The Serratus Anterior
The Serratus Anterior Muscle: Trigger Points and Referred Pain
Where Is the Serratus Anterior Located?
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About the Serratus Anterior
The Serratus Anterior is a broad muscle located along the side of the rib cage, underneath the shoulder blade. It helps move the shoulder blade forward and upward and holds it against the rib cage while you reach, push, or lift your arm.
Because it works during many movements of the arm and shoulder blade, repetitive pushing, overhead activity, or heavy breathing may overload it and contribute to tender areas or trigger points.
Serratus Anterior Referred Pain and Related Symptoms
Trigger points in the Serratus Anterior may refer pain along the side of the rib cage. Discomfort may also spread toward the lower shoulder blade, the inner side of the arm, or the hand.
- Pain or tenderness along the side of the ribs.
- Discomfort beneath the armpit or around the lower shoulder blade.
- Pain that may travel down the inner side of the arm.
- Discomfort during reaching, pushing, or overhead activity.
- Discomfort during deep breathing in some cases.
These symptoms may resemble other muscular, rib, lung, nerve, or heart-related conditions. A referred-pain pattern may provide a useful clue, but it cannot confirm the cause of chest, rib, shoulder, or arm pain.
The image above shows possible Serratus Anterior trigger points and referred discomfort.
What May Contribute to Serratus Anterior Trigger Points?
- Repeated pushing, punching, or reaching movements.
- Frequent overhead lifting or working with the arms raised.
- A sudden increase in upper-body exercise or activity.
- Carrying or lifting heavy loads.
- Long periods of vigorous coughing or labored breathing.
- A direct blow or strain to the side of the rib cage.
How to Help Prevent Serratus Anterior Trigger Points from Returning
- Increase pushing and overhead exercises gradually.
- Take breaks during repetitive upper-body work.
- Use comfortable shoulder positioning while lifting and reaching.
- Warm up before demanding upper-body activity.
- Allow enough recovery time between strenuous activities.
- Modify movements that repeatedly bring back your symptoms.
Reducing or modifying the aggravating movement may be as important as massaging the tender area.
Serratus Anterior Self-Massage
Gentle self-massage may help reduce tension and tenderness in the Serratus Anterior.
1.Starting Position
2. Massage With Your Fingers
3. Massage With A Tennis Ball
Serratus Anterior Massage Instructions
Picture 1 — Starting Position: To massage your right serratus anterior, place your right hand on your left shoulder. Then reach your left hand beneath your right armpit and place your fingertips along the side of your rib cage, as shown in Picture 2.
Picture 2 — Massage with Your Fingers: Using your fingertips, gently massage the serratus anterior with slow, controlled movements. This area may be sensitive, so begin with light pressure and increase it gradually as tolerated.
Picture 3 — Massage with a Ball: Place a soft massage ball between the side of your rib cage and a wall. Lean gently into the ball and move slowly until you find a tender area. Apply comfortable pressure for a few seconds, then release. You can also make small, slow movements from side to side to massage the serratus anterior.
Use caution: Do not press directly into the armpit, breast tissue, front of the chest, or forcefully against the ribs. Stop if the massage causes sharp pain, numbness, tingling, breathing difficulty, dizziness, or increased chest pain.
Sources and References
- Clair Davies and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. New Harbinger Publications, 2013.
- Anatomy, Thorax, Serratus Anterior Muscles — NCBI Bookshelf.
- Winged Scapula — Cleveland Clinic.
I hope you find this information helpful.
Thank you for reading,
Michel Bourgeois
Licensed Massage Therapist
This article is provided for educational purposes only and does not constitute medical advice, a diagnosis, or treatment.