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Serratus Anterior Pain

The serratus anterior muscle runs from the front side of the scapula to the side of the rib cage.

The muscle is responsible for holding the scapula near the rib cage. As a result, it helps stabilize it.

Whenever you move your upper arm forward, like when throwing a punch for example, this muscle abducts (moves laterally away from the spine).

Serratus anterior pain isn’t fun. In this article, we’ll talk about why it happens as well as how you can treat it.

Common Triggers

As with any form of pain, prevention is always better than treatment.

Once you know what’s causing your pain, it will be easier to avoid the trigger.

This will result in faster and more efficient healing. Here are some of the common triggers associated with pain in this muscle:

  • Swimming
  • Lifting Weights
  • Tennis
  • Prolonged Hard Cough
  • Hyperventilation
  • Sprinting

As you can see, these triggers are all related to physical activity.

If you’re a runner, for example, then the constant swinging of your arms can strain the serratus anterior muscle.

Even something like hyperventilation can be a cause. If you do any of these activities, and you’re suffering from serratus anterior pain, then take a break.

Once you give your muscle time to rest, it should fully heal on its own. However, this can’t happen if you’re constantly damaging it.

Summary: Common triggers include tennis, weightlifting, hyperventilation, sprinting, swimming, and even prolonged hard coughs.

How Does Serratus Anterior Pain Manifest?

How can you tell if it’s the serratus anterior muscle that’s causing discomfort and not some other muscle in your body?

Here’s how to tell:

  • Chest Pain: There will be pain on one (or both) sides of the chest. Typically, the pain is stronger below the armpits, and can be triggered by twisting, breathing, or coughing.
  • Tenderness Below Armpits: Another common complaint patients have is pain below their armpits. It can manifest on one or both sides, and ranges from dull to acute.
  • Pain When Reaching Back: If you’re experiencing pain when reaching backwards, or when reaching above your hard, then chances are you’re suffering from serratus anterior pain.

Obviously, the only way to know for sure is to get diagnosed by a doctor.

You don’t need to do this if the pain is mild or if you’ve only had it for a few days.

But if the pain is getting worse, or if it hasn’t gotten better after a few weeks, then you should talk to a doctor about it.

Summary: This symptom can manifest as chest pain, tenderness below the armpits, or pain while reaching back or reaching above your head.

Innervation

Let’s quickly talk about how the serratus anterior is innervated (which nerves run through it).

The nerve that runs through this muscle is the long thoracic nerve.

The fibers of this nerve originate from the spinal roots C5-C7.

This means that if these nerves get damaged in any way, it can result in pain.

For instance, the nerve is susceptible to physical trauma (getting hit).

It’s also possible to damage the nerve during a routine lymph node removal in the armpit.

Talk to your doctor if you’ve had an armpit lymph node removal in the past.

Summary: The long thoracic nerve runs through the serratus anterior muscle. If it gets damaged, either through trauma or surgery, it can lead to pain.

Ways to Treat Serratus Anterior Pain

If you have a mild case of serratus anterior pain, then it should resolve on its own. How long?

Typically, within a few days. If it’s a more severe case, as in a strain or tear, then expect healing to take a lot longer (weeks to months).

Since this type of injury is often due to overuse, it’s very important that you rest the muscle. If you’re going to do physical activity, make it light.

You should also consider hiring a physiotherapist who is specialized in removing tight muscle knots.

A few sessions may alleviate your pain by a large degree. Regular massages probably won’t be as effective.

You can also experiment with acupuncture to relieve your serratus anterior pain. Here are some exercises you can try that can provide relief:

  • Wall Presses: This basically like a pushup with the only difference being that you’re pushing against a wall while standing.
  • Pushups: Pushups are easy exercises that virtually anyone can do. Don’t push yourself, though. Do them slowly to avoid injury.
  • Rope Pulling: Rope pulling can be an effective way to reduce your pain. Just make sure that you’re not overdoing it.
  • Punching a Boxing Bag: Not only can punching a boxing bag give you some good cardio, but it can also help with your symptoms.

The key point is this: don’t push too hard. These exercises should be done in moderation. That way, you won’t reinjure your serratus anterior muscle.

Gradually re-introduce these exercises back into your life. Don’t go crazy performing them all at once.

Summary: Rest is by far the most recommended option by doctors to help get rid of serratus anterior pain.

The Bottom Line

The most common causes for pain in the serratus anterior muscle is overuse and/or physical activity.

If you’re an active swimmer or mountain climber, it’s recommended that you take a break for a while.

Give your muscle time to rest. Once it’s fully healed, you’ll be as good as new. Until then, don’t push it.

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