I didn’t feel the sensation of scapular winging. I feel that my scapula is tipping again. My shoulder joint always seems to be unsupported when doing pull-ups and when doing push-up my right pec feels overworked. I can only guess that my Serratus anterior is not firing and my pec is doing most the work. I try as best I possibly can to focus on contracting the supporting muscles around my scapula in an effort to feel the same contractions or muscle activation as in my good shoulder (left side is good) but as much I try I cannot. Nerve issue? I don’t know. Maybe I can send you a video. My wife says superficially she doesn’t noticed a difference but I feel the difference in the mechanics within my scapula. I’m also experiencing some tightness in my trapezoid or rhomboids. Not sure if that is from compensation for other muscles. So in closing. My biggest concern is the lack of support I feel in my shoulder area and the minor scapular winging. Unlike the first occurrence I am able to lift my arm above my head and shoot a basketball but I’m concern there might be a deteriorating condition.

        Ronnie Sanchez at

        • Hey Ronnie,
          You have pointed out a huge weakness in online corrective intervention. You list a set of symptoms, but without seeing you in person it is really hard for me to make an evaluation. I can only guess that you have upper body dysfunction (, and I can only recommend that you look beyond the serratus anterior and incorporate intervention for the entire compensation pattern. Could it be a nerve issue?… sure, but I have no way of knowing that without an in-person evaluation. Chances are a nerve issues would originate from the cervical spine and you would have at least a loss of range in your neck, if not symptoms of tightness, pain, and other nerve signs. I wish I could help more… I mean that sincerely, but I think you need to find a good PT and see if you cannot work with them to construct a more comprehensive routine for addressing your issues.
          Good luck, and if I can be of any further help please e-mail me at

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