Serratus Anterior Muscle Pain Causes, Symptoms, & Treatment

Struggling with serratus anterior muscle pain? Get expert medical information on causes, symptoms, and proven treatment options. Learn when to seek professional help and prevention strategies

The serratus anterior muscle, often called the “boxer’s muscle,” plays a crucial role in shoulder and arm movement. Located along the sides of your ribcage, this fan-shaped muscle helps you push objects forward and raise your arm above your head. When this muscle becomes painful or injured, it can significantly impact your daily activities and quality of life.

What Causes Serratus Anterior Pain?

Serratus anterior muscle pain commonly develops due to overuse or improper use of the muscle. Athletes who participate in boxing, swimming, or activities involving repetitive arm movements are particularly susceptible.

Poor posture, especially prolonged computer use with rounded shoulders, can strain this muscle.

Additionally, direct trauma to the ribcage area or sudden, forceful movements can lead to acute pain in the serratus anterior.

Recognizing the Symptoms

When experiencing serratus anterior pain, you might notice sharp or aching discomfort along the sides of your ribcage, particularly when reaching overhead or pushing objects away from your body. The pain often intensifies during deep breathing or coughing. Some patients describe a burning sensation or tenderness when touching the affected area. You might also notice increased difficulty in maintaining proper shoulder blade position, leading to a condition called “winging scapula.”

Long thoracic nerve damage may result from nerve compression due to anesthesia or Saturday night palsy, which is a radial neuropathy due to falling asleep with one’s arm hanging over the armrest of a chair. Heavy load bearing may also entrap the nerve, resulting in atrophy of the serratus anterior and subsequent winging of the scapula. Athletics and overuse may lead to nerve traction. Electric shock, blunt injury, cold exposure, immunization, viral infection, and brachial neuritis are additional causes of nerve injury.

Professional Medical Assessment

If you’re experiencing persistent pain in your serratus anterior region, consulting a healthcare provider is essential. Your doctor will typically perform a physical examination, checking your range of motion and muscle strength. They may also observe your shoulder blade movement during various arm positions to assess for any abnormalities. In some cases, imaging studies might be necessary to rule out other conditions affecting the chest wall or shoulder region.

Serratus Anterior Muscle Pain Treatment

Conservative treatment usually yields positive results for serratus anterior muscle pain. Your healthcare provider might recommend a combination of rest from aggravating activities and gentle stretching exercises.

Physical therapy often proves beneficial, focusing on proper posture, strengthening exercises, and techniques to prevent future injury. Ice or heat therapy can help manage pain and inflammation, while over-the-counter pain medications might be suggested for temporary pain relief, this may may include NSAIDs such as Ibuprofen or Naproxen or any other types.

In case of serratus anterior muscle injury, RICE method should be used as the first procedure: Rest, Ice application, Compression application and elevation of the limb.

Prevention Strategies

Maintaining good posture throughout the day helps prevent serratus anterior pain. When working at a computer, ensure your workspace is ergonomically arranged. Regular stretching and strengthening exercises can help maintain muscle flexibility and strength. For athletes, proper warm-up routines and technique modifications may be necessary to prevent overuse injuries.

When to Seek Immediate Care

While serratus anterior muscle pain is typically not emergency, certain symptoms warrant immediate medical attention. Seek urgent care if you experience severe, sudden pain, difficulty breathing, or if the pain is accompanied by unexplained chest pressure. These symptoms might indicate more serious conditions requiring immediate medical intervention.

Long-term Management

Recovery from serratus anterior pain requires patience and consistency with recommended treatment protocols. Working closely with your healthcare provider and following prescribed exercise programs helps ensure optimal healing. Many patients benefit from incorporating regular stretching and strengthening exercises into their daily routines, even after pain resolution, to prevent recurrence.

Resources and References

1. Lung K, St Lucia K, Lui F. Anatomy, Thorax, Serratus Anterior Muscles. [Updated 2024 Sep 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: Pubmed