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Serratus Anterior Muscle: Rib, Arm, Finger, Upper Back Pain

The serratus anterior contributes to pain on the side of the rib cage and around the shoulder blade. Pain radiates to the inside of the arm, descending to the hand and into the ring and little fingers. You may experience pain and tightness in the chest. You may also experience difficulty breathing, pain when inhaling, and the feeling that you cannot completely exhale.

Contents of Article

    Where Is The Serratus Anterior Muscle?

    Serratus Anterior Anatomy Showing Trigger Points

    The serratus anterior attaches ribs 1-8 to the shoulder blade (scapula).

    What Movements Does It Control?

    • Pulls shoulder blades forward toward the front of the body
    • Aids with inhalation by raising the ribs

    Looking for detailed muscle anatomy? The Serratus Anterior Muscle Anatomy page has origin, insertion, innervation, and blood supply information. It also lists agonists and antagonists for each muscle action.


    Serratus Anterior Muscles Trigger Points Symptoms:

    Serratus Anterior Referred Pain Pattern

    Serratus anterior trigger point (TrP) pain is usually localized on the side of the ribs under the arm. The trigger point may refer pain into the inside of the arm that travels down into the hand to the ring and little fingers. It can also refer pain to the inside border of the shoulder blade.

    The symptoms:

    • Pain in the ribs just under the armpit.
    • Pain down the inside of the arm to the fourth and fifth fingers
    • Aching pain below the shoulder blade
    • Pain when inhaling
    • The feeling that you cannot fully exhale
    • Sharp pain in the side (side stitch)
    • Pain and difficulty reaching behind the body
    • Pain and difficulty when pulling shoulders back
    • Sensitivity in and around the area of the breast

    Sombra Warm Therapy Gel is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice for pain caused by trigger points, muscle/joint over-use and stiffness, and arthritis. (Not sold in stores)

    Medical professionals and trainers recommend Biofreeze Professional Gel for the pain and symptoms of muscle strains. It provides excellent pain relief and may help reduce inflammation caused by a strain.

    What Causes Serratus Anterior Trigger Points To Develop?

    • Hyperventilation
    • Intense coughing and sneezing
    • Slumping posture
    • Lifting or holding heavy objects overhead
    • Swimming
    • Tennis
    • Chin-ups
    • Push-ups
    • Weightlifting
    • Gymnastics specifically the rings and pommel horse
    • Riding a bicycle for an extended period of time (the up and down motion of peddling affects muscle)

    TWD Recommends

    If you have rounded shoulder, forward head posture, or a habit of slouching, correcting your posture will reduce muscle pain. The Truweo Posture Corrector is adjustable and comfortable. It gently pulls your shoulders back, which helps retrain muscle memory to maintain proper posture. Many people notice an immediate reduction of pain and tension. Start slowly, wearing the brace for short periods throughout the day, gradually increasing the time-worn.

    How To Avoid Development of Trigger Points In The Serratus Anterior

    • Pay attention to how you breathe. When inhaling and exhaling, your abdomen should be rising and falling. The movement should not be in the chest. Concentrate on inhaling deeper until the abdomen expands, then exhale slowly. Keep practicing until it becomes a habit.
    • If you find yourself hyperventilating, concentrate on slowing down your breathing. And yes, breathing into a paper bag works!
    • Stand and sit up straight. Slumping posture contributes to shallow or chest breathing that taxes the muscle.
    • When you find yourself becoming out of breath during exercise and other strenuous activities, take a break and catch your breath. Straining to catch your breath is a prime contributor to serratus anterior trigger points.
    • Coughing and sneezing are how the lungs and sinuses clear themselves and force out impurities. But if you are sick, have allergies, or have a chronic condition that affects your breathing, you may need help suppressing continuous coughing and sneezing. Talk to your doctor about solutions that will work for you.
    • When exercising, pay attention to your form, and do the exercise correctly. Don’t push too far past your conditioning.
    • Athletes who swim, play tennis, golf, or baseball are susceptible to trigger points in the serratus anterior due to overuse of the muscle. Make a habit of checking for tender points to stay on top of treatments.

    TWD Recommends

    The Cureve Hot Cold Pack can be used for warm and cold treatments. It is recommended that you use cold packs for injuries, swelling, and after a TrP treatment. Use a warm treatment when the muscle is tight and needs to relax.

    Serratus Anterior Trigger Point Treatment

    The serratus anterior muscle is easily self-treated. The Trigger Point Therapy Workbook is an excellent book that will teach you how to locate and treat trigger points in the serratus muscles and other muscles throughout the body.

    Many chiropractors, physical therapists, and massage therapists have training in trigger point therapy and show you self-treatment methods. Not all have the specific training so ask before making an appointment.

    How Long Before I Feel A Reduction In Pain?

    A reduction of pain and the ability to breathe easier is noticeable almost immediately. Treat the trigger point several times a day for 1-2 minutes per treatment for relief. Continue treatment until the trigger point is deactivated and can no longer be felt. Treatment consistency is important for success.

    Interesting facts:

    The serratus anterior is overworked by hard or heavy breathing. People with asthma and emphysema often suffer from symptoms of this muscle. Tightness and trigger points in the serratus anterior can contribute to headaches, jaw pain, dizziness, and numb hands for those who have difficulty breathing because of asthma, COPD, and emphysema.

    Serratus anterior muscle pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

    • Thoracic outlet syndrome
    • Slipped rib
    • Intercostal muscle tear
    • Asthma
    • COPD
    • Emphysema
    • Pleurisy
    • C5 C6 C7 C8 radiculopathy
    • T1 T2 T3 T4 radiculopathy
    • Gallbladder Dysfunction
    • Pancreatitis
    • Ankylosing spondylosis
    • Heart Disease


    Other muscles that should be considered and examined:

    Satellite trigger points associated with the serratus anterior muscle

    If you find trigger points in the serratus anterior, you will likely find trigger points in some or all of these muscles:

    • Latissimus Dorsi
    • Scalenes
    • Sternocleidomastoid

    TWD Recommends

    You’re tired. Your muscles are sore and stiff. All you want to do is lie down and be able to relax.

    The Snailax Vibrating Massage Mat With Heat is made for those times. The mat features a full-body vibrating massage and has multiple settings for massage and heat. The remote allows you to adjust settings with a push of a button. A wonderful way to ease aches and pains in the back, hips, and legs at the end of the day! Sixty-nine inches (5′ 9″) long.

    Muscles with similar pain patterns

    Serratus Posterior Superior
    Pectoralis Minor
    Latissimus Dorsi
    Pectoralis Major