You can only view 3 videos without an account. Become a Member to access all videos on the website.
Serratus Anterior Manual Muscle Testing (MMT) for an Active Population
The Serratus Anterior Manual Muscle Testing (MMT) for an active population is a specific test for measuring the strength of a particular muscle in the body. This test focuses on the Serratus Anterior muscle, which is located in the upper chest of an individual. It is important for many activities, including upper-body movement and stability. The MMT involves the individual pushing their arm against resistance while a clinician measures the amount of force that was produced. This allows the
Transcript
00:00:0400:00:06
This is Brent of the Brookbush
00:00:0400:00:06
...blank
00:00:0600:00:08
Institute, and in this video we're going over
00:00:0800:00:10
serratus anterior manual muscle testing
00:00:1000:00:13
for an active population. Since we are
00:00:1300:00:14
dealing with a more active population,
00:00:1400:00:15
we're going to go ahead and take that
00:00:1500:00:17
Kendall scale of the one through five
00:00:1700:00:19
with pluses and minuses and set it aside.
00:00:1900:00:21
We're going to replace it with a simpler
00:00:2100:00:23
scale of strong, weak, with compensation,
00:00:2300:00:26
or with pain. You're going to find that
00:00:2600:00:27
we're going to make this test a little
00:00:2700:00:29
bit more provocative, because with this
00:00:2900:00:31
more active population who's putting a
00:00:3100:00:33
lot more intensity through their human
00:00:3300:00:34
movement system, I think what you'll find
00:00:3400:00:37
is a little dysfunction can go a long
00:00:3700:00:40
way towards creating some pain and
00:00:4000:00:42
decreasing performance. I'm going to have
00:00:4200:00:44
my friend, Melissa, come out. She's going
00:00:4400:00:47
to help me demonstrate. Now, first let me
00:00:4700:00:49
show you the serratus anterior manual
00:00:4900:00:52
muscle test that I don't like. I'm going
00:00:5200:00:55
to go ahead and have you lie down. You
00:00:5500:00:56
guys probably already know that the
00:00:5600:00:59
serratus anterior does protraction and
00:00:5900:01:03
upward rotation. This has led to some
00:01:0300:01:05
individuals trying to test the serratus
00:01:0500:01:07
anterior through protraction. So, Melissa,
00:01:0700:01:08
I'm going to have you take your
00:01:0800:01:11
your arm to make a fist and punch it up
00:01:1100:01:13
straight towards the ceiling. And then,
00:01:1300:01:14
what I'm going to do is I'm going to
00:01:1400:01:17
take my hands like this, and I'm going to
00:01:1700:01:18
put a downward force straight through
00:01:1800:01:21
the table and see if you can hold it.
00:01:2100:01:24
Of course, Melissa is a beast and she can
00:01:2400:01:27
hold it. The problem with this
00:01:2700:01:31
test is it's testing protraction, but the
00:01:3100:01:33
serratus anterior isn't you're
00:01:3300:01:35
only protractor. The other two
00:01:3500:01:37
muscles that are really good at
00:01:3700:01:40
protraction are our pectoralis minor
00:01:4000:01:42
and potentially our pectoralis major. a
00:01:4200:01:45
little indirectly through the humorous,
00:01:4500:01:47
but nonetheless aiding in that joint
00:01:4700:01:50
action. They have a tendency to become
00:01:5000:01:53
overactive. The pectoralis minor, in
00:01:5300:01:54
particular, has a propensity to become
00:01:5400:01:56
synergistically dominant for the
00:01:5600:01:58
serratus anterior. So, the question
00:01:5800:02:01
becomes, "In this position, can I
00:02:0100:02:02
differentiate between pectoralis minor
00:02:0200:02:05
and serratus anterior activity?" The
00:02:0500:02:08
answer is, "No." Melissa could compensate,
00:02:0800:02:12
which I know my athletes are really good
00:02:1200:02:14
compensators. So, I need to find a new
00:02:1400:02:17
test that will make it harder for Melissa to
00:02:1700:02:17
compensate.
00:02:1700:02:22
I'm going to have her sit up the. The other
00:02:2200:02:24
test that we find in Kendall's manual
00:02:2400:02:26
muscle testing is actually a far better
00:02:2600:02:28
test and tests the serratus anterior as
00:02:2800:02:30
an upward rotator, although this test
00:02:3000:02:32
does take a little bit more skill and a
00:02:3200:02:34
little bit more practice. I'm going to
00:02:3400:02:35
have Melissa go ahead and raise her arm
00:02:3500:02:40
to about 120 degrees of flexion, enough
00:02:4000:02:41
that I'm getting a little bit of
00:02:4100:02:46
upward rotation in the scapula, but I can
00:02:4600:02:48
still create a nice downward force here.
00:02:4800:02:49
Now, what you're going to do with this
00:02:4900:02:52
hand is really important. You're going to
00:02:5200:02:54
take two of your fingers, maybe your
00:02:5400:02:56
index finger and middle finger, and put
00:02:5600:02:58
them on the inferior angle of their
00:02:5800:03:00
scapula. You're going to use your thumb
00:03:0000:03:04
to palpate those those front fibers of
00:03:0400:03:06
the serratus anterior that aren't
00:03:0600:03:09
covered by the scapula. Now, what I'm
00:03:0900:03:11
actually testing for when I press down
00:03:1100:03:14
Melissa's arm is not whether she can
00:03:1400:03:18
hold her arm up here. It's whether her
00:03:1800:03:22
scapula collapses into these two fingers,
00:03:2200:03:25
because her serratus anterior is
00:03:2500:03:28
incapable of stabilizing and upwardly
00:03:2800:03:31
rotating her scapula. I'm
00:03:3100:03:35
going to start here, here, and apply some
00:03:3500:03:37
force. and what I notice right away is
00:03:3700:03:42
the harder I push down, the more
00:03:4200:03:44
contraction I can feel of her serratus
00:03:4400:03:48
anterior as her inferior angle is
00:03:4800:03:50
maintained at the same position I
00:03:5000:03:53
started. Alright, so let's show a
00:03:5300:03:55
different angle. I'll have you turn this way.
00:03:5500:03:57
Again, guys, just to show you a
00:03:5700:03:59
different angle, and I'm going to have to use
00:03:5900:04:01
like some tricky hand positioning here.
00:04:0100:04:05
Go ahead and raise your arm up. I had
00:04:0500:04:08
my fingers on her inferior angle. I'm
00:04:0800:04:10
going to switch it around here and use
00:04:1000:04:12
my thumb this time. And then, I
00:04:1200:04:14
place my fingers right here, so that
00:04:1400:04:18
I can get a nice broad palpation area
00:04:1800:04:21
for those serratus anterior fibers. I'm
00:04:2100:04:24
then going to push down her arm. Of course, we
00:04:2400:04:29
don't see any tipping down of her
00:04:2900:04:30
inferior angle, no
00:04:3000:04:32
rotation, and I'm actually getting a
00:04:3200:04:35
little bit of a- I can it feel an
00:04:3500:04:37
increase in tissue density underneath
00:04:3700:04:40
these two fingers. Then, again, we'll
00:04:4000:04:43
do from the back, so face that way. You
00:04:4300:04:46
guys can see this is her inferior angle, and
00:04:4600:04:49
as she reaches up to 120 degrees, now
00:04:4900:04:51
that's her inferior angle. We see a
00:04:5100:04:54
little bit of upward rotation. I would
00:04:5400:04:58
take these two fingers and then my thumb,
00:04:5800:05:00
in this case, and I'm just going to use a
00:05:0000:05:04
nice broad area to palpate.
00:05:0400:05:06
Then I'm going to go ahead and apply
00:05:0600:05:10
some pressure and see if I can feel
00:05:1000:05:13
serratus anterior getting more dense,
00:05:1300:05:15
increasing tissue density under my thumb, and
00:05:1500:05:20
see if I can feel her inferior angle go
00:05:2000:05:23
into downward rotation as I press. Now, of
00:05:2300:05:25
course, in this position, Melissa is
00:05:2500:05:28
really strong. The truth of the matter is that
00:05:2800:05:31
we're not done yet. As I've mentioned in
00:05:3100:05:34
other videos, it's not always these very
00:05:3400:05:38
neutral positions that's where the
00:05:3800:05:41
weakness is. If Melissa's an overhead
00:05:4100:05:44
athlete- she's a baseball player who has
00:05:4400:05:47
to throw, she's a volleyball player who
00:05:4700:05:49
has to spike a volleyball, she's a tennis
00:05:4900:05:51
player who has to serve, she's a
00:05:5100:05:52
basketball player who has to keep her
00:05:5200:05:55
arms up- we're as concerned about
00:05:5500:05:58
serratus anterior strength here,
00:05:5800:06:00
maintaining optimal shoulder alignment,
00:06:0000:06:04
as we are here. So, now what we're going to
00:06:0400:06:08
do, again, is see if she has optimal
00:06:0800:06:10
mobility. If she doesn't have optimal
00:06:1000:06:12
mobility and can't get herself to 180
00:06:1200:06:13
degrees, that might be a real good place
00:06:1300:06:16
to start with our interventions. We also
00:06:1600:06:20
want to make sure that she has strength
00:06:2000:06:23
up here. Whether that's before we've done
00:06:2300:06:25
our mobility techniques, if she already
00:06:2500:06:27
has that hundred and eighty degrees, or
00:06:2700:06:30
let's say she came in and she was 165
00:06:3000:06:32
degrees, and then I did my mobility
00:06:3200:06:35
techniques got her to 180, now we need to
00:06:3500:06:36
test to make sure that she can control
00:06:3600:06:39
this range. So, I'm going to do the exact
00:06:3900:06:41
same test, exact same
00:06:4100:06:43
palpations. I'm going to have her come
00:06:4300:06:46
up this way. I'm going to grab the
00:06:4600:06:49
inferior angle here now, put my thumb
00:06:4900:06:54
over her serratus anterior- I don't know
00:06:5400:06:57
if you guys could see that, but that was
00:06:5700:07:00
almost instantaneous. As soon as I
00:07:0000:07:03
started putting pressure, her inferior
00:07:0300:07:05
angle just slid right under my fingers.
00:07:0500:07:09
Alright, so I grab here. I hope you
00:07:0900:07:11
guys can see that. I put my hand here, and
00:07:1100:07:15
then you'll see- and she starts to
00:07:1500:07:23
fall. So, we know that she is strong in
00:07:2300:07:25
120 degrees of flexion, but she's not
00:07:2500:07:27
strong at 180 degrees of flexion. If she
00:07:2700:07:30
had come in with shoulder pain, that
00:07:3000:07:32
gives me a lot different information. I
00:07:3200:07:34
need to continue to work on her serratus
00:07:3400:07:37
anterior activation, and maybe towards
00:07:3700:07:39
that end range. Maybe it's going to be
00:07:3900:07:41
something like wall angels that I need
00:07:4100:07:45
to do, or that very end range of that
00:07:4500:07:48
Sahrmann progression for serratus anterior
00:07:4800:07:50
activation that we we did in a previous
00:07:5000:07:54
video. Things like punch-ups are not going to
00:07:5400:07:56
be adequate. Getting her to do
00:07:5600:07:59
a dumbbell press with a plus is not
00:07:5900:08:01
going to be adequate. We need to work
00:08:0100:08:04
serratus anterior activation at end
00:08:0400:08:06
range of upward rotation of the scapula.
00:08:0600:08:08
Now, the last thing I want to show you
00:08:0800:08:10
guys, which Melissa doesn't do, but she's
00:08:1000:08:12
going to help me demonstrate is the
00:08:1200:08:14
other result we could get besides strong,
00:08:1400:08:18
weak, weak at end range in Melissa's case
00:08:1800:08:22
is compensation. It's very, very common.
00:08:2200:08:25
So, what would happen is here- is as
00:08:2500:08:29
I hold here, hold here, and go to press, we
00:08:2900:08:32
probably see Melissa go into anterior
00:08:3200:08:35
tipping and elevation of the scapula,
00:08:3500:08:37
like this. So, I'd go to press down, and
00:08:3700:08:39
she'd do all this weird compensating
00:08:3900:08:42
to really try to lock down her
00:08:4200:08:44
scapula. That's her pec minor and maybe
00:08:4400:08:47
levator scapula, and maybe even
00:08:4700:08:49
rhomboids start to take over. Of course,
00:08:4900:08:51
then you would write down "compensation"
00:08:5100:08:54
and maybe note what joint action she
00:08:5400:08:56
compensated into to give you an
00:08:5600:08:57
indication of what muscles are
00:08:5700:08:59
synergistically dominant for her
00:08:5900:09:02
inhibited serratus anterior. I hope you
00:09:0200:09:05
guys enjoyed this video. I hope these
00:09:0500:09:08
manual muscle tests give you some new
00:09:0800:09:11
information on what activation
00:09:1100:09:12
techniques are appropriate for your
00:09:1200:09:16
clients and patients, and maybe even how
00:09:1600:09:17
some of those activation techniques
00:09:1700:09:19
should be applied, through what
00:09:1900:09:21
range of motion. I look forward to
00:09:2100:09:24
hearing how you guys increase
00:09:2400:09:26
performance, how you reduce pain and
00:09:2600:09:28
dysfunction, and how you guys get better
00:09:2800:09:31
outcomes. Please leave me comments. I love
00:09:3100:09:32
to hear from you. I also love your
00:09:3200:09:34
questions, so feel free to add your
00:09:3400:09:38
questions to the bottom of this video.
Related Videos
Rope Row
Single Leg Alternating Horizontal Abduction with External Rotation
Wobble Lunge
Wobble Squat
Combined Deep Cervical Flexor and External Rotator Activation
Femoral Nerve Neurodynamic Tests
Lumbar Movement Assessment
Slump Test
Upper Body Movement Assessment
Straight Leg Raise Test and Well Leg Raise Test
Tibial Internal Rotator Manual Muscle Testing (MMT) for an Active Population
Posterior Tibialis Manual Muscle Testing (MMT) for an Active Population
Shoulder External Rotator Manual Muscle Testing (MMT) for an Active Population
Gluteus Maximus Manual Muscle Testing (MMT) for an Active Population
Deep Cervical Flexor Endurance Test
Serratus Anterior Reactive Activation
Serratus Anterior Isolated Activation
Serratus Anterior Activation Progressions
Serratus Anterior Isolated Activation
Serratus Anterior Manual Muscle Testing (MMT) for an Active Population