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Vol. 23. Issue 6.
Pages 459-466 (01 November 2019)
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Vol. 23. Issue 6.
Pages 459-466 (01 November 2019)
DOI: 10.1016/j.bjpt.2019.01.008
Kinesiologic considerations for targeting activation of scapulothoracic muscles - part 1: serratus anterior
Donald A. Neumanna,
Corresponding author

Corresponding author at: Department of Physical Therapy, Schroeder Complex, Box 1881, Marquette University, Milwaukee, WI 53233, USA.
, Paula R. Camargob
a Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
b Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil

  • The serratus anterior (SA) is associated with shoulder painful conditions.

  • This paper reviews the anatomy, kinesiology, and pathokinesiology of the SA.

  • This paper describes and illustrates exercises that specifically target the activation of the SA.

  • This paper can help clinicians develop exercises that specifically challenge the SA.

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The serratus anterior (SA) is capable of a wide range of actions across the scapulothoracic joint. Furthermore, the lack of control, strength, or activation of this important muscle is believed to be associated with several painful conditions involving the shoulder complex. Studies and clinical intuition have therefore identified several exercises that selectively target the activation of the SA.


This paper reviews the anatomy, innervation, testing, and complex actions of the SA. In addition, this paper describes the classic signs and symptoms of weakness or reduced activation of the SA. Several exercises are described and illustrated that purportedly target the activation of the SA, with the intention of optimizing muscular control and encouraging pain free shoulder motion.


This review provides the theoretical background and literature-based evidence that can help explain the SA's complex pathokinesiology, as well as guide the clinician to further develop exercises that likely challenge the muscle. This paper is written along with a companion paper entitled: Kinesiologic considerations for targeting activation of scapulothoracic muscles: part 2: trapezius. Both papers prepare the reader to expand their pallet of exercises that target and challenge these two dominant muscles, with a goal of improving function of the shoulder for several painful conditions caused by their reduced or altered activation pattern.

Physical therapy
Shoulder rehabilitation
Scapular dyskinesis
Serratus anterior exercises
Scapulothoracic joint


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Brazilian Journal of Physical Therapy

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