Shoulder pain and the neglected Serrates Anterior

We have all heard at one time or another to draw are shoulder blades together, contract our rhomboids, open the chest. Although we want to have upright posture and this cue helps, it does so  at the expense of  focusing on one muscle and neglecting others.

Like everything in the universe our body needs to work in balance, like a well rehearsed orchestra. This means that the simple action of lifting our arm overhead to get a plate form the cabinet, involves the coordinated effort of the muscle, bones and ligaments of not only the shoulder but the spine, hips and lower legs as well.

​For this article we will look at the shoulder.

In order to avoid injury to the shoulder especially with overhead reaching or weight bearing activities (like plank, push ups and my favorite the beast), as the muscles that move the arm upward contract we need a counter balance from muscle that depress the arm bone and move the scapular out to the side to avoid impingement of the tendons in the shoulder joint.
The serrates anterior  is a large muscle that wraps around the side of the rib cage and it is a major contributor to balanced motion of the shoulder. The muscle looks like long talons that wrap around the side rib cage.  Here are a few of its important contributions to motion.

1. It protracts the shoulder blades. . This means it pulls the shoulders apart from one another and in doing so wraps the shoulder blades along the side body ribs. It locks the shoulder blades in place there. Without this action the shoulder blades would move toward the back body and”wing”  away . You would much less power in the arm if this does not happen.

2. They work as a team with the rhomboids to keep your shoulder blades in place. As the rhomboids pull the shoulder blade back the serratus pull them forward so you have a balanced action. This is important when lifting something, or when you are pushing against something like the floor in for example downward dog, cobra,table top in yoga. If the serratus does not fire the shoulder blades would move back and in doing this it will decrease the space in the shoulder joint and the shoulder is pulled out of alignment. Ultimately this causes instability in the joint, decreased space and poor coordination.

3.It plays a major role in shoulder health when lifting the arm. As we lift our arm overhead the shoulder blade must move out to the the side and tip slightly upward. This action along when other shoulder depressors like the lower trap and lats move the head of the arm bone down so that the tendons that sit between the top of the arm bone and the collar bone don’t get pinched. You are using the serrates to effectively create space. If the serratus does not fire well than the upper trap will take over and cause your shoulder to move up toward your ear, the head of the shoulder will roll forward, resulting in not only shoulder impingement but neck pain as well. (Can you see the beauty of balanced motion)

So what can we do to improve the function of this amazing muscle,  the serrates anterior.

1. stand in good alignment. This does not mean draw the shoulder blades together with such force that your shoulders are now in the back plane of the body. It means as you inhale  gentle draw shoulder back and the shoulder blades down, so that the shoulders are lined up over the hips. (just mindfully moving in this way even if you can not achieve full posture is enough to start building pathways in the brain that this is where the body should rest)

2. practice protraction of the shoulder blade.
-lean against the wall with your palms and elbows on the wall . Press your forearm into the wall and without moving the arms start to move the elbows away from one another, feel the shoulder blades move away from one another. Hold 5 seconds relax to neutral and repeat 5 to 10 times

3. Snow angles on the wall in a pain free range
-back to wall back of the arms against wall elbow bent, slowly slide arms up the way with elbows bend like making a snow angel. Pay attention to the shoulder blades moving out to side as you raise the arms and returning to the back as you lower.  Pay close attention to drawing the shoulders away from the ears as you lift the arms upward!!

4. Push up with a plus.
– on hands and knees. Keep arms straight and shoulder distance part. Press into the floor as you move your shoulder blades away from each other than gently slide them inwards without squeezing..

Keep the balanced action and alignment of the shoulder in mind with all you exercise. Think serratus!! and pain-free shoulder mobility.

Barbara Franzino, MAPT

In my never ending endeavor to understand the wisdom of the human body, movement and health I have developed a method of treatment that assists the body’s natural healing process. I have studied for over 20 years under many great teachers and my treatment method combines manual therapy, myofascial release and mindful movement to rid the body of pain and restore motion.

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