Skip to content

Serratus Posterior Superior Muscle: Breathing Difficulty

The serratus posterior superior muscle is located in the upper back. It contributes to pain in the upper back, chest, arm, and hand. Two indicators of muscle dysfunction are a deep aching pain under the shoulder blade and in the little finger. The muscle can also cause a sharp stabbing pain when you inhale, making breathing difficult.

Contents of Article

    Where Is The Serratus Posterior Superior Muscle?

    Serratus Posterior Superior Anatomy showing trigger point locations

    The serratus posterior superior muscle connects the bottom neck vertebrae (C7)  and the top upper back vertebrae (T1, T2, T3) to the 2nd – 5th ribs.

    What Movements Does It Control?

    • Forced inspiration (breathing in sharply when gasping or breathing hard)
    • Raises the 2nd -5th ribs to assists inhalation

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


    Serratus Posterior Superior Muscle Trigger Points Symptoms:

    Serratus Posterior Superior Referred Pain Pattern

    A deep aching pain under the shoulder blade is one indicator of trigger points (TrPs) in the muscles. Another tale-tell symptom of TrPs in this muscle is an aching pain in the little finger. Trigger points can also cause pain to run down the back of the arm that concentrates in the elbow. The pain often descends into the back of the forearm into the wrist, hand, and the ring and little fingers.

    The serratus posterior superior raises the upper ribs during inhalation. Trigger points in the muscle are also notorious for contributing to breathing difficulty, especially taking a deep breath.

    Other symptoms:

    • Deep aching under the shoulder blade
    • Pain in the low point of the elbow
    • Pain in the wrist and hand extending into the little finger
    • The pain persists even at rest
    • Pain is occasionally felt in the chest muscles
    • Difficulty breathing especially inhaling

    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 Posterior Superior Trigger Points To Develop?

    • Labored breathing (asthma, emphysema, bronchitis, pneumonia)
    • Gasping for air during sports activities
    • Extreme coughing or sneezing “fits.”
    • Hyperventilation
    • A habit of shallow chest breathing
    • Lifting heavy objects with arms straight to the front of the body
    • Rounded shoulder posture

    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 Posterior Superior

    • Pay attention to your posture. Standing, lifting, sitting, and sleeping with your shoulders rolled forward keeps the serratus posterior superior in a constant state of tension.
    • Not breathing properly is another major contributor to the development of trigger points. Make sure you are “belly breathing,” breathing deeply, so your belly extends while inhaling. Short, shallow breathing, in which breathing movement is in the chest (chest or shallow breathing), overworks the muscle, which will cause trigger points to develop.
    • Don’t lift or carry objects with your arms straightened in front of the body.

    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.

    Serratus Posterior Superior Trigger Point Treatment

    Trigger points in this muscle can be hard to find and treat because the serratus posterior superior is located under the shoulder blade. Fortunately, the trigger point can be uncovered by taking the hand of the affected side and grabbing the opposite shoulder, which moves the shoulder blade and uncovers the TrP.

    A physical therapist, massage therapist, sports therapist, or a chiropractor trained in TrP therapy can show you how to find the trigger point and apply self-treatment. Not all have the specified training, so be sure to inquire before making an appointment.

    If you have time and patience, you can learn self-treatment. The Trigger Point Therapy Workbook is an excellent book to have on hand. It explains trigger points, how and why they develop. There are diagrams of TrPs locations in each muscle and how to apply self-treatment. The best thing about owning this book is you can use it as a reference to learn how to treat muscle pain throughout the body.

    If you use the workbook, you will want to buy the Kieba Massage Lacrosse Balls. The massage balls are needed to apply the treatment.

    If you have difficulty breathing due to a medical condition, checking for and treating the serratus posterior superior TrPs regularly will help ease your breathing difficulty.

    How Long Before I Feel A Reduction In Pain?

    Trigger points in the serratus posterior superior can be stubborn and take time to deactivate, but relief is felt in just a few treatments. It is important to continue treatments until the trigger point is completely deactivated. TrPs respond best to several 1-2 minute treatments spread throughout the day.

    Interesting facts:

    • Sharp pain while inhaling is often a sign of a problem with the muscle
    • Unrelenting aching pain in the little finger is another prime symptom

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

    • Chronic Obstructive Pulmonary Disease
    • Emphysema
    • Pleurisy
    • Thoracic outlet syndrome
    • Cubital tunnel syndrome
    • Epicondylitis
    • Scapulocostal syndrome
    • Ulna neuropathy
    • Deltoid tendonitis
    • Post injection soreness of the deltoid,
    • Shoulder pointer
    • Glenohumeral dislocation
    • Scoliosis
    • Spondylitis
    • Ankylosing spondylitis
    • C7 C8 T1 T2 T3 Radiculopathy


    Other muscles that should be considered and examined:

    Satellite trigger points associated with the serratus posterior superior muscle:

    If trigger points are found in the serratus posterior superior these muscles should also be checked for trigger points:

    • Trapezius
    • Splenius
    • Latissimus dorsi
    • Scalenes
    • Rhomboid Major
    • Rhomboid Minor
    • Iliocostalis
    • Longissimus Thoracis
    • Multifidus

    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. An excellent 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 Anterior
    Latissimus Dorsi
    Pectoralis Minor