Serratus Anterior Muscle - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the anatomy of the Serratus Anterior muscle.

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Serratus Anterior Muscle
The serratus anterior muscle originates on the superolateral surface of the upper 8 or 9 ribs. The muscle inserts into the medial border on the anterior side of the scapula. The serratus anterior muscle is divided into three parts: serratus anterior superior, serratus anterior intermediate, and serratus anterior inferior. The serratus anterior muscle is the most powerful “protractor” of the scapula. The scapula is moved laterally and anteriorly along the chest wall. The serratus anterior muscle is sometimes called the “boxer’s muscle” or the “big swing muscle”. With the same motion that occurs from throwing a punch, the serratus anterior muscle is responsible for pulling of the scapula forward and around the rib cage. The serratus anterior muscle is innervated by the long thoracic nerve. The long thoracic nerve arises from three nerve roots, C5, C6, and C7 cervical nerve roots. The long thoracic nerve then passes between the clavicle and first rib, then down along the lateral chest wall giving innervation to the serratus anterior muscle. Deficit of the serratus anterior muscle is most commonly caused due to impingement or injury of the long thoracic nerve. If the serratus anterior muscle becomes paralyzed, the condition is known as “medial winging of the scapula”. The long thoracic nerve can be injured by trauma, pressure, neuritis/inflammation, or surgery. Signs/symptoms of long thoracic nerve injury include medial winging of the scapula, difficulty elevating arm, weakness, pain, spasms (periscapular muscles trying to compensate for deformity), or cosmetic deformity. The Wall Test is used for clinical evaluation for medical winging of the scapula. The patient is asked to face a wall, standing about two feet from the wall and then push against the wall with flat palms at the waist level in order to identify a long thoracic nerve injury. The resistance of forward flexion test is also used. This is a test in which the patient resists the examiner’s attempt to bring down the forward flexed upper limbs. Lateral winging of the scapula is different from medial winging of the scapula. Lateral winging of the scapula is due to dysfunction of the trapezius muscle. Lateral scapular winging involves injury to the spinal accessory nerve. The treatment for medial scapular winging is nonoperative. Observation for a minimal of 18 months to wait for the nerve to recover without surgery. MRI to indicate if a lesion is pressing on the nerve. Muscle test and EMG or serratus anterior strengthening are also used. To treat it operatively, do a pectoralis major transfer.

[navaneeth_us]

These videos with clear description of anatomical aspects is GOLD.

[abbatis]

I am a 76 year old athlete working on muscle function. Very good. Thank you

[parvanehhosseini]

Thank you very much, I am a Pilates teacher and rehab specialist and I found your video very helpful to find the motions which can help lateral and medial scapula winging, Excellent Video

[apurvajadhav]

This video is a straight masterpiece. I'll be forever grateful for finding this.

[ariz]

Dr Professor,
Your lectures are a joy to listen too.
Thank you for sharing your knowledge

[beatapiekarska]

Thank you for all your videos. They help me so much to put myself diagnosis as doctors could not find any injury but injury was. I cannot live normal life for 3, 5 years.  The doctors are not precise enough. God bless you!

[Ayayron_e]

Perfect timing doctor! I'm studying the shoulder right now 😉👍 thank you

[shifter]

This was much more helpful than the previous video I saw. What was different was this one told me what the muscle does in a layman way. "Boxers muscle"

[MrTeks]

Your videos are very informative, wonderfully articulated to all kinds of viewers bc of it's simplicity yet you put a lot of thought in it.
Thank you for free knowledge.

[BeaulieuYoga]

I am a Registered Nurse Yoga Instructor and Health Coach in private practice. This is an excellent explanation of anatomy and function of the serratus anterior which helps me design a Therapeutic approach to the Yoga poses I teach. Thank you for your presentation. Namaste, Nurse Judith

[HananFuad-ipzi]

i can't explain how much your videos are helpful and informative😍

[mohammedkj]

I never trained this muscles! Thx doctor I am going to train it well

[premonitions]

Excellent!! Your diagrams are so clear and thorough!!

[nefanasa]

Thanks you, your video helping me to figured out my rib pain

[ScaevolaGM]

That was super helpful, thank you for the good explanation.

[natashafranko]

Thank you very much that was really helpful and you present and explain it so well.

[aprilslovesongs]

Thank you so much, I was looking for application concepts of some muscles to prepare for possible questions

[BarryFence]

What an excellent video. Very clearly explained. I'm just unsure of how to differentiate the winging at 4:47 of the video. Some arrows to denote motion would have been helpful. Thanks!

[TaxEvasin]

What about fixing lateral winging? Sometimes during shoulder workouts, I feel my left scapula unstable at the very bottom. The only way to get away from the flaring sensation is to do a 'lat spread' and try to tuck it in as best I can and engage those lower fibres.

[FabienDelcausse]

Helpful and instructive. Best video on the subject.