The Serratus Anterior, which is also known as the “Big Swing Muscle” or “Boxer’s muscle”, is an important muscle that helps optimize the proper movement of our shoulders. Not only does this muscle have a cool name, but it is also needed for a plethora of arm movements; whether it be an open chain movement (punching/grabbing something out of the cabinet) or a closed chain movement (pushups, planks, downward dogs, or handstands). Moreover, the serratus anterior is probably best known for its help in preventing scapular winging, which is when our shoulder blade abnormally moves away from our thorax during arm movements. This article will demonstrate the best serratus anterior exercises to improve activation and control of this very important scapular stabilizer!

 

What Is The Serratus Anterior?

The Serratus Anterior is a broad, flattened muscle that runs from the lateral surface of the ribs, passes posteriorly around the thoracic wall, and inserts on the costal surface of the medial border of the scapula. You can feel this muscle by putting your hand just underneath your armpit. The function of this muscle is to allow for forward elevation of the arm and to pull the scapula forward around the rib cage (protraction). Due to its large role in stabilizing the scapula as well as contributing to overall shoulder health, when weakness is present, it often manifests with either scapular winging or poor scapular control (1,2).

Serratus Anterior: 3 Functional Components

There are 3 separate components to the serratus anterior, including a superior, middle, and inferior component. These are described below (1):

• Superior: This portion originates from the first and second ribs and inserts into the superior medial angle of the scapula. This component serves as the anchor that allows the scapula to rotate when the arm is lifted overhead.

 

• Middle: The middle component of the serratus anterior stems from the third, fourth, and fifth ribs and inserts on the vertebral border of the scapula, serving to protract the scapula.

 

• Inferior: The inferior component originates from the sixth through ninth ribs and inserts on the inferior angle of the scapula. This portion also protracts the scapula as well as rotates the inferior angle upward and laterally.

 

All in all, with all portions of this muscle working together, the serratus anterior’s MAIN action is to protract and upwardly rotate the scapula, keeping the shoulder blade close to the thoracic wall in addition to optimally positioning the glenoid for ultimate efficiency of the upper extremity during various overhead motions.

 

Improve Your Serratus Anterior Activation and Shoulder Health Today!

The serratus anterior is an essential component of adequate control of our shoulder. The Shoulder [P]Rehab Program is a physical therapist developed, step-by-step program that teaches you how to optimize your shoulder health.  To learn more, click HERE! 

 

Why Is It Important To Train The Serratus Anterior?

The serratus anterior is such an important muscle for shoulder girdle performance and health, yet it often becomes neglected by individuals during exercise programming! If this muscle is weak and/or inhibited, the shoulder blade will not move smoothly along the thorax (rib cage) the way it should with functional arm movements, such as reaching overhead. What will happen when the serratus anterior is not engaged properly is the inferior border of the scapula will become more prominent (scapular winging).

 

 

Furthermore, if our body develops a faulty movement pattern that is performed regularly, that is when overuse injuries may occur, such as shoulder impingement or rotator cuff tendinopathy, both of which can be combated with our Shoulder [P]Rehab Program! Tendon injuries are often related to overuse. To learn more about the topic of tendons, read our blog post below.

READ: TENDINITIS VERSUS TENDINOSIS: IMPORTANT DIFFERENCES

 

The Best Closed Chain Serratus Anterior Exercises

We oftentimes begin with closed chain serratus exercises. Closed chain exercises are achieved when your body is stabilized or fixed onto the floor. Frequently, we as physical therapists find that the impairment may be due to the fact that the serratus has poor control, not that the serrratus has poor strength. Performing scapula exercises in a closed chain environment allows for better feedback. Your body weight onto your shoulders creates a resistance cue for your scapula protractors to work, largely being the serratus anterior!

2 amazing cues while performing these include:

• Twist your triceps in towards your armpit. Why triceps in towards the armpit? To minimize how much those big pec muscles will assist, in order to bias the muscle we want to work. The Serratus Anterior!

 

• Push your body away from the floor. This is achieved by pushing the shoulder blades out and around your body.

 

Modified Push Up Plus

Sample Phase 1 Shoulder [P]rehab Program Exercise

With this modified push up plus, you dictate how much load to place on your shoulders. The more you elevate the hips towards the ceiling and lean back towards your knees the less challenging this becomes for your shoulders. The more you shift your body weight forward onto your hands the more demand will be placed on your shoulders.

 

Push Up Plus

If you are looking to further challenge yourself, you can elevate your knees completely off the floor with this traditional push up plus!

If you are looking for a more in-depth exercise progression for the serratus in a closed chain environment, check out this post.

 

The Best Open Chain Serratus Anterior Exercises

When performing any exercise, make sure that it is in line with your intent! People often compensate when performing wall slides with excessive scapular elevation. For example, if strengthening the scapular elevators – upper trapezius and levator scapula – is the goal such as in patients with TOS (Thoracic Outlet Syndrome), then performing the wall slide with scapular elevation is not a problem. That being said, the wall slide shown here is designed to target the serratus anterior by maximizing scapular upward rotation, not elevation!

Furthermore, an article by Ellenbecker at al (2016) corroborated that excessive activation of the deltoid and upper trapezius muscles could be counterproductive for scapulohumeral rhythm during shoulder elevation (2). Moreover, increased upper trapezius and anterior deltoid muscle activity can cause reduced strength and coordination in the force couple between the lower trapezius and serratus anterior.

Excessive upper trapezius and anterior deltoid muscle activity have also been linked to sub-acromial impingement. In order to achieve full overhead motion, you need to ensure that you have adequate mobility at the glenohumeral joint, scapulothoracic joint, and thoracic spine. For many of those who lack shoulder mobility, it often isn’t the actual glenohumeral joint that is limited. Rather, it’s a lack of full scapular upward rotation or full thoracic spine extension that is to blame.

 

Learn More Ways to Activate Your Serratus Anterior

 

Wall Slides – Serratus Anterior Activation

The wall slide when done correctly is a great way to activate the serratus anterior. This is an important exercise to incorporate for individuals with shoulder pathology. It is especially functional and translatable to individuals with shoulder impingment issues, as many of these individuals begin to have pain above 90 degrees of shoulder flexion, which may be due to poor serratus anterior activation and/or altered scapular kinematics from other musculature. Therefore, the wall slide exercise gives individuals the opportunity to work on serratus anterior muscle recruitment above 90 degrees of shoulder elevation.

How To Correctly Perform Wall Slides For the Serratus Anterior

In this video of the Wall Slide Exercise for the serratus anterior, the black blob here represents the scapula. Below are directions on how to perform this exercise.

• Place pressure into the wall to ensure you are engaging your scapula, which will make it easier to avoid excessive elevation of your shoulder girdle.

 

• There is roughly a 2:1 ration of glenohumeral joint to scapulothoracic joint motion. With 180 degrees of total shoulder flexion,  there will ideally be about 60 degrees of scapular upward rotation.

 

• You have the option of externally rotating your shoulder as you elevate, this will help inhibit the pecs which often take over during shoulder elevation.

 

• A progression of this exercise is shown with a resistance band + a Wall lift (which emphasizes the lower trapezius).

 

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More Serratus Anterior Exercises

These 3 exercises will help to improve upward rotation of the scapula during shoulder elevation.

• Exercise #1 – Elbow to Ceiling: Anchor the resistance band around your back. I use a CLX TheraBand in the video. Place the band over your elbow and trace it down your forearm to your hand. Begin by pushing your elbow up towards the ceiling while focusing on protraction of the scapula.

• • Option: Elevate the shoulder to 120 degrees of shoulder flexion and 30 degrees of horizontal abduction to maximize the activation of the serratus anterior.

 

• Exercises #2 – Serratus Anterior Uppercut: Using the pectoral muscles is a common compensation when performing an uppercut. If your intent of this exercise is to target the serratus anterior here is a quick tip: externally rotate your shoulder as you elevate your arm. Your pectoralis major is an internal rotator at the shoulder. External rotation will reciprocally inhibit the larger pectoralis musculature!

 

• Exercise #3 – Ball in Pillow Case Swings: As crazy as this exercise seems, it is a great way to get the scapular muscles firing. Really exaggerate the scapular motion during these movements:
  • Frontal Plane Circles
  • Figure 8 Swings
  • Sagittal Plane Circles

 

If the muscles that surround the shoulder as well as the shoulder blade are weak and/or inhibited, it may lead to potential issues, such as shoulder instability. Listen to our [P]Rehab Audio Experience with Dr. Mahkni as he discusses the topic of shoulder instability! You can also read more on the topic of shoulder instability here!

LISTEN: SHOULDER INSTABILITY WITH DR. MAHKNI

 

The Best Serratus Anterior Exercises: Supine Overhead Reach

Here are 2 very simple yet effective Serratus Anterior Exercises:

Exercise 1

• Lay on your back with a theraband wrapped around your back

 

• Keeping your elbows straight and reach overhead, focus on the extra scapula push-out when you are overhead, this will help with Serratus Anterior Activation!

 

• Notice how the theraband is pulling across, this will help with rotator cuff and serratus anterior activation, and minimize the pec muscles from doing the work.

 

Exercise 2

• Focus on a hip hinge while you are standing.

 

• Raise your arms overhead.

 

• Notice how I rotate my shoulder externally, but pointing my thumbs towards the ceiling. This is very subtle, but can make all the difference in recruiting more serratus anterior and less pec muscle engagment.

 

• With both of these exercises do not arch the low back. One can make this more functional by elevating the shoulders in the scapular plane of movement, by horizontally abducting your shoulders 30 degrees.

 

Bear Hug

Sample Shoulder [P]rehab Program Exercise

 

Begin this exercise with a staggered stance, use either a theraband or crossover symmetry unit pulling from behind you. Push against the resistance to bring your arms all the way out in front of you, this includes pushing your shoulder blades away from you. Slowly come back to the starting position then repeat bringing your arms out as if you were going to give someone a big hug!

 

The serratus anterior is an important muscle that must be activated properly for overhead shoulder stability. If you want to learn more about how to optimize your overhead shoulder stability, click on the link below to our very own [P]Rehab Overhead Shoulder Stability Program!

 

The Best Serratus Anterior Exercises: Uppercut

When performing an uppercut, oftentimes one will overcompensate with the pectoral muscles! If your intent of this exercise is to target the serratus anterior here is a quick tip: Externally rotate your shoulder as you elevate your arm. Make sure to keep the elbow medial to your wrist during this exercise, this will ensure external rotation at the shoulder.

If you are looking for a comprehensive break down of EMG activity with the  Serratus Anterior based on different exercises,  check out this chart. As you can see, elevating your shoulders to 120-140 degrees of elevation seems to be the sweet spot for increasing serratus engagement!

Serratus Scoop

• HOW: Begin by lying on your back with a band wrapped around your back. Cross the band over your chest. With a band in each hand, bring your arms up and overhead as much as you can against the resistance of the band and return to the starting position.
  

 

• FEEL: You should feel your shoulder muscles working.

 

• COMPENSATION: Don’t arch your back.

 

Closing Thoughts

The serratus anterior is a very important muscle for shoulder health as well as proper scapular motion. There are excellent ways you can work on increasing the activation as well as the overall strength of this muscle, such as using the exercises we have demonstrated in this article! It is important to always educate yourself as well as understand what movement deficits may be driving an underlying issue of the body. Inadequate serratus anterior muscle function has been associated with a multitude of shoulder issues. Click here to learn how to bulletproof your shoulder today!

 

Take Control and Maximize Your Shoulder Health

To win an NBA championship in this current era it seems at least 3 superstars are needed on the team. Behind these 3 superstars includes the entire support staff that takes care of the day-to-day operations allowing the stars to perform. Sounds like they are using the model of the shoulder! You will learn how to create balance among the support staff which will allow the 3 joints of the shoulder to perform to their superstar abilities!

 

REFERENCES

1. Martin, R. M., & Fish, D. E. (2007). Scapular winging: Anatomical review, diagnosis, and treatments. Current Reviews in Musculoskeletal Medicine, 1(1), 1-11. doi:10.1007/s12178-007-9000-5
2. Anderson, CH, Zebis ME, Saervoll, CH, et al. Scapular Muscle Activity from Selected Strengthening Exercises Performed at Low and High Intensities: Journal of Strength & Conditioning Research. September 2012: 2408-2416.

 

About The Author

Arash Maghsoodi, PT, DPT, CSCS

[P]rehab Co-Founder & Chief Marketing Officer

Arash Maghsoodi received his Doctorate in Physical Therapy from the University of Southern California. For his undergraduate studies, he attended San Diego State University and studied Kinesiology. After sustaining a career-ending ankle sprain while playing collegiate soccer, he realized how disabling and life-altering injuries can be. Arash currently resides in beautiful Santa Monica, California. His clinical experience is primarily in the orthopedic and sports setting. He has treated a wide variety of conditions ranging from the post-operative individual to the professional athlete. Arash is keeping the family legacy of becoming a physical therapist, as his mother is a practicing clinician of 30 years in the Orange County area.

 

 

 

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.