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Anterior serrated muscle and back pain
Medical expert of the article
Last reviewed: 04.07.2025
Serratus anterior muscle - m. serratus anterior
With simultaneous contraction of all fibers, it holds the scapula in place, shifting it somewhat forward. The upper teeth of this muscle pull the medial angle of the scapula forward and laterally. The lower teeth lower the scapula and pull its lower angle not only downwards but also forwards; in doing so, the scapula rises and with it the free part of the upper limb.
- Origin: I - IX rib
- Attachment: Angulus superior et inferior, Margo medialis scapulae
- Innervation: spinal nerves C5-C7 - n. thoracicus longus
[ Diagnostics
Trigger zones are usually located in the subcutaneous portion of the muscle along the midaxillary line approximately at the level of the nipple, above the 5th and 6th ribs, but sometimes higher or lower. To conduct the examination, the patient is placed half-turned on the healthy side with a partially extended arm. Painful points are palpated in the thickening of the muscle directly under the skin, and with severe pain, a local convulsive response appears.
Referred pain
It is concentrated on the anterolateral surface of the chest at the middle level and in a separate area medial to the inferior angle of the scapula. The pain can also spread along the medial edge of the arm, involving the palm and ring finger. Interscapular pain caused by the serratus anterior muscle TZ is quite refractory to postural relaxation, which is why it is often interpreted as psychogenic.
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