The Serratus Anterior is holds important roles for both the scapula and the gleno-humeral joint. The Serratus anterior muscle takes its origin from the outer surfaces and superior borders of upper eight or nine ribs, and fascia covering their intercostal spaces. It inserts on the anterior (costal) surface of medial border of scapula and inferior angle of scapula. As it rotates the scapula, it allows for abduction and flexion of arm. It also protracts scapula (pulls it forward on chest wall and holds it closely to chest wall), facilitating pushing movements such as push-ups or punching.
Trigger points in the serratus anterior muscle are fairly common in patients with shoulder dysfunction. The Serratus anterior is a multi-pennate muscle which means it has many different heads (consider these as separate muscles) each of which may manifest a trigger point. Trigger point pain maps tend to be either local or central. Local: where each digitation attaches to rib. Central: rib (6–8), localized pain, radiating anteriorly and posteriorly in a 5–10 cm patch. Pain inferior angle of scapula. Pain in ulnar aspect of upper extremity.
How do you treat trigger these trigger points? We’d be delighted if you want to share your own best practice.