Serratus Posterior Inferior Referred Pain Pattern

Serratus Posterior Inferior Muscle: Trigger Point Pain

The serratus posterior inferior contributes to aching in the middle and lower back. The aching is felt at the bottom of the ribs and toward the outside of the lower back. Because of the location of the pain, people often fear it is associated with the kidneys.

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    Serratus Posterior Inferior Muscle

    Where Is The Serratus Posterior Inferior Muscle?

    The muscle is located in the middle to lower back. It connects the lower 4 ribs to four vertebrae (T11, T12, L1, L2) in the middle and lower back.

    What Movements Does It Control?

    • Forced expiration (breathing out when breathing hard)
    • Assists with twisting at the waist
    • Assists with straightening the trunk (standing up straight)

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

    Serratus Posterior Inferior Muscles Trigger Points Symptoms:

    Pain caused by trigger points in the SPI is centered around the TrP and does not radiate or refer to other areas of the body.

    The symptoms:

    • Pain in the lower back when stretching to reach overhead
    • Pain in the lower back when twisting at the waist
    • Pain in the lower back when bending over
    • Discomfort breathing, most noticeable when exhaling

    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)

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

    What Causes Trigger Points To Develop In The Serratus Posterior Inferior?

    • Twisting the body when lifting
    • Overreaching overhead or to the side of the body
    • Lifting something heavy using the back muscles instead of leg muscles
    • Sleeping on a sagging or too soft mattress

    TWD Recommends

    If you have rounded shoulder, forward head posture, or have a habit of slouching, correcting your posture will reduce your 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 slowly increasing the time worn.

    How To Avoid Development of Trigger Points In The Serratus Posterior Inferior

    • If you have a job or activity that requires you repeatedly reach overhead, try using a step ladder or long-handled tools. Think of ways to reduce the time you hold the arms up and overhead.
    • When lifting, do not bend over and then lift. Squat down and bend the knees keeping your back straight and use your legs as the power source to pick up the item. Also, do not use a twisting motion at the waist while lifting. Secure the item then turn the body before taking a step.
    • Sleeping on a lumpy or too soft mattress will cause soreness, stiffness, and the development of trigger points. Consider replacing your mattress.

    TWD Recommends

    A lumpy or too soft mattress wreaks havoc on the body. It can cause pain throughout the body, especially the muscles of the lower back. TWD has two affordable mattresses that we recommend.
    The first is Casper Sleep Essential. This mattress is firm but has enough softness to provide support. Highly recommend it to those who like a firm but not a hard mattress.

    The Snuggle-Pedic Mattress is not as firm as the Casper but provides needed support. It is recommended for those who need support but prefers a softer feel.

    Serratus Posterior Inferior Trigger Point Treatment

    One of the first steps to reducing and eliminating pain is to check for and deactivate any trigger points in the muscle. You can find a massage therapist, physical therapist, or a chiropractor trained in trigger point therapy to show you how to find and self-treat the TrP. Not everyone has specific training, so be sure and ask before making an appointment.

    Another option is to use The Trigger Point Therapy Workbook to learn self-treatment. The book explains trigger points thoroughly and includes diagrams to show the location of the trigger point and how to treat it. The workbook is recommended to everyone interested in learning about and how to reduce muscle pain throughout the body.

    If you plan to use the workbook, you will need to buy a tool to apply the treatment to hard to reach muscles, which include the serratus posterior inferior. I recommend the Thera Cane Massager. The cane has knobs on which are perfect for TrP treatment, and the cane shape makes it easy to treat those hard to reach places.

    Another option is to use small hard balls like The Kieba Massage Lacrosse Balls. You use the balls by placing the ball between your back and wall rolling the ball up and down or across the area. The balls work well for treatment, however, require that you have good balance as well as good motor control which is why I prefer the Thera Cane.

    TWD Recommends

    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.

    How Long Before I Feel A Reduction In Pain?

    Trigger points respond best to several 1-2 minute treatments throughout the day. A reduction of pain and tightness is noticeable after a few treatments.
    It is important to be consistent with your treatments and continue treatment until the Trp is deactivated.

    Interesting facts:

    • The serratus posterior inferior is one of the muscles that is achy and stiff when you have slept on a mattress that is too soft.
    • It is the muscle that cramps when you stretch too far when trying to reach something overhead.
    • If the serratus muscles are tight, they can contribute to breathing difficulty

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

    • Rib Subluxation/Dislocation
    • Slipping rib syndrome
    • Costochondritis
    • Sprain/Strain syndrome of the mid-back
    • Thoracic Spine Hyperkyphosis
    • Scoliosis
    • Kidney Stones
    • Kidney Infection
    • Ankylosing Spondylitis
    • T10 T11 T12 radiculopathy


    Other muscles that should be considered and examined:

    Satellite trigger points associated with the serratus posterior inferior muscle:

    Trigger points in the SPI muscle will cause TrPs to develop in other muscles. These are known as satellite trigger points. You will need to check these muscles for additional TrPs.

    • Iliocostalis
    • Longissimus thoracis

    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! 69 inches (5′ 9″) long.