The serratus anterior is an oft-neglected muscle of the shoulder girdle, simply because the average person doesn’t know about it.  As a result, it can get weak disrupting shoulder joint biomechanics.

The serratus anterior attaches to the shoulder blade (scapula) and the thoracic cage (essentially the upper and mid-back).  It’s main function is to act as a scapular stabilizer; in other words, when we do shoulder movements, particularly reaching over head, the scapula must get locked into place against the t-cage, allowing unimpeded movement.

When serratus anterior muscle gets weak, stabilization is lost, and it can lead to a number of dysfunctions, including shoulder impingement (very painful), and degeneration (even more painful).  The classic postural sign of a weak serratus anterior is the shoulder blade protruding at its medial border, or the edge closest to the spine.  ”Winging,” as it’s called, is not an uncommon sight among thin women (in fact, I observe it quite regularly here in Hollywood and Beverly Hills), but plenty of men have it too.

The answer to a weak serratus anterior is to strengthen it with an exercise called a press-through (aka push-up with a plus).  The actual movement is called protraction of the shoulders, which is the exact opposite of retraction (pulling the shoulders back).  I prefer the weight-bearing version for the use of gravity to help strengthen the muscle, but some people are not strong enough initially to do that.  For those that need to build up to the weight-bearing press-through, there are two alternate versions they can do.

And some people have difficulty just initiating the protraction movement altogether.  For these people, the neurological connection to the muscle and that movement has been disrupted.  The wall version of the press-through is what I recommend to re-establish this neurological connection.

Watch the video below to see a demonstration of the best serratus anterior exercise (weight-bearing press-through), as well as instruction on doing the two alternate versions.  Remember to build up to doing the weight bearing exercise, as this will ultimately give you the strength you need to maintain proper shoulder biomechanics.  As a plus, you’ll reduce winging, which will look better as well.

*Severe and one-sided winging should be checked by a doctor as it could signify a neurological lesion of the long thoracic nerve.


26 Responses to Serratus Anterior Exercises for Shoulder Pain Relief

  1. Liam Morgan says:

    Hi dr nick your section on serratus anteriour was extremely helpful and interesting . I have serious winging on rIte side I’ve had a shoulder disfunction about 2 years maybe 3 .. It came and gone through weight training back in summer 2011.. But now muscle has gone its came back .. I work as a construction worker doing a lot of work involving my hand above my head I.e boarding drywall ceilings.. Never exactly new what caused the damage initially . I’ve been to hospital and they told me have physical therapy but due to always working away I struggle to attend ..I can manage push ups simple and and I can bench with no ease as well just got no stabilisation what so ever .. Any advice would be great thanks
    Liam Morgan

  2. Liam Morgan says:

    I’ve worked thRough all this … Never resting it .Ive had the sleepless nights I couldn’t protract my shoulder at all at one point .. I feel like I could have the worse case you have ever seen. My left shoulder is beginning to weaken and I got them sharp shooting pains through deep into the core of my muscle. Cannot sit up straight for to long ie eating dinner at table. I also have these pains in my upper back like I’ve just got bit or stung by something .. Please reply the doctors I’ve seen have all been useless
    Liam

  3. When you ‘followed’ me on twitter (and I followed you), I had to come see your website — wow! Thank you so much for the wonderful videos! I’m adding the butt and hip ones to my routine ..
    I’m a young 64 — and am finding it harder and harder to stand or sit up straight ..esp. since I’m at the computer a lot!! I don’t want to have a rounded back ..Do you have some good exercises for that?
    Blessings, Angelica

  4. Holly Eubanks says:

    I have breastfed my son since he was born on 1/22/13. Since then I had nerve pain shooting down my right arm which led to right arm weakness. The weakness is improving, but I have had significant right scapular winging for the last 6 weeks with no relief from chiropractor. MRI of spine was benign. When I try to do this protraction of my shoulders, I feel a popping in that shoulder joint. What could this indicate from a professional’s standpoint? Thank you so much for your time.

  5. Bruno says:

    I’ve suferred from this so MUCH those past years. Never find a solution nor a relief. Your advice seems really reliable. Gonna try this asap.

    Thankss

  6. Lewis says:

    Nice explanation, could you take your top off so I could exactly whats going on please?

  7. Daniel Dos Santos says:

    Hey Dr, im in desperate need of help. I have a pigeon chest on my left side and winging scapula on my left side. I have had problems with my left side for as long as i can remember. Anatomically literally all the muscles on my left side are different to my right. For eample as the scapula wings it causes my shoulder to sit differently and therefore i have faulty recruitment patterns in all the muscles. Noticed my left tricep outer head is significantly bigger than the rest of the tricep, also i cannot properly contract my chest or opoosing back muslces. i have sean a physio and been discharged twice, as they said there wasnt more they could do. Question are the effects the winging has on my body common also is there anything more i can do to correct the winging and utilise the muscles in my left side properly? Thank you for the help in advance. Finally i am currently doing a strength training program with all compound lifts, and i do muay thai kickboxing.

    • Dr. Nick Campos Dr. Nick Campos says:

      You seem to be describing cosmetic issues more than functional ones. Do you have pain? What is it you can no longer do? Outside of these types of issues, I wouldn’t be able to give you any valuable insight–I just don’t deal in cosmetics.

      • Daniel Dos Santos says:

        It isnt cosmetic as i can perform exercises with my left side but they do not target or use the right muscles creating imbalances in my body. My whole left side of my upper body is basically f***** as these deficiencies make it hard to progress with strength training and any other sport, as certain muscles wont grow or activate as i have faulty recruitment patterns any suggestions?
        Thanks

        • Dr. Nick Campos Dr. Nick Campos says:

          Yes go see a doctor. If it is a musculoskeletal problem you will get help. If it is as you describe it here–there are probably many solutions–keep searching. That’s the best I can give you here sir. All the best.

  8. tolu says:

    Hi doc, I dislocated my shoulder 7 years ago with the humeral head out of the socket and my scapula sticking out from my back. I had my shoulder reduced crudely as there was no medical help nearby. And now 7 years later I’m still feeling pains in d medial border of my scapula close to the spine. My shoulder feels subluxed and I can feel it move when I try to push the humeral head into its socket. Please can the exercise in ur video help me get better as surgery isn’t an option for me. Thank you

    • Dr. Nick Campos Dr. Nick Campos says:

      You’d really be better off getting checked by a doctor sir. I can’t give a diagnosis and treatment plan over a comment on a post. I’d have to see you and evaluate you to give you anything of value regarding your specific situation. Sorry sir–I wish I could be of more help.

  9. Karl says:

    Hey Doc, I have had trouble in my right shoulder, I assume through bodybuilding; where I have a lack of ROM and sharp pain when I retract my elbow behind my back as in a ‘Dip’ movement – even when just doing the actual movement with no weight bearing. Is this the same issue as caused by the serratus or something different?

    • Dr. Nick Campos Dr. Nick Campos says:

      You should get it checked, Karl–sports chiropractor or orthopedist. If you are in LA, you can call me.

  10. Julio Breton says:

    Dr.

    I have been reading on serrator anterior injuries and believe I have damaged my serrator through bench pressing overuse.

    I am taking NSAIDs for pain and applying trigger point massage wih a tennis ball. Is there anything else I can do to manage the pain? Applying heat or cold therapy? Anything else I can do to reduce sharpness of this pain?

    Thanks,

    • Dr. Nick Campos Dr. Nick Campos says:

      Discontinue offending exercise until it heals, then start with the exercises I show in the video, being mindful of reps, sets and version so as not to exacerbate

  11. Ak says:

    Hello Dr.

    My left scapula wings and my RHEUMATOLOGY & PHYSICAL MEDICINE’s doctor told me that my left serratus anterior is weak because and I quote “when you were a child, someone hit you in the back and hit your nerve” thats’s part of what he says. So I’ve been training my traps and serratus anterior for the past 3 months as instructed, and the doctor says that my serratus anterior is 55% better than before. It still wings though and my shoulder rounds forward. I see improvment but i’m only 55% better. How long will it take me to fully recover? I’m only doing the exercises that my doctor tells me to do, and I’m not doing any (chest, legs, biceps, triceps..ect) exercises. Only serratus and trapizeus and lats. Thanks.

  12. robert says:

    hey Dr. nick i have a sharp pain on my left serratus anterior could you please give me some advise
    on how to get rid of the pain.
    Thank you

    • Dr. Nick Campos Dr. Nick Campos says:

      Yes, get it checked by a doctor. When you have a diagnosis, come back and I’ll tell you what I know about that diagnosis.

  13. Martin says:

    Hello, dr. Nick,

    I do have a problem with serratus anterior as well.
    As I have cleared out I have had hard (spastic) pectoral muscles (mostly pectoralis minor) for 5-8 years, possibly. This muscle spasm inhibited long thoracic nerve so that I can not feel serratus anterior. Thus, my question is: is it possible to start feeling this muscle by only doing excersises or, maybe, only some medical treatment, like electroterapy could help me to feel serratus anterior?

  14. Jessie says:

    Dr. Nick,
    My sister who is a PTA directed me to your website after I’ve been c/o what I believe may be serratus anterior muscle pain…
    I’ve had upper back pain since I was a teenager, I get deep tissue massages, go to a chiropractor and get trigger point releases when the pain gets really bad, I have daily headaches and take ibuprofen 800 in the morning when my pain is the worst, sometimes I repeat the dose in the evening but mostly just in am… Trigger points are usually right along the underside of my scapula and the base of my neck c6-7 area…. The last 6 weeks or so I’ve noticed pain that feel like new trigger points around my anterior humoral head and in my armpit near 3-5 rib and more recently if pushed pain radiates to my scapula and down my arm all the way to my 4th and 5th digit. The last 2 weeks I have also noticed pain down my lateral forearm and down my 4th and 5th digits that also have some numbness associates, there is a trigger point at between my posterior proximal ulna and radius as well as a spot near my anterior lateral ulna that if pressed pain shoots down my 4th and 5th digit. I’m an emergency room nurse so I do a lot of pulling, pushing, and reaching (especially being 5′ 1″) it has been bothering me everyday at work and I have stopped all recreational weight lifting for the past 4 weeks without relief. I hate wasting money on expensive unnecessary tests like mri’s and would rather do home therapy, does this sound most consistent with serratus anterior muscle pain and will at home trigger point release and excercises to strengthen it be the best plan of care or does this sound like something more serious and I should just suck it up and get the expensive tests?

    • Dr. Nick Campos Dr. Nick Campos says:

      You have to get that checked out, Jessie – Too many symptoms which sound unrelated, and the “numbness” is concerning, particularly along with neck pain. Where are you located?

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