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 compensation.”  A “wall angel” may be a better test.

 

Overactive Synergists:
Article: Overactive Synergists Cheat Sheet – for more on this concept and a complete list of under-active muscles and their synergists.  Release and stretch prior to activation & cue joint motion to reciprocally inhibit these muscle during activation exercise.

  1. Pectoralis Minor – release (inhibit w/ posterior tipping, thoracic extension, and retraction)
  2. Subscapularis – release (inhibit w/ external rotation)
    1. Child’s Pose is an effective stretch for both muscles

 

Isolated Activation:

  1. Floor Scaption to pointed thumbs
  2. Floor Scaption to fist
  3. Floor Scaption to forearms
  4. Floor Angels
  5. Wall Scaption to pointed thumbs
  6. Wall Scaption to fist
  7. Wall Scaption to forearms
  8. Wall Angels
  9. Facing Wall Slides with ER Band
  10. Facing Wall Slides with ER Band w/ Ball

Serratus Anterior Isolated Activation:

Serratus Anterior Isolated Activation Progressions (Sahrmann Activation with Brookbush/Fluegel Modifications):

Core Support:

 

Integrated Stabilization

  • Push-up Progression

 

Reactive Integration:

  • Single Leg Chest Pass
  • Two Legs Unstable Chest Pass
  • Single Leg Unstable Chest Pass

 

Subsystem Integration:

Posterior Oblique Subsystem Progression:

  1. Squat to Row
  2. Static Lunge to Row
  3. Reverse Lunge to Row

 

Sample Activation Circuit:

Perform each exercise for 10-20 reps with a weight that is challenging, but ensures that ideal form will be maintained.  Perform in a circuit (without rest between exercises) 1-3 times through.

Release and stretch short/hypertonic structures first:

  1. Wall Scaption to Thumbs (Isolated Activation)
  2. Static Ball Bridge w/ Rotation (Core Support)
  3. Push-Up w/ Protraction (Integrated Stabilization)
  4. Single Leg Stability Ball Chest Pass (Reactive Integration)
  5. Static Lunge to Unilateral Row (Sub-system Integration)

 

© 2013 Brent Brookbush

Questions, comments, and criticisms are welcomed and encouraged –


Comments

Serratus Anterior Activation — 3 Comments

  1. Pingback: Solutions Table: Overhead Squat Assessment |

  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.
    Chelsea

    • 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,
      B2

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