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Shoulder Pain and Serratus Anterior

Shoulder Pain and Serratus Anterior

There is a sudden increase in neck and shoulder pain pertaining to many reasons. The most evident reason to this is our poor ergonomics which leads to muscle imbalances. Tightness or weakness of muscle around the shoulder or neck increases the load on its counterpart or other joints. One such muscle is serratus anterior, its weakness is usually targeted but the tightness factor is often overlooked.

Serratus anterior muscle lies underneath the shoulder blade and comes out on the sides of the rib cage. It is commonly known as punching muscle or boxer’s muscle. Serratus anterior has many functions in keeping a smooth and coordinated movement of the shoulder blade and arm. It helps in rotating the scapula upwards for arm to elevate overhead. It also keeps the shoulder blade pressed against the thorax and helps in bringing it forward around the thorax.




Serratus anterior weakness

Now since we know the movements it does around the shoulder, it is easy to relate what will happen if the muscle is weak. Reduced upward rotation from serratus anterior will increase load on other upward rotators, which is your upper trapezius muscle. Increased load on upper trapezius muscle will cause tightness and ache around the neck. Secondly, its ability to hold shoulder blade pressed against the rib cage also reduces. This affects the ability to pull or push objects and alters shoulder joint mechanics which can lead to problems like shoulder impingement.



Serratus Anterior tightness

Ever noticed when we are working on computers, the hand controlling the mouse is often kept away from the body? This is one of the leading causes of serratus anterior tightness now a day. When our arms are extended forward for prolonged hours it draws the shoulder blade forward, thus making serratus anterior muscle rest in a shortened position. Over time this leads to gradual onset of problems in shoulder joint as the joint mechanics gets altered.




Targeting strength and flexibility of serratus anterior muscle

Shoulder Impingement : Simplified

Shoulder Impingement – Causes & Treatment

The term impingement itself explains some kind of pinching or compression in shoulder joint. Most common location of shoulder impingement is under the sub acromion arch followed by less common sub coracoid impingement.

Sub acromion arch is formed by clavicle (collar bone) and acromion process of scapulae (shoulder blade). The space below sub acromion arch comprises of one of the rotator cuff muscle (supraspinatus) and a bursae which sits over the head of humerus (arm bone). If the space between sub acromion arch and head of humerus decrease it causes compression and irritation of supraspinatus muscle and the bursae.

 

It is more common in middle aged group but can also be seen in active sporting individuals at young age. Usually, the symptoms are pain, stiffness and clicking. Pain is worse with overhead arm movements and sleeping on the affected shoulder. Location of pain is around tip of the shoulder and might refer down till mid arm on outer side. Hand behind back might also be painful in some cases.

In sub coracoid impingement the affected muscle is another rotator cuff muscle (subscapularis). Location of symptoms is more in front of the shoulder as compared to subacromion impingement.

Causes

  • Poor posture – protracted shoulders, thoracic kyphosis (hunch back)
  • Stiff and decreased mobility in thoracic area
  • Altered position and movement of scapula
  • Tight and overactive pectorals muscles and deltoids
  • Weak rotator cuff muscles and scapular stabilizers
  • Repetitive overhead movements
  • Poor sporting technique
  • Involvement in activities performed away from body (painting , desk work)
  • Type II and Type III acromion (Curved or hooked acromion)
  • Development of  a bone spur on front or side of acromion

 

 Conservative treatment

  • Posture correction
  • Ergonomic advice – workplace setup
  • Strengthening scapular stabilizers and rotator cuff muscles
  • Stretching exercises for tight muscles(e.g.: pectorals)
  • Soft tissue mobilization
  • Joint mobilization
  • Sporting technique correction
  • Improving overall core strength and control to reduce stress on shoulder in activities like throwing, smashing.
  • Taping
  • Icing to reduce inflammation
  • Correcting sleeping position

 

Rehab Mantra
Love Life. Stay Fit

READ OTHER ARTICLES

Shoulder Pain and Serratus Anterior

Shoulder Pain and Serratus Anterior

There is a sudden increase in neck and shoulder pain pertaining to many reasons. The most evident reason to this is our poor ergonomics which leads to muscle imbalances. Tightness or weakness of muscle around the shoulder or neck increases the load on its counterpart or other joints. One such muscle is serratus anterior, its weakness is usually targeted but the tightness factor is often overlooked.

Serratus anterior muscle lies underneath the shoulder blade and comes out on the sides of the rib cage. It is commonly known as punching muscle or boxer’s muscle. Serratus anterior has many functions in keeping a smooth and coordinated movement of the shoulder blade and arm. It helps in rotating the scapula upwards for arm to elevate overhead. It also keeps the shoulder blade pressed against the thorax and helps in bringing it forward around the thorax.




Serratus anterior weakness

Now since we know the movements it does around the shoulder, it is easy to relate what will happen if the muscle is weak. Reduced upward rotation from serratus anterior will increase load on other upward rotators, which is your upper trapezius muscle. Increased load on upper trapezius muscle will cause tightness and ache around the neck. Secondly, its ability to hold shoulder blade pressed against the rib cage also reduces. This affects the ability to pull or push objects and alters shoulder joint mechanics which can lead to problems like shoulder impingement.



Serratus Anterior tightness

Ever noticed when we are working on computers, the hand controlling the mouse is often kept away from the body? This is one of the leading causes of serratus anterior tightness now a day. When our arms are extended forward for prolonged hours it draws the shoulder blade forward, thus making serratus anterior muscle rest in a shortened position. Over time this leads to gradual onset of problems in shoulder joint as the joint mechanics gets altered.




Targeting strength and flexibility of serratus anterior muscle

Shoulder Impingement : Simplified

Shoulder Impingement – Causes & Treatment

The term impingement itself explains some kind of pinching or compression in shoulder joint. Most common location of shoulder impingement is under the sub acromion arch followed by less common sub coracoid impingement.

Sub acromion arch is formed by clavicle (collar bone) and acromion process of scapulae (shoulder blade). The space below sub acromion arch comprises of one of the rotator cuff muscle (supraspinatus) and a bursae which sits over the head of humerus (arm bone). If the space between sub acromion arch and head of humerus decrease it causes compression and irritation of supraspinatus muscle and the bursae.

 

It is more common in middle aged group but can also be seen in active sporting individuals at young age. Usually, the symptoms are pain, stiffness and clicking. Pain is worse with overhead arm movements and sleeping on the affected shoulder. Location of pain is around tip of the shoulder and might refer down till mid arm on outer side. Hand behind back might also be painful in some cases.

In sub coracoid impingement the affected muscle is another rotator cuff muscle (subscapularis). Location of symptoms is more in front of the shoulder as compared to subacromion impingement.

Causes

  • Poor posture – protracted shoulders, thoracic kyphosis (hunch back)
  • Stiff and decreased mobility in thoracic area
  • Altered position and movement of scapula
  • Tight and overactive pectorals muscles and deltoids
  • Weak rotator cuff muscles and scapular stabilizers
  • Repetitive overhead movements
  • Poor sporting technique
  • Involvement in activities performed away from body (painting , desk work)
  • Type II and Type III acromion (Curved or hooked acromion)
  • Development of  a bone spur on front or side of acromion

 

 Conservative treatment

  • Posture correction
  • Ergonomic advice – workplace setup
  • Strengthening scapular stabilizers and rotator cuff muscles
  • Stretching exercises for tight muscles(e.g.: pectorals)
  • Soft tissue mobilization
  • Joint mobilization
  • Sporting technique correction
  • Improving overall core strength and control to reduce stress on shoulder in activities like throwing, smashing.
  • Taping
  • Icing to reduce inflammation
  • Correcting sleeping position

 

Rehab Mantra
Love Life. Stay Fit

READ OTHER ARTICLES