Having a strong and well functioning shoulder is something we take for granted. And when it comes to shoulder or neck injuries, without a doubt one of the biggest factors to ensuring healthy shoulder function is the role a muscle known as Serratus anterior plays. In this article we are going to give 10 exercises that are great for encouraging this muscle to fire, and work in the way it is designed. It is important to follow a simple step by step process when working with any injury, and shoulders in particular can be very difficult due to the amount of small tiny muscles involved. We always use what is called the Success Formula - assess mobility and flexibility first, followed by stability and movement skills before finally moving  to strength and power. Knowing the cause of your injury is important for not dealing with this will only lead to frustration and leave a weakness throughout the body. The exercises listed below are provided in order from more isolated around the shoulder, with focus on regaining "flexibility & mobility", before moving to more ‘stability’ and eventually integrated full body exercises. You will find the more integrated and functional exercises focus more on the legs initiating the movement. This is a common area of weakness often missed in rehab as people focus so much on the area in pain and forget that if the legs are weak the shoulder will have to pick up the slack. The functional movements are always the most difficult but are superior to all other exercises, if done correctly, as they relate to a real world task, sport or movement we need.

Understanding The Role Of Serratus Anterior

Before we jump straight into the exercises I encourage you to watch the video below that explains the 3 critical factors needed for a healthy shoulder.

The serratus anterior in combination with lower trapezius and the rotator cuff muscles plays a pivotal role in providing two key movements to the scapula.

1. Posterior tilt
2. Upward rotation

Without these two things achieved you will see postural and movement dysfunction that creates pain. Stretching, massage and manual therapy will not be able to change anything if you do not address this dysfunction with corrective exercises. Having said that you will need to address any tight muscles or trigger points that may have developed from this faulty movement and poor alignment.

Without addressing this first you may actually complete the corrective exercises with compensation. This is where the muscles that are called "tonic muscles" over ride the neural message from the brain and basically rob the weaker "phasic muscles" like serratus anterior and lower trapezius from any work. Below is a series of videos that gives you some trigger point release and some stretches to work on to release the tonic muscles such which dominate movements around the shoulder.

Great article to read for more information are 3 Key Factors Needed To Heal An Injured Shoulder

Pec minor stretch (flexibility)

Of all the muscles that causes trouble to the shoulder and neck Pec Minor would be the worst!

Rarely is this in pain or do people even know they have tightness here as the pain will manifest into other areas. Without releasing this muscle you will struggle to strengthen the areas of weakness. They will be greatly inhibited. In the video below I show you how to firstly release a tight Pec Minor with massage, and secondly how to address 3 of his "gang members" who also inhibit other muscles. To understand this concept better I encourage you to read our article on Posture as I give many examples of Tonic vs Phasic muscles.

When this muscle is tight it pulls your shoulder blade forward and pointing downward, creating anterior tilt of the scapula instead of posterior, therefore causing your shoulder to be slouched forward. Doing this stretch will improve your shoulder blade’s positioning to be more back and facing upward which is the role of serratus anterior.

Trigger Point Release

Shoulder and neck pain easily develop several areas within the body that have severe tightness known as trigger points. And while stretching & mobility drills are great for helping to correct your problem, they do not help much in the initial stages of releasing these nasty hot spots. A much more aggressive approach using massage or small tools that get into the trigger point are what is needed. I use two different tools for this. A foam roller and a small tool called Pocket Physio or muscle mate. The video below shows you how to do this.

See article How To Get Rid Of A Stiff Neck for more information on how these trigger points develop.

Thoracic Mobility

Just like the pec minor, this area is often a huge part of the problem but goes untreated as it is not often in pain. Nobody thinks to look here but make no mistake if you have a thoracic extension or rotation mobility problem you are guaranteed to have a neck and shoulder problem. 

As the thoracic spine loses it's mobility you have two choices.

1. Ignore the fact you cannot extend correctly, and force the shoulder to find more mobility instead. When this happens and you lift your arm overhead, your humurous bone is unable to effectively stabilize the ball in the socket, and begins to mash tendons, ligaments and eventually starts smashing into the top of the shoulder. Bang, now you have the early stages of a shoulder impingement or rotator cuff tear. It does not happen with one movement, but thousands of poor ones evolving due to compensation. Add on top of that scapula dysfunction and all types of trigger points and compensation that develop into neck pain as a result, this is not a good alternative.
2. Try to make up for the lost thoracic extension by using your lumbar spine to extend more instead. The lumbar spine is very easily damaged if it loses it's mobility. Injuries like facet joint sprains, SIJ dysfunction and even disc bulges are very common here.

Both situations are less than ideal, but you the body has no choice. It has to find another way, and it always will. It won't worry if it is a good choice, it will only choose the one it can do.

Make sure you watch the video below and implement the first 3 drills consistently.

Okay we are now up to the point where we are ready to implement the exercises that will not only stabilize the scapula and shoulder joint but strengthen the muscles to hold it in place during all movements of the arm.

If you are suffering with a shoulder or neck problem make sure you get a copy of our special report below Step by Step Guide To Getting Rid Of Shoulder Pain that provides over 90 pages of information, that has over 60 specific exercises, drills and programs for effectively managing a shoulder injury. Click here to see more information and download a free checklist or click the image below to get your copy instantly.

Serratus Wall Slides

In the video above I provide you with 2 stability drills. One for lower trapezius and the second for serratus anterior. They look very similar however the serratus drill requires a pushing action to keep the foam roller pushed against the wall. This drill would be by far the best in terms of learning scapula movement and postural control. It is not enough to strengthen but it does teach the correct mechanics needed for the more difficult exercises to follow.

Instructions:

1. Stand with your hands against the foam roller that is against the wall
2. Set your posture as per previous wall slide exercises
3. Gently push your arms into the foam roller and begin to slide your arms overhead
4. Make sure you feel the scapula wrap around as you lift your arms up
5. Slowly lower your arms making sure not to lose your posture on the way down
6. Repeat

This is my favourite drill for the person in pain.

TRX Serratus Overhead Extension

A progression from the previous exercise and this one provides the added instability forcing greater reactivity in order to execute more effectively. Instructions are the same as the previous exercise.

Scapula Stability Drill

This exercise is a regression of the push-up exercise with the sole focus of trying to restore optimal scapula function and protraction during a pushing movement. Once again, minimal strength is needed to complete this exercise, but maximal stability and timing of the scapula is required.

The band around the wrists tries to feed more retraction of the scapula during a pushing action forcing the brain to adapt and apply a protraction correction which requires the use of serratus anterior. This can be quite difficult to do for the person with pain and you have to be careful of over-using it in the early stages. Combined with trigger point release and the use of simpler exercises like the wall slides can help you tackle this. But it can be a great way to progress to the more difficult push-ups and chest press

Chest Press On Foam Roller Holding Dumbbell Upside Down (stability)

Another stability exercise we have here, its purpose is for improving your shoulder’s balance, stability and movement function of all the muscles surrounding the scapula and shoulder. One of those exercises that is a lot harder than it looks. Holding the end of dumbbell challenges the shoulder’s balance and stability, and by doing it on the foam roller it naturally gets your body in the perfect posture and since the scapular isn’t resting on anything it helps the scapular produce full movement, therefore, activating serratus anterior.

Instructions:

1. Lie on the foam roller with your head & tailbone supported, holding the end of a dumbbell.
2. Lower the dumbbell next to your shoulder slowly.
3. Push up with a straight arm and reach high up; allowing the scapular to be pushed forward

Push-ups 

Now we are moving into more of a strength phase, when you’ve improved on your flexibility, mobility and stability of the shoulder it can then move into improving strength.

And when it comes to serratus anterior there is not many better exercises than the push up. The push up is a very simple exercise, however, when done correctly it allows your scapula to move fluently and initiating serratus anterior to work well. We prefer this to the dumbbells and cables in the beginning as it still forms part of the infant development stage where the shoulder is much stronger in the four point position of crawling. This is known as closed kinetic chain exercise and often it is much easier to work with.

If there is any pain here we can regress to the wall slides exercise.

Great exercise to read for more information on push ups click here

Instructions:

1. Lie face down hands in a comfortable width at shoulder height.
2. Breathe in and lower your chest down as you lower your arms down, however, keep your hips/lower back area and head still.
3. Breathe out and press up with the arms, keeping the tummy drawn in and glutes squeezed.

This video gives you a great visual of what happens with the scapula during this movement and how much influence the serratus anterior has over this movement.

Reactive Neuromuscular Training Exercise With The Chest Press

Once you have worked your way through a shoulder rehab program and you try to implement pushing exercises again you can often come up against some problems. Many people find the chest press very hard to do again and feel very weak in this action. They are very likely to still have a faulty movement pattern at play, and if they go back to what they were doing they will end up in pain again! All of your hard work will go down the drain as you aggravate the shoulder again. Ignoring the exercise is not a good idea either for the weakness in the pushing action needs to be addressed to get rid of the problem for good.

One of the best ways to overcome this is using this RNT technique.

Using tubing during the exercises helps to activate the often overpowered internal rotator subscapularis, by feeding the external rotators, which gives the shoulder more space and freedom to work. It also helps to activate the lazy but very important serratus anterior. A great exercise for teaching your shoulder how to move correctly again. It is amazing how different people feel when you add the tubing to their hands. You may need to use it for some time until the brain remembers to switch on the subscapularis and the serratus improves with overall strength.

Watch the video below from the 11:30 mark.

By using a Swiss ball it allows your glutes to be constantly switching on and challenges your balance opposed to being on the floor or on a bench. Do not underestimate the role of the glutes with the shoulder. We have seen many shoulder injuries created from weak glutes as it plays a role in activating the anterior sling. Read our article about Core Strength Using The Slings for more information.

Instructions:

1. Lying on a swiss ball so that your head and shoulders are supported by the ball.
2. Have the resistance band around each thumb and have someone else pull it above you, then hold a dumbbell on each hand.
3. With the hips up (squeezing your glutes), breathe in, lower the weights so the elbows are at about 90 degrees by your side.
4. Breathe out and press the dumbbells up until the elbows extend straight.

Single Arm Cable Push In Lunge Stance

Now we are looking more into integrating the body together, as mentioned in the article before it is essential with real life movements and tasks. This exercise initiates your lower body to be stable and supportive, while using your trunk and upper body to move the weight through rotation and pushing, both movements utilizing a lot of the serratus anterior.

Instructions:

1. Standing with a good posture in a lunge stance, feet a comfortable width apart and holding a cable with one hand.
2. Drawing your belly button in towards your spine & push the cable forward, rotating with your upper body.
3. Breathe in and slowly return to the start and repeat.

You can read more about this exercise in the article - Why the single cable push is much more than an upper body exercise

Turkish Get Up

I would go as far to say that this exercise could be used on it's own it is that good! Here is a list of the benefits to your body from the Turkish Get Up. Read our article Why The Turkish Get Up Is The Best Exercise

1. Greatly improves shoulder stability and thoracic mobility at the same time!
2. Improves overall body stability and integration between upper and lower body
3. Promotes reflexive stability of the torso
4. Encourages great mobility of the hips and thoracic spine, the two areas most people are lacking
5. Improves the body's ability to coordinate and enhance balance from lying to standing
6. Develops upper body strength, trunks strength, and glute strength

Instructions:

1. Lying on your back on the floor holding a single kettlebell at arms length above your shoulder.
2. Drawing your belly button inwards perform a sit up whilst holding the dumbbell overhead using your opposite arm for assistance.
3. From the sitting position bend one knee and place your foot on the floor whilst tucking the opposite leg behind your knee.
4. Push off your leg to rise to standing.
5. Reverse the movements lowering under control then repeat

Barbell Single Arm Squat Push (functional strength / power)

This exercise incorporates the whole body to move together to produce strength and power. The movement of the upper body press improves shoulder strength, as this movement is under load. The core and middle back (thoracic spine) have to work to stabilize your spine and it also teaches your hips to move correctly producing a lot of power throughout the movement.

Instructions:

1. Standing upright holding the end of a barbell feeling like your leaning forward.
2. Lower into a squat whilst lowering the bar to your shoulder. Keep your chest up for a good posture.
3. Rise out of the squat onto your toes and straighten your elbow to push the end of the bar forward.
4. Repeat then perform on the other side.

Medicine Ball Single Arm Throw (power)

The last exercise of the list is focusing on mainly power as you need speed throughout the exercise. This is similar to the barbell squat push exercise we see earlier, but incorporates a forward pressing movement. In order to move correctly throughout this exercise the body first must attain flexibility, mobility, stability and strength to place the body in the right posture, and now this movement requires speed. This exercise is very beneficial if you’re an athlete and play sports that require throwing.

Instructions:

1. Take a comfortable stance wide enough that allows you to squat down, having the ball resting between your legs.
2. Take a deep belly breath; engage the TVA drawing the belly button inward & lower down into a comfortable squat keeping the natural arch in your low back.
3. At the bottom, as fast as you can pick up the ball, jump up from the squat & toss the medicine ball as far as you can forward.
4. Land in a squat position after you throw the ball to get back into the athletic stance position

Why Functional Movement Is A Must

Even though this article we are talking about an isolated muscle, there is no point trying to strengthen this muscle on it's own without the entire body working together with it. We do not move like that, so you cannot train like that. This is where the body building world has corrupted our thinking, and to be honest the health field is as much to blame for they try to specialize on areas in pain so much they forget that we move as an integrated system, with each system relying on the other. A bit like a musical band that must play in time together to create nice music. We must be smarter with how we use exercise to correct problems and also enhance performance.

And for more information and detailed instructions of many other exercises make sure you get our Free Report below.

Conclusion

I hope this article gives you great insight into how to slowly and gradually progress your exercises with an intelligent approach that will guarantee optimal movement. Remember you cannot gain optimal strength and power without stability, and you cannot achieve stability without optimal flexibility and mobility. Each step is bound by the one before. Teaching your body to activate serratus anterior is essential if you want to get rid of shoulder pain and neck pain, or if you want to have incredible power for throwing sports like Tennis, Golf, Baseball etc. Take your time with each phase and remember quality is more important than quantity. 

If you live in Melbourne and would like to book in for a Free Postural and Movement assessment click the image below to schedule a time.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 14 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specialises in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise. He has worked with professional athletes in Golf, Tennis, Basketball and Football but is known throughout the local community more for his work with injury prevention and rehabilitation. Having participated at high level in many sports himself and also recovering from several serious injuries he has spent considerable time developing detailed assessments and programs to cater for injury and pain.

References

• Movement - By Gray Cook
• Shoulder & Scapula Injuries in Athletes - By Chris Mallac
• Corrective Exercise Solutions for the Hip & Shoulder - by Evan Osar
• Diagnosis & Treatment Of Movement Impairment Syndromes - By Shirley Sahrman
• Low Back Disorders - by Stuart McGill
• Back Pain Mechanic – by Stuart McGill
• Anatomy Trains - by Thomas Meyers
• Motor Learning and Performance - By Richard A Schmidt and Timothy D Lee
• Assessment & Treatment Of Muscle Imbalance - By Vladimir Janda
• Scientific Core Conditioning Correspondence Course - By Paul Chek
• Scientific Back Training – By Paul Chek