Damage to the Serratus Anterior

The serratus anterior is a muscle located on the lateral sides of the upper rib cage. Although an unappreciated muscle, the serratus anterior plays a significant role in stabilizing the shoulder joint and shoulder blade. Therefore, damage to this muscle can result in certain anatomical and physiological dysfunction.

A woman does push-ups on an exercise mat. Credit: DragonImages/iStock/Getty Images

Anatomy

The serratus anterior is located on the upper, lateral edges of the upper eight to nine ribs and connects to the outer borders of the scapula, according to the University of Washington Department of Radiology. When contracted, the serratus anterior draws the scapula upward and rotates it. It receives its blood supply from the circumflex scapular artery. The long thoracic nerve activates the scapula, so if it is damaged it may cause serratus anterior paralysis.

Winged Scapula

Traumatic injury to the long thoracic nerve may cause winging of the scapula secondary to serratus anterior dysfunction. The most common causes of long thoracic nerve injury include pressure lesions or neuritis, which is inflammation of the nerve, according to Shoulderdoc.co.uk. To test for winged scapula, you can face a wall and push against it with your palms at waist level. If the scapula protrudes backwards, the test is positive.

Treatment

If you have a winged scalpula secondary to a damaged serratus anterior, you may need surgical treatment. According to a 2007 article published in the "Journal of Brachial Plexus and Peripheral Nerve Injury," decompression and repair of an acutely damaged long thoracic nerve can result in significant improvements in a winged scapula. In more chronic cases; however, a tendon transfer from the pectoral muscle may be needed to treat scapular winging.

Exercises

Exercising the serratus anterior is important in preventing damage or promoting recovery. A 1999 article published in "The American Journal of Sports Medicine" states that punching exercises, pushups and pullups are important to perform regularly to strengthen the serratus anterior muscle. These exercises should be performed under the supervision of a qualified physical therapist if you had a recent serratus anterior injury or surgery. Otherwise, these exercises can be incorporated into your regular exercise routine two or three times per week.

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