Serratus Anterior Activation

(for Upper Body Dysfunction):

By Brent Brookbush DPT, PT, COMT, MS, PES, CES, CSCS, H/FS


For a complete review of origins, insertions, neural innervations, actions, integrated actions, arthrokinematics, motor behavior, subsystem involvement, and trigger points – check out these articles:

  • Serratus Anterior

For an introduction to activation exercise, including a list of commonly activated muscles, the goal of activation exercise, activation circuits, progression, acute variables, order of activation exercise and a PDF of the “Integrated warm-up template”, check out this article:

  • Introduction to Activation Exercise

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

Carefully assess dysfunction in every individual before suggesting corrective techniques.

Overhead Squat Assessment:

  • Arms Fall (Long/Under-active)
  • Shoulders Elevate (Long/Under-active)


Manual Muscle Testing (MMT):

  • Serratus Anterior Manual Muscle Testing (MMT) for an Active Population (1):
    • A common result indicating dysfunction is weak, and/or with compensation. As pressure is applied, either the inferior angle of the scapula moves medially (weakness) or scapular elevation and anterior tipping is noted implying synergistic dominance of the pectoralis minor, levator scapulae, and upper trapezius. Further, there seems to be a correlation between serratus anterior inhibition and subscapularis over-activity.
    • Provocative testing – The only serratus anterior MMT consistently used by the Brookbush Institute is the one titled "Preferred Test"in Muscles Testing and Function with Posture and Pain by Kendall et al. (1). This test is done in a seated position and evaluates the capacity of the serratus anterior to maintain the scapula in an upwardly rotated position. It is our opinion that the "punch up" test, commonly used in a clinical setting for serratus anterior MMTs, too often results in a false negative due to synergistic dominance of the pectoralis minor and perhaps additional force generated from the pectoralis major.


Overactive Synergists:

Muscles that commonly become synergistically dominant when the t