Super Serratus – Evaluation, Treatment, Movement and Exercise for Serratus Anterior: Background

This first video introduces you to Serratus Anterior and shoulder heath in general. The serratus anterior is connected to the scapula, which is connected to the shoulder via the Glenohumeral joint. The joint consists of the humerus bone (arm) and the glenoid fossa. The head of the humerus fits into the glenoid fossa (or cavity) which is part of the scapula. The acromion is at the top of the scapula and the space between the head of the humerus and the acromion is where impingement can occur if there is an imbalance or poor posture. I emphasize this many times because it is so important – pay attention to the movement and stability of the scapula as well as the position/posture of the shoulder joint. Always think in terms of synergy and overall balance of the whole shoulder complex. Practice your observation skills and you will be doing a service to yourself and your clients by being able to identify imbalances and postural issues and correct them before they cause pain and injury. Prevention is always best!

Here we introduce the action of the scapula, via the scapulothoracic joint. Follow along yourself. Have someone observe your scapula in action and/or take a pic. Also observe your own shoulder posture especially from the side or lying supine on a massage table. We will also introduce our first exercises!

In this recap we cover the following:

What do we want you to take away from this class?
We want you to know the location, origin and insertion of serratus anterior.
We want you to understand the action and role of the muscle – helps guide and keep the scapula moving along the thorax. Abducts and Protracts the scapula.
We want you to know how to treat it – we cover this in the last two lesson plans.

Everything else is context – helping you understand the environment in which serratus anterior resides.
We first talk about the bones – the scapula as you now know contains the glenoid fossa which along with the head of the humerus makes up the shoulder joint. For proper function, we need free mobility and stability here. There are other related joints: the acromion connects to the clavicle and the clavicle connects to the sternum. We also have the scapulothoracic joint, which we mentioned was not a true synovial joint, where the scapula joins the thorax. This is where the motions of elevation, depression, protraction, retraction, upward rotation and downward rotation occur.

Next we talk about the muscles. We can break it down as follows:
Muscles that are involved in keeping the scapula tracking along the rib cage. Primary muscles here would be: Serratus Anterior, Rhomboids, Levator Scapulae, Trapezious, and Pectoralis Minor.
Next we have the Rotator Cuff muscles – Supraspinatus, Infraspinatus, Teres Minor, Subscapularis. These muscles are mostly involved with internal and external rotation of the shoulder (supraspinatus also abducts the arm). Their role is to tightly hold the shoulder joint together.
Finally we have the larger muscles such as pectoralis major and minor and latissimus dorsi.
Desmond describes the group as a happy family. Everyone working together and in harmony, expressing itself as optimal function. However, as you know, sometimes dysfunction can occur within the family. When this happens, optimal function is lost, leading to poor movement as well as pain and injury. Imbalances can occur where, for instance, the scapula does not track well, the shoulder joint is unstable, or the larger muscles overwhelm the action of the stabilizer muscles.
Dysfunction can be expressed as scapular winging, internal rotation of the shoulder (poor posture, rounded shoulders) and restriction in the movement of the scapula.

The antidote to this is have an understanding of the anatomy and function of the shoulder complex and institute a combination of flexibility, strengthening and hands-on work.