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Why Serratus Anterior Is So Important For Healthy Shoulder Function

Written by: Nick Jack
Category: 2014
on 27 October 2016
Hits: 16022

With all the technology available in modern society it has provided great opportunities to do things never before possible, but at the same time has and continues to come at a cost to our health. Without doubt the use of the smartphones has seen an epidemic of neck and shoulder problems due to the poor posture being placed on the neck. I work closely with a well respected chiropractor with over 30 years experience, and he has never seen so many young patients with neck pain than he has in the last 2-3 years! Postural problems caused from sitting too much, looking at smartphones, tablets and TV all lead to potential head, neck and shoulder problems. Muscles in the shoulder can become extremely tight leading to headaches, treat with migraines and potential serious injuries like shoulder impingement or disc bulges in the neck! Most people will resort to stretching, massage, even chiropractors and physiotherapists to release these tight muscles. And while these strategies are great and can help, they do not solve the ultimate problem.  For without improving stability of the shoulder, and strengthening muscles that have become lazy and weak, the tight muscles will just tighten up again within a few days. To get off the merry go round and fully restore function to the shoulder a complete approach is needed. And without a doubt you will need to one strengthen the Serratus Anterior. This muscle plays a massive role in this puzzle, but is very difficult to isolate and strengthen. Here is an article provided by Nathan Fejes that explains why this is so important and how to go about not just strengthening this muscle, but all the factors associated with it.

In this article we will be explaining exactly why we need to work the Serratus Anterior muscle, in order to achieve a healthy shoulder function. I will also explain how it prevents shoulder pain, neck pain and many of the back problems many people suffer with. 

To fully understand how this little known muscle works together with other areas of the body to provide movement is a key point to make a note of. This is often missed in rehabilitation programs, but you will see is very important for long term success. I will be using the integrative and holistic approach, as we have found that there is no one side that fits all. So what do I mean when I say I need to look at the whole body? For if you have a shoulder problem, surely you just need to work on the shoulder, right? No, the human body is a complex design with many systems reliant on the next. I know this sounds very hard, but I hope to make sense of this as we go and show you what else to look for, that will make it seem easy and give you better reasoning behind the exercises we will go through.

The various components of rehabilitation to address and assess are flexibility, stability, posture, strength and movement skill patterns. All of these could be the potential problem or cause of your problem, and may inhibit with the serratus anterior function, and ultimately cause you pain. Again, I will make it look simple and explain the purpose of why we need these components. The image below is gives you an idea of the steps we must take address the cause of the problem.

Each step is relying on the previous one. You cannot skip steps, and you definitely cannot leave one out which is what many people do. And as you will see they are all bound by each other. If one fails, it puts the others at risk and you go back to the start.

Below is a Free checklist you can download that takes you through all the necessary steps in trying to heal a shoulder injury.

Not All Muscles Act The Same

Firstly, the purpose of strengthening Serratus anterior is to help the scapular (shoulder blade) sit more downward & facing up as this will help your shoulder joint move back into the right position and not cause any pinching. This muscle is classified as a Phasic muscle. Vladimir Janda was the first to come up with these terms and he describes in great detail about this in his book “Assessment & Treatment of Muscle Imbalance”. In simple terms tonic muscles are prone to tightness or shortness, and the phasic system muscles are prone to weakness or inhibition.

The Phasic muscles are commonly recognized as the muscles that are mainly responsible for movement, where as the Tonic muscles are mainly responsible for stability, posture and stabilization. When there is a muscle imbalance or faulty movement at work the tonic muscles take over and the phasic muscles basically shut down. In this case Serratus Anterior is being "inhibited" by Levator Scapula and Upper Traps to do movements.

Here is a good analogy to help explain this. Imagine like the office lady loading the truck in the loading dock. Sure she will have a go, maybe even load some of the stock onto the truck but she will easily become overloaded and end up with pain as this is not her job. She will make many mistakes unknowingly, and the longer she continues to do this these mistakes will become big problems! At the same time the guys who were meant to load the truck get lazy and sit in the cafe eating donuts and drinking coffee.

When the serratus anterior becomes lazy and weak, this is a disaster to the shoulder for it's function is to keep the scapular in the right position through static posture and movement! It also leads to development of poor posture which leads to other injuries. This is known as upper cross syndrome.

See picture below.  

If we then move further up from the shoulder, the shoulder coming back and the scapular being upright will then help the neck becoming less hunched forward. Once they’re sitting in a better posture, this will reduce pain. The image above is a great example of a bad posture and what happens to the muscles around that area.

Now if we look further into other components around serratus anterior, it has other helping muscles that assist in getting the scapular sitting more upright, they are upper trapezius and lower trapezius. By also strengthening these muscles, it will help get you into a better posture, therefore, fixing the problem of pain in the first place.

But.......

Before we can do that, we must look at are the muscles that may be inhibiting serratus anterior from working properly! These inhibitor muscles are the levator scapulae, rhomboids and pec minor, when these muscles are tight and rigid, it will cause the scapular to sit rotating forward, therefore, causing the shoulder to roll over, and again, the neck to be hunched forward. This is where the flexibility and mobility drills comes into play, if we stretch these tight muscles, especially levator scapulae and pec minor, this will enhance serratus anterior’s function.

Muscle Approach vs Movement Approach To Improving The Serratus Anterior Function

Movement not muscle is something we talk about a lot and mentioned quickly in the intro and when it comes to shoulder pain it is critical. Far too often the upper trapezius is blamed for all the trouble but as this is not always the case. The upper traps play a key role in providing stability to the scapula and act as a reactionary muscle when things go wrong elsewhere.

Make sure you read the articles below to fully understand that your problem will be more to do with movement than tight muscles.

It is great to stretch and loosen tight areas but if you continue to move poorly because that is all you know you will end up in the same place. When you understand that the brain and the nervous system control all of our movements via motor programs, it makes sense to try and use strategies and exercises to correct and improve how we move. You can change hundreds of muscles in one go with movement.

Even though the issue is in the shoulder, moving properly through the trunk and the legs is one of the first things to look at! As much as it is important to focus on the shoulder blade area to correct the scapular’s movement, the trunk plays an important roll through trunk rotation and extension; if you become more efficient in these movements you will be taller from a better posture and more flexible through twisting. These are important movement skills to have in everyday life, whether it’s lifting furniture around, reaching around the back seat of your car, reaching up high areas or even throwing a ball.

If you think about your trunk area, it consists of big muscles and is a big part of your body, imagine if it functions properly and how much easier the serratus anterior will only have to be working! With the legs it’s a similar concept; with movements such as lifting objects from the floor, carrying heavy objects or vacuuming the house, if the legs aren’t supporting your body the rest of the body like the trunk and then the shoulder area and then the neck will all have to be working extra hard to perform well, and therefore, will all lead to earlier fatigue, faulty movement patterns and then injury! This can then lead to why your shoulder or neck is in pain or working as good as it should be in the first place.

The images below show an a Deadlift movement, and an overhead movement. These movements that are not only an exercise in the gym, but a real life movement we use everyday.

The Deadlift by the way would possibly be the best exercise to use for postural correction. They display one with poor movement, and another with the correct movement.

 

Not only can the problem be looking at the body upwards and downwards, but also diagonally!. This is where the use of the slings comes into play. Meaning if your right serratus anterior isn’t working properly, your left glute may be inactive also. Our body works opposing each other, with walking and completing movements similar as mentioned above, etc, the opposing arm generally works together with the opposing leg, this refers to the analogy of the anterior and posterior slings.

More images below simulate everyday movement through that way and refer to the theory that the problem does not just arise from a weak serratus anterior and shoulder girdle, but the whole body, one image shows what weak legs vs strong legs looks like and the end result of what happens to the trunk and shoulder positions with weak legs! (To see specific examples on throwing and the use of the slings read the article Why Lunges Are Essential)

In the case of throwing the ball the legs start the movement, the trunk then rotates and right at the very end the shoulder throws the ball. If there is a weakness in the first two steps the shoulder has no choice but to find a way to generate power on it's own. With much weaker and smaller muscles. Remember the office lady! If you don't believe me try throwing a ball as far as you can without moving your feet.

  

Not only is posture worse and movement production reduced, but strength and power is lost also. If we correct your movement problem, we are a step closer to fixing the problem. In part 2 of this article we will show you how we will correct this with strength exercises and also power. But before we jump to that we must address stability.

Stability training is a very important component to rehabilitation, as this will test the joint's ability to handle load and coordinate tasks at a reflex speed and timing. Therefore, being able to ensure the body is competent to produce movement with good technique and posture. We have found that a lot of programs miss this component of fitness and that when adding them in to someone’s program they achieve great results with reduced pain. It is also a great component because it increases the difficulty and challenge for the body, but without adding the load progression too early in a program cycle.

Many times we find that people have great strength but lack the stability to know how to move freely. They have taught their body to stiffen up in order to create stiffness and protect the joint. Only training that exposes this and challenges this weakness will make any progress. We would classify movement skills as stability training, and this must be done early on to guarantee correct movement.

Good exercise examples of how to do this are below.

The wall slides drill would be one of the best stability drills you can use for serratus anterior. Read the article - Why I love the wall slides drill so much to see more.

Only after you have completed the Flexibility and Stability stage of training can you progress to strength exercises and finish the rehabilitation process. If you are at that stage then you can proceed to reading our article 10 Ways To Strengthen Serratus Anterior. If however you are in pain you MUST stay in the mobility and stability stage until you can move your arms overhead pain free.

As this article only covers just a small piece of what to do I encourage you to get our special report How To Get Rid Of Shoulder Pain Forever that takes you through all of the steps. With over 95 pages of information complete with pictures, instructions and even video links you have the ultimate resource for restoring your shoulder to full strength. Click here or on the image below to see more and get your copy today.

Conclusion

Serratus Anterior is a key muscle for keeping healthy function of the shoulder and plays a pivotal role in preventing neck pain and shoulder injuries. Just using stretches, massage and treatment for the area in pain will achieve little result. As will just trying to strengthen with isolated exercises. Learning how to move correctly and teaching the body how to use this muscle with the other muscles supporting the scapula is the key. Make sure you use your stretches and begin your stability work in preparation for strengthening. Part 2 we will cover all of the strength training exercises.

If you enjoyed this article make sure you check out our Special Report on Functional Training as this gives you an in depth look at how we are designed to move, complete with pictures and instructions of over 30 exercises.

 And if you live in Melbourne and would like to schedule a Free Postural and Movement assessment click the image below to book a time.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 14 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specializes in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.

References:

  • Movement - By Gray Cook
  • Corrective Exercise Solutions for the Hip & Shoulder - by Evan Osar
  • The Psoas Solution - by Evan Osar
  • Diagnosis & Treatment Of Movement Impairment Syndromes - By Shirley Sahrman
  • Low Back Disorders - by Stuart McGill
  • Knee Injuries In Athletes - by Sports Injury Bulletin
  • The ACL Solution - by Robert G Marx
  • Understanding & Preventing Non-Contact ACL Injuries - American Orthopaedic Society For Sports Medicine
  • Anatomy Trains - by Thomas Meyers
  • Motor Learning and Performance - By Richard A Schmidt and Timothy D Lee
  • Assessment & Treatment Of Muscle Imbalance - By Vladimir Janda
  • How To Eat, Move & Be Healthy by Paul Chek
  • Scientific Core Conditioning Correspondence Course - By Paul Chek
  • Advanced Program Design - By Paul Chek
  • Twist Conditioning Sports Strength - By Peter Twist
  • Twist Conditioning Sports Movement - By Peter Twist
  • Twist Conditioning Sports Balance - By Peter Twist