By Gavin Buehler
The serratus anterior has traditionally been one of the most overlooked, yet important muscles for structural wellness. Most have never heard the name, or don’t fully understand the global effect it has throughout the body. I’m going share thoughts on why this muscle plays a key role and why you should be giving it the love it deserves!
Where it is & how it looks
When I touch the area of where this muscle is on most patients, the common response is, “What are you on? Why is it so tender?” I’ll share with them the muscle name and the common response is, “Huh? Serratus what?” It’s tender because you don’t know you have it, what it does or how to use it, and so it feels like crinkled up saran wrap.
The serratus anterior attaches to the upper posterolateral (back/side) of ribs 1 through 8 or 9 fanning out and connecting to the medial (inside) border of the scapula (shoulder blade). That is a lot of real estate! Consider that your thorax (area between neck and abdomen), makes up most of your upper body and consists of 12 vertebrae, 12 ribs and the sternum (breastbone.) We have a muscle that spans over roughly three quarters of this area with very little acknowledgement aside from, “It protracts the shoulder (makes the shoulder blade glide forward around the ribcage.)” Tensile tissue covering that much area in the body probably carries more implications.
Quick rant… Muscles and soft tissue in general hold a resting tone, which means there are tensile forces always acting affecting global tension throughout the body to give us structural integrity so that we aren’t just a pile of bones. Every tissue has more function than the apparent motor functions that we have attached to them. This consideration needs to be recognized to understand how “everything is connected.”
Here's a quick video I did for a simple visual of tensegrity: https://youtu.be/qnmalnydfho
What does it do then?
Notable movements of the serratus anterior (that we currently know about) include:
Scapular protraction & ribcage retraction
Scapular upward rotation, posterior tilt & stabilization
Rib internal & external rotation
Accessory breathing muscle providing rib cage movement
Upper fibers provide upper contralateral thoracic rotation
Lower fibers provide lower ipsilateral thoracic rotation
Let’s add in that it has the largest linear surface attachment point of any muscle connecting to the scapula, which is the foundational bone and attachment surface area for the entire shoulder complex and arm appendage. Basically, this muscle is one of, if not the main muscle connecting arm to body.
Fun Fact: A look at shoulder pain EMG findings show that the serratus anterior is one of two muscles in the shoulder complex that are always noted to be the weakest in people that present with shoulder pain.
But we’re not going to dive into shoulder specifics here, we can see that this muscle is essential for shoulder health. I want to show you some other possible impacts this muscle might have.
Let’s also notice how many ribs this muscle attaches to and the effect it has on the movement of those ribs which will impact breathing and torso movement.
From a fascial perspective, this muscle is part of the spiral line. You can see in these diagrams how it knits into the obliques, crosses the abdomen creating a supportive core sling, and then travels
down the entire leg to the foot. It also connects through the rhomboids spiraling up to the opposite side of the neck. Without getting too deep,
you can see from these images alone how integrated this muscle is. Now imagine this entire fascial line as something like a tensioned rubber band. If any area along that band has a dysfunction, it will affect the overall tension of the band and things will shift and compensate. Let’s say the area through your left serratus is weak and flaccid, that section of the band may be loose and easily stretched. Other areas of the band now take up the slack so perhaps now you start to feel tension in your right hip and/or mid-back. Conversely, if this area is tight on your right side (dominant side for most), then you may notice your right shoulder and torso rolling forward while your left hip gets pulled up rotating the left side pelvis back. This could in turn start to aggravate your left side low back… does this sound familiar?
Understand that I am sharing a perspective here, and hopefully shedding light on an overall principle. This is just one component of many possibilities when it comes to soft tissue dysfunctions throughout the body. I’ve highlighted the serratus anterior due to my personal research and clinical findings noting that little information about this muscle and its importance has been acknowledged. This is merely a piece of a very complex puzzle.
How can I strengthen this muscle?
I’m glad you’re curious! Please check out this month’s F.I.T. Tip. I share a couple of my favorite exercises to effectively stimulate this muscle.