
The serratus anterior is a fan-shaped muscle that originates on the superolateral surfaces of the upper eight or nine ribs and wraps around the ribcage, attaching to the underside of the scapula (shoulder blade). It is essential for shoulder movement, posture alignment, and upper body mobility. The serratus anterior is prone to injury due to overuse, strain, or poor posture, especially in sports with repetitive motions such as swimming, tennis, and weightlifting. Injury to the serratus anterior can result in pain, postural problems, impaired shoulder mobility, and discomfort during exercise or daily activities. In rare cases, serratus anterior pain may be linked to dysfunction of the long thoracic nerve, which can weaken or paralyse the muscle, leading to a condition called winged scapula.
| Characteristics | Values |
|---|---|
| Common Causes of Pain | Muscle injuries, overuse, asthma, ankylosing spondylitis, and other medical conditions |
| Sports Involving Repetitive Motions | Swimming, tennis, weightlifting, boxing |
| Related Syndromes/Conditions | Serratus anterior myofascial pain syndrome (SAMPS), winged scapula |
| Functions | Shoulder movement, posture alignment, upper body mobility, stabilising shoulder blade, assisting breathing |
| Location | Sides of rib cage, originating from upper ribs and attaching to shoulder blade |
| Shape | Fan-shaped |
| Treatment | Ice, compression, elevation, NSAIDs, warm compresses, massages, stretching, physical therapy |
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What You'll Learn

Overuse or overworking the muscle
The serratus anterior is a fan-shaped muscle that originates on the superolateral surfaces of the upper eight or nine ribs and wraps around the ribcage, attaching to the underside of the scapula (shoulder blade). It is responsible for moving the scapula forward and rotating it upward, and it also assists in breathing by expanding the rib cage.
Overuse or overworking of the serratus anterior muscle can lead to pain and discomfort, especially since it plays a crucial role in shoulder blade stabilisation and breathing. This type of pain is common in sports or activities that involve repetitive motions or arm movements, such as swimming, tennis, boxing, throwing, or weightlifting. The repeated motions can strain the serratus anterior, leading to inflammation or microtears in the muscle fibres.
Athletes or individuals who participate in these sports or activities are more susceptible to serratus anterior pain due to the frequent and repetitive nature of the movements. Over time, the constant stress and tension on the muscle can lead to soreness and pain. Additionally, improper exercise technique, poor posture, or postural imbalances can further contribute to overuse and pain in the serratus anterior.
The pain associated with serratus anterior overuse may manifest as discomfort around the rib cage or under the armpit. It can also result in postural problems, impaired shoulder mobility, and discomfort during exercise or daily activities. In some cases, the pain may radiate to other parts of the body, such as the chest, back, or arm, making it challenging to lift the arm overhead or have a full range of motion.
To prevent and manage serratus anterior pain due to overuse, it is essential to focus on proper warm-up, stretching, and strengthening exercises. Stretching before and after activities can help reduce the risk of injury. Additionally, maintaining good posture and addressing any postural imbalances can alleviate stress on the muscle. In cases of mild discomfort or soreness, at-home treatments such as ice packs, compression, and nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce swelling and ease pain. However, if the pain persists or is severe, it is important to consult a doctor for further evaluation and treatment.
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Lack of use, poor posture, or improper exercise technique
The serratus anterior is a fan-shaped muscle that originates on the superolateral surfaces of the upper eight or nine ribs at the lateral wall of the thorax and wraps around the ribcage, attaching to the underside of the scapula (shoulder blade). It is essential for shoulder movement, posture alignment, and upper body mobility.
Weakness in the serratus anterior can occur due to lack of use, poor posture, or improper exercise technique. Lack of use can cause the muscle to weaken, leading to instability in the shoulder and scapula, and affecting upper body movements like lifting or pulling. This can also lead to postural problems, impaired shoulder mobility, and discomfort during exercise or daily activities.
Poor posture, such as slouching, hunching over a desk, or sitting for long periods with rounded shoulders, can put constant stress on the serratus anterior. This can lead to soreness and tension in the muscle, as well as pain that typically manifests as discomfort around the rib cage or under the armpit.
Improper exercise technique, such as performing activities with repeated arm motions (e.g., swimming, throwing, weightlifting, boxing) without proper form, can strain the serratus anterior. Over time, this can lead to inflammation or microtears in the muscle fibers, causing pain and discomfort.
If you suspect that your serratus anterior pain is due to lack of use, poor posture, or improper exercise technique, there are some treatments and exercises you can try at home. Applying ice to the sore area, wearing tighter shirts or using bandages for compression, and taking nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce swelling and ease pain. You can also try stretching and strengthening exercises specifically for the serratus anterior, such as lying on your back and raising your arm towards the ceiling, making a fist, and slowly punching up.
However, it is important to note that if your pain does not resolve in several days or is severe, you should consult a doctor or healthcare provider for a full assessment and further guidance.
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Damage to the long thoracic nerve
The long thoracic nerve is a somatic motor nerve of the thoracic wall that supplies innervation to the serratus anterior muscle. Damage to the long thoracic nerve can weaken or even paralyse the serratus anterior muscle. This can lead to a condition called neurogenic scapular winging, where the scapula takes on a "winged" appearance due to shoulder instability.
Weakness or paralysis of the serratus anterior muscle caused by long thoracic nerve damage can result in pain, weakness, and limited shoulder movement. Specifically, it can impair the ability to raise the arm over 90 degrees and affect the upward rotation of the scapula. This can have a significant impact on daily activities and sports or workout performance.
There are several tests that can be used to examine serratus anterior muscle weakness and scapular winging, including the Serratus Anterior Strength Test or Push Out Test. Imaging tests such as an MRI scan or X-ray may also be ordered to diagnose the condition.
Treatment for long thoracic nerve dysfunction may include conservative approaches such as physical therapy or, in more severe cases, surgical reconstruction. Most patients experience a return of serratus anterior function with conservative treatment, but recovery may take up to 2 years.
To prevent damage to the long thoracic nerve and subsequent serratus anterior muscle issues, it is important to maintain proper posture and exercise form, especially during activities with repeated arm motions such as swimming, throwing, weightlifting, or boxing. Stretching before and after activities can also help reduce the risk of injury.
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Sports with repetitive motions
The serratus anterior muscle is a fan-shaped muscle located on the sides of the rib cage. It is responsible for moving the scapula (shoulder blade) forward and rotating it upward, and it is essential for shoulder movement, posture alignment, and upper body mobility.
For athletes, a healthy serratus anterior muscle is key to avoiding shoulder pain, improving posture, and enhancing performance. However, the serratus anterior can be prone to injury and pain due to overuse, strain, or improper technique during exercise. This is particularly true for sports with repetitive motions, such as:
Swimming
The act of swimming involves repeated arm motions, which can strain the serratus anterior muscle, especially if proper form is lacking. Over time, this can lead to inflammation or microtears in the muscle fibers.
Tennis
Tennis players often experience serratus anterior pain due to the repetitive nature of the sport, which involves repeated arm movements and rotations of the shoulder.
Weightlifting
Weightlifting, especially with heavy weights, can strain the serratus anterior muscle. The act of lifting weights involves repeated arm motions and can lead to inflammation or microtears in the muscle fibers if proper form is not maintained.
Boxing
Boxing involves repeated arm movements and throwing motions, which can strain the serratus anterior muscle. As the serratus anterior is responsible for the movement of the scapula when a person throws a punch, it is commonly referred to as the "boxer's muscle."
It is important for athletes in these sports to be mindful of their form and technique to avoid straining the serratus anterior muscle. Additionally, proper stretching before and after activities can help reduce the risk of injury.
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Underlying medical conditions
The serratus anterior muscle plays an important role in the body, and issues with this muscle often result in pain in the chest, back, or arm. It can also cause difficulty in lifting your arm overhead or moving your arm and shoulder normally.
There are various underlying medical conditions that can lead to serratus anterior pain or symptoms similar to it. These include:
- Serratus anterior myofascial pain syndrome (SAMPS): This is a rare condition that presents with pain over the fifth to seventh ribs, radiating to other parts of the upper body. It is often diagnosed after other conditions have been excluded.
- Arthritis or bursitis: These conditions can cause pain and inflammation in the serratus anterior muscle.
- Rotator cuff tear or shoulder separation: These conditions can cause pain and inhibition of the muscles that support the shoulder, leading to a condition called scapular winging, where the shoulder blade protrudes outwards due to weakened muscles.
- Long thoracic nerve damage: The long thoracic nerve is located near the armpit and can be damaged during surgical procedures involving the shoulder or lymph node resection in breast cancer patients. It can also be overstretched during athletic activity, leading to serratus anterior weakness or paralysis.
- Rib cage injury: As the serratus anterior muscle attaches to the rib cage, an injury to the ribs can also cause damage to the muscle. In some cases, a rib fracture can result in an avulsion fracture, where the muscle tissue is pulled away and broken off from the bone.
- Asthma and ankylosing spondylitis: These medical conditions can contribute to serratus anterior pain and should be evaluated by a doctor.
It is important to seek medical advice to determine the underlying cause of serratus anterior muscle pain and to receive appropriate treatment.
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Frequently asked questions
The serratus anterior muscle can be damaged by overuse, strain, or poor posture. This can lead to instability in the shoulder and scapula, affecting upper body movements like lifting or pulling.
Pain in the serratus anterior muscle may occur in the chest, back, and arm. It may be perceived as burning or stabbing in nature. In some cases, the pain may radiate down to the fingers.
Serratus anterior pain can be caused by muscle injuries, overuse, or certain medical conditions such as asthma and ankylosing spondylitis. It is common in sports with repetitive motions, such as swimming, tennis, or weightlifting.
At-home treatments for a damaged serratus anterior muscle include applying ice, compression, and taking nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen. If at-home treatments don't work, a doctor may recommend physical therapy, medication, or massage therapy.











































