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The serratus anterior in a cadaver dissection

Serratus Anterior

Integrated functional anatomy of the serratus anterior. Attachments, nerves, palpation, joint actions, arthrokinematics, fascia, triggerpoints, and behavior in postural dysfunction. Examples of common activation exercises, subsystems, and strength exercises for the serratus anterior.

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Course Description: Serratus Anterior

This course describes the anatomy and integrated function of the serratus anterior muscle (a.k.a. serratus, S.A., serratus muscle, riblet muscle, rib muscles). This muscle is located on the lateral side of the ribcage, is composed primarily of type I muscle fibers, and crosses the scapulothoracic joint (a.k.a. the shoulder blade, shoulder girdle).

The serratus anterior is the primary protractor of the scapula (shoulder blade), will contribute to upward rotation, and posterior tipping of the scapula, and some research suggests the lower fibers may contribute to depression of the scapula. Further, the serratus anterior is the primary stabilizer of the shoulder girdle, and like the rotator cuff, is likely to exhibit an increase in muscle activity during all motions and exercise for the upper extremity. Additionally, this muscle will eccentrically decelerate scapular retraction, anterior tipping, downward rotation, and potentially elevation. This course also describes the role of the serratus anterior in scapulothoracic, sternoclavicular and acromioclavicular joint arthrokinematics, fascial integration, postural dysfunction, and subsystem integration.

Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) must be aware of the integrated anatomy of scapula for the analysis of human movement, and the development of sophisticated exercise programs and therapeutic (rehabilitation) interventions. Further, this course is essential knowledge for future courses discussing the synergistic function of the serratus anterior (e.g. serratus anterior muscle activity increasing to stabilize the scapula during shoulder elevation), injury prevention, and physical rehabilitation (e.g. long thoracic nerve dysfunction, thoracic outlet syndrome, serratus anterior weakness, AC and SC joint pain, shoulder impingement, shoulder pain during humeral elevation, scapular winging, shoulder laxity, etc.) and serratus anterior exercises and techniques for enhancing sports performance (e.g. upper body (arm) stability, strength, power, hypertrophy, etc.)… including why there are better choices than a scapular push-up.

Pre-approved credits for:

Pre-approved for Continuing Education Credits for:

This Course Includes:

  • AI Tutor
  • Text and Illustrations
  • Audio Voice-over
  • Research Review
  • Technique Videos
  • Practice Exam
  • Pre-approved Final Exam

Brookbush Institute’s most recommended techniques for the Serratus Anterior (see videos below):

The serratus anterior in a cadaver dissection
Caption: The serratus anterior in a cadaver dissection

Introduction to the Serratus Anterior
3 Sub Sections

Serratus Anterior Muscle Actions
1 Sub Section

Fascial Integration

Postural Dysfunction and the Serratus Anterior

Exercises and Techniques for the Serratus Anterior
3 Sub Sections

Bibliography

  1. Phillip Page, Clare Frank, Robert Lardner, Assessment and Treatment of Muscle Imbalance: The Janda Approach © 2010 Benchmark Physical Therapy, Inc., Clare C. Frank, and Robert Lardner
  2. Dr. Mike Clark & Scott Lucette, “NASM Essentials of Corrective Exercise Training” © 2011 Lippincott Williams & Wilkins
  3. Donald A. Neumann, “Kinesiology of the Musculoskeletal System: Foundations of Rehabilitation – 2nd Edition” © 2012 Mosby, Inc.
  4. Michael A. Clark, Scott C. Lucett, NASM Essentials of Personal Training: 4th Edition, © 2011 Lippincott Williams and Wilkins
  5. Leon Chaitow, Muscle Energy Techniques: Third Edition, © Elsevier 2007
  6. Tom Myers, Anatomy Trains: Second Edition. © Elsevier Limited 2009
  7. Shirley A Sahrmann, Diagnoses and Treatment of Movement Impairment Syndromes, © 2002 Mosby Inc.
  8. David G. Simons, Janet Travell, Lois S. Simons, Travell & Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition,© 1999 Williams and Wilkens
  9. Cynthia C. Norkin, D. Joyce White, Measurement of Joint Motion: A Guide to Goniometry – Third Edition. © 2003 by F.A. Davis Company
  10. Cynthia C. Norkin, Pamela K. Levangie, Joint Structure and Function: A Comprehensive Analysis: Fifth Edition © 2011 F.A. Davis Company
  11. Florence Peterson Kendall, Elizabeth Kendall McCreary, Patricia Geise Provance, Mary McIntyre Rodgers, William Anthony Romani, Muscles: Testing and Function with Posture and Pain: Fifth Edition © 2005 Lippincott Williams & Wilkins
  12. Karel Lewit. Manipulative Therapy: Musuloskeletal Medicine © 2007 Elsevier
  13. Carolyn Richardson, Paul Hodges, Julie Hides. Therapeutic Exercise for Lumbo Pelvic Stabilization – A Motor Control Approach for the Treatment and Prevention of Low Back Pain: 2nd Edition (c) Elsevier Limited, 2004
  14. Andrew Biel, Trail Guide to the Human Body: 4th Edition, © 2010
  15. David B. Jenkins, Hollinshead's Functional Anatomy of the Limbs and Back: Eighth Edition © 2002 Saunders
  16. Lawrence, R. L., Braman, J. P., Laprade, R. F., & Ludewig, P. M. (2014). Comparison of 3-dimensional shoulder complex kinematics in individuals with and without shoulder pain, part 1: sternoclavicular, acromioclavicular, and scapulothoracic joints. journal of orthopaedic & sports physical therapy, 44(9), 636-A8.
  17. Scovazzo, M.L., Browne, A., Pink, M., Jobe, F.W., and Kerrigan, J. (1991). The painful shoulder during freestyle swimming: An electromyographic cinematographic analysis of twelve muscles. The American Journal of Sports Medicine. 19(6). 577-582
  18. Glousman R, Jobe F, Tibone J et al. Dynamic Electromyographic Analysis of the Throwing Shoulder with Glenohumeral Instability. J Bone Joint Surg 70A(2):220-226, 1988
  19. Ludewig PM, Cook TM. Alterations in Shoulder Kinematics and Associated Muscle Activity in People with Symptoms of Shoulder Impingement. Phys Ther 80:276-291, 2000
  20. Helgadottir, H., Kristjansson, E., Einarsson, E., Karduna, A., & Jonsson, H. (2011). Altered activity of the serratus anterior during unilateral arm elevation in patients with cervical disorders. Journal of electromyography and kinesiology,21(6), 947-953.
  21. Hardwick DH, Beebe JA, McDonnell MK, Lang CE. (2006). A comparison of serratus anterior muscle activation during a wall slide exercise and other traditional exercises. Journal of Orthopaedic & Sports Physical Therapy. 36(12) 903-910
  22. Oladipo GS, Aigbogun Jr EO, Akani GL. (2015). Angle at the medial border: the spinovertebral angle and its significance. Anatomy Research International. 1-5.
  23. Nasu H, Yamaguchi K, Nimura A, Akita K. (2012). An anatomic study of structure and innervation of the serratus anterior muscle. Surg Radiol Anat. 34:921-928.
  24. Park K, Cynn H, Yi C, Kwon O. (2013). Effect of isometric horizontal abduction on pectoralis major and serratus anterior EMG activity during three exercises in subjects with scapular winging. Journal of Electromyography and Kinesiology. 23(2): 462-468.
  25. Reed D, Cathers I, Halaki M, Ginn KA. (2015). Does load influence shoulder muscle recruitment patterns during scapular plane abduction? Journal of Science and Medicine in Sport.
  26. Day, JM, Bush H, Nitz AJ, Uhl TL. (2015). Scapular muscle performance in individuals with lateral epicondylalgia. JOSPT. 45(5): 414-424.

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