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Picture

How to Strengthen the SErratus Anterior

10/23/2015

3 Comments

 
Picture
The serratus anterior (SA) muscle is vitally important for shoulder function. The muscle is best known for it's role in scapular upward rotation and posterior tilting of the scapula during shoulder movements. Additionally, it works in conjunction with the upper trapezius as a force couple to achieve full shoulder elevation. The SA is often weak in many of my patients with shoulder dysfunction. The reason for this is multi-fold. Two common reasons for SA weakness include: 1. anterior tilting of the scapula secondary tightness pec muscles & 2. over-dominant downward rotators. Both of these causes can be attributed in part to chronic postural positioning. With anterior tilting of the scapula, the shoulder is placed in an anterior and internally rotated position, lengthening the SA and inhibiting its function. With over-dominant downward rotators, the forward head posture stresses the upper cervical spine creating tension in the levator scapulae and rhomboids. Again, this posture facilitates the downward rotators, making full upward rotation difficult to achieve. 

Picture
Testing the Strength of the Serratus Anterior
Supporting the arm on your shoulder, passively flex the arm to 110 degrees and protract the scapula. Monitor inferior scapular angle. Ask the patient to maintain this position as you release the arm If not, apply a downward force proximal to the elbow. If the scapula jogs underneath your fingers, the test is graded <3-/5. 


Strengthening the SA Muscle
​A 2006 JOSPT article entitled, "A Comparison of Serratus Anterior Activation During a Wall Slide Exercise and Other Traditional Exercises" found that the wall slide exercise was an effective exercises for SA strengthening. The article also found that the push-up plus exercise had good activation at 90 degrees of shoulder flexion. Clinically, I prefer to have my patients perform wall slides over the push-up plus. As I mentioned earlier, the SA helps the shoulder reach full upward rotation. The wall slides exercise allows for SA activation through the entire range of motion. Below is a video of several exercises by our author Chris Fox for strengthening the SA.

​-Jim 
3 Comments
Glenn
10/30/2015 08:39:52 pm

I'm just going to wing these exercises like a weak serratus anterior!

Reply
Jim
11/1/2015 08:19:10 am

Haha Glenn. I like the humor. Thank you for continuing to follow TSPT!

Jim

Reply
omalone1
6/29/2018 01:32:59 am

Gwiz, you risk people doing wal slides with poor forms

And what about progressions

Reply



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  • Home
  • About Us
  • Insider Access
    • About Insider Access
  • Online Courses
    • Hooper's Knee
    • Physical Therapist Entrepreneur Course
    • Physical Therapist Consultant Course
    • Orthopedic Management of the Cervical Spine
    • Return to Sport Essentials Course
  • Resources
    • Newsletter
    • Business Minded Sports Physio Podcast
    • Day in the Life of a Sports PT
    • Residency Corner
    • Special Tests >
      • Cervical Spine >
        • Alar Ligament Test
        • Bakody's Sign
        • Cervical Distraction Test
        • Cervical Rotation Lateral Flexion Test
        • Craniocervical Flexion Test (CCFT)
        • Deep Neck Flexor Endurance Test
        • Posterior-Anterior Segmental Mobility
        • Segmental Mobility
        • Sharp-Purser Test
        • Spurling's Maneuver
        • Transverse Ligament Test
        • ULNT - Median
        • ULNT - Radial
        • ULNT - Ulnar
        • Vertebral Artery Test
      • Thoracic Spine >
        • Adam's Forward Bend Test
        • Passive Neck Flexion Test
        • Thoracic Compression Test
        • Thoracic Distraction Test
        • Thoracic Foraminal Closure Test
      • Lumbar Spine/Sacroiliac Joint >
        • Active Sit-Up Test
        • Alternate Gillet Test
        • Crossed Straight Leg Raise Test
        • Extensor Endurance Test
        • FABER Test
        • Fortin's Sign
        • Gaenslen Test
        • Gillet Test
        • Gower's Sign
        • Lumbar Quadrant Test
        • POSH Test
        • Posteroanterior Mobility
        • Prone Knee Bend Test
        • Prone Instability Test
        • Resisted Abduction Test
        • Sacral Clearing Test
        • Seated Forward Flexion Test
        • SIJ Compression/Distraction Test
        • Slump Test
        • Sphinx Test
        • Spine Rotators & Multifidus Test
        • Squish Test
        • Standing Forward Flexion Test
        • Straight Leg Raise Test
        • Supine to Long Sit Test
      • Shoulder >
        • Active Compression Test
        • Anterior Apprehension
        • Biceps Load Test II
        • Drop Arm Sign
        • External Rotation Lag Sign
        • Hawkins-Kennedy Impingement Sign
        • Horizontal Adduction Test
        • Internal Rotation Lag Sign
        • Jobe Test
        • Ludington's Test
        • Neer Test
        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
          • Adson's Test
          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
        • Biceps Squeeze Test
        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
        • Medial Epicondylalgia Test
        • Mill's Test
        • Moving Valgus Stress Test
        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
        • Varus Stress Test
      • Wrist/Hand >
        • Allen's Test
        • Carpal Compression Test
        • Finkelstein Test
        • Phalen's Test
        • Reverse Phalen's Test
      • Hip >
        • Craig's Test
        • Dial Test
        • FABER Test
        • FAIR Test
        • Fitzgerald's Test
        • Hip Quadrant Test
        • Hop Test
        • Labral Anterior Impingement Test
        • Labral Posterior Impingement Test
        • Long-Axis Femoral Distraction Test
        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
        • Anterior Drawer Test
        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
        • Lachman Test
        • McMurray Test
        • Noble Compression Test
        • Pivot-Shift Test
        • Posterior Drawer Test
        • Posterior Sag Sign
        • Quad Active Test
        • Thessaly Test
        • Valgus Stress Test
        • Varus Stress Test
      • Foot/Ankle >
        • Anterior Drawer
        • Calf Squeeze Test
        • External Rotation Test
        • Fracture Screening Tests
        • Impingement Sign
        • Navicular Drop Test
        • Squeeze Test
        • Talar Tilt
        • Tarsal Tunnel Syndrome Test
        • Test for Interdigital Neuroma
        • Windlass Test