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Serratus Anterior Muscle: Chest, Rib, Arm, Finger and Upper Back Pain, Breathing Difficulty

Pain in the side of the chest, arm, fingers and middle back can indicate serratus anterior dysfunction. People with asthma, emphysema and chronic bronchitis often experience problems with this muscle.

What are the pain and symptoms associated with the serratus anterior?

  • Pain on the side of the chest toward the middle of the ribcage
  • Pain down the arm to the fourth and fifth fingers
  • Pain below the shoulder blade
  • Difficulty breathing
  • Inability to take a deep breath
  • 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

Where is the serratus anterior muscle?

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

What movements does the serratus anterior control?

  • Rolls shoulders forward
  • Aids in inhalation by raising the ribs

Activities that cause serratus anterior pain and symptoms:

  • Swimming
  • Tennis
  • Chin ups
  • Push ups
  • Lifting or holding heavy objects overhead
  • Weightlifting
  • Gymnastics
  • Riding a bicycle for extended period of time (peddling affects muscle)
  • Hyperventilation
  • Severe coughing


Serratus Anterior Origin, Insertion, Action

You use the serratus anterior muscle to raise your arms to the front of the body and to inhale during breathing.

Interesting facts about the serratus anterior:

  • The serratus anterior is easily taxed 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.

Clinical diagnoses to which the serratus anterior muscle symptoms may contribute:

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

Other muscles that should be considered and examined in conjunction with the serratus anterior:

Satellite trigger points associated with the serratus anterior :

  • Latissimus Dorsi
  • Scalenes
  • Sternocleidomastoid

For detailed anatomy information:  
Serratus Anterior Muscle Anatomy

Help with Serratus Anterior Muscle Pain and Symptoms

Cold Gel Therapy for Serratus Anterior Rib Injury and Pain

Biofreeze Pain Relieving Gel is an excellent pain relieving gel that I use on clients who have sudden onset muscle pain or recent injuries. Biofreeze Cold Therapy gel works like ice and does not promote swelling. A recent study showed that Biofreeze decreased pain 2 times more than ice and the pain relief lasts 9 – 10 longer. If your pain is from a recent injury such as strained serratus muscle from coughing or recent high rib injury that affects the serratus anterior, I would recommend Biofreeze.

Hot Cold Packs For Serratus Anterior Muscle Pain

CorPak Soft Comfort Hot & Cold Pack Wrap is a large pack that can be used for hot or cold treatment. The pack is large enough to cover the serratus anterior muscle and drape down over the back. To treat the serratus anterior lay your unaffected side and drape the pack over the side of your ribs starting just under the arm covering the side of the rib cage.

Warm Therapy Gel for Serratus Anterior Muscle Pain

Sombra Warm Therapy Pain Relieving Gel is a pain relieving gel that I use both personally and in my massage therapy practice. Unlike other over the counter heating creams, it provides warmth without burning heat.  Applying Sombra to the serratus anterior muscle as well as to the upper back, chest and arm area can help relax muscle spasms caused by the serratus anterior. I recommend Sombra for chronic pain and chronically sore tight muscles.

Breathing Correctly Can Help With Muscle Pain

Improper or irregular breathing is one of the main contributors to serratus anterior muscle dysfunction.  Learn To Breathe is a DVD by internationally renowned yoga instructor Max Strom that walks you through several breathing exercises that will help you improve your quality of breathing. The exercises are especially beneficial for people who suffer from breathing problems such as asthma,  emphysema,  COPD, and allergies.  I often recommend this DVD to friends and clients who have breathing problems. Yoga experience is not necessary.

Self Treatment For Your Serratus Anterior Pain

Do you know that small knots in the serratus anterior muscle can contribute to pain in the chest, arm, fingers and upper back? It can also contribute to difficulty breathing.

Injury to the serratus anterior muscle can cause a multitude of symptoms. If you are suffering from pain on the side of the rib cage, pain just under the shoulder blade, pain and numbness in the arm going down into the ring and little fingers, and often have sharp pains in your side (side stitches), then your pain is likely trigger points in the muscle. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief will help you locate and treat these trigger points, relax the muscle, and relieve and possibly eliminate your symptoms.  Not only will this book help with your serratus anterior muscle pain, but it will also help with other muscle pain that you may be experiencing.