The serratus anterior is one of the most important muscles when it comes to shoulder health, but it is often neglected. This muscle runs from the medial border of your scapula and inserts on your ribs. While many people are familiar with the rotator cuff, the serratus anterior is just as important for overall shoulder health.

Functions of the Serratus Anterior

The serratus anterior is responsible for two key movements: protraction and upward rotation. Protraction involves the sliding of the scapula around the rib cage towards the front. Upward rotation involves the rotation of the scapula such that the bottom of the scapula rotates outwards and up.

Upward rotation is particularly critical because it allows us to move our arms overhead. If our scapula does not upwardly rotate, we cannot achieve the range of motion we need at the shoulder. This interplay of joints in the shoulder complex is known as scapulohumeral rhythm.

Scapular Dyskinesia

If scapulohumeral rhythm is off, it can lead to abnormal mobility or alignment, known as scapular dyskinesia. An example of this is scapular winging, where your scapula tilts anteriorly and the bottom part sticks out like a wing. One contributing factor to this condition can be a lack of strength in muscles that posteriorly tilt the scapula, including the serratus anterior.

Strengthening the Serratus Anterior

To improve shoulder health, it's important to focus on both activating and strengthening the serratus anterior. However, before working on this muscle, it's important to mobilize its antagonist: the pec minor. This muscle does some opposite actions to the serratus anterior and can inhibit its contraction if it is overactive.

One way to mobilize the pec minor is to stretch it in line with its fibers. To do this, pull one shoulder blade back while dropping into a stretch with your upper arm in line with the fibers of the pec minor. You can also activate your external rotators by bringing your hand off an object as far as you can by rotating at the shoulder.

Once you've mobilized your pec minor, you can focus on exercises that activate and strengthen your serratus anterior.

Exercise 1: Posterior Tilt

The first exercise focuses on establishing a mind-muscle connection between your brain and the muscles that control posterior tilt. Research shows that intentionally focusing on this movement can increase the activity of these muscles.

To perform this exercise, lay down with your feet flat on the floor and your knees bent. Place the backs of your arms against the ground with your elbows at a 90-degree angle. Drive your elbows back into the ground at about 30% to create tension. From here, focus on posteriorly tilting your scapula by scooping the bottom of the scapula back so it sits flush against your ribcage.

If performed correctly, you should feel a contraction in your lower traps and serratus anterior. Don't worry if you don't get it right away - it may take some practice. Make sure you're not retracting your shoulder blades, but instead lifting your chest by posteriorly tilting your scapula. Hold the contraction for a couple of seconds before releasing and repeating for 8 reps and a couple of sets.

Exercise 2: Protraction with Resistance Band

For this exercise, you'll need a resistance band. Wrap it around your back so it catches on your shoulder blade. The goal is to train both protraction and upward rotation of the shoulder

blades, as these are two movements controlled by the serratus anterior.

To perform this exercise, aim upwards at a 45-degree angle while protracting your shoulder blades as far as you can. Hold the end position before returning to the starting position. Repeat for a couple of sets.

Exercise 3: Wall Slides

The final exercise is easy to perform and only requires a wall and a t-shirt. Place your arms in the t-shirt and then against the wall as if you're doing a plank. Make sure your abs are engaged and your body is in a straight line.

Protract your shoulder blades to create a "hunchback" position. From here, slide your arms up the wall as high as you can while maintaining protraction. You should feel a contraction in your serratus anterior. Once you reach the top, drag your arms back down to the starting position.

As you develop strength in your serratus anterior, you can walk your feet away from the wall to increase difficulty.

By performing these exercises regularly, you can improve strength and activation of your serratus anterior muscle and improve overall shoulder health.