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Old 03-12-2008, 07:43 PM   #1
Eric Kerr
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Default Serratus anterior

Had some ART work done on my right shoulder due to some tingling running from my neck to posterior cap. The area always felt strong, but somewhat unstable when doing overhead lifts. Range of motion was also a little impaired. Long time injury that I'm finally trying to do something constructive about.

Chiro said that I needed to strengthen my serratus anterior and do some posterior cap stretches.

The stretches are no problem, its the push-up pluses that he wants me to do. I can barely feel those muscles to tell they are activated so I keep losing my arch when doing the push-up pluses. Also area seems to fatigue quickly when I do activate them correctly, so I'll probably have to start doing them on a wall before moving to actual knee, then regular push-ups.

Any tips for getting them right? Or other exercises for the serratus anterior?

Oh he recommended no pushing exercises other than the push-up pluses for two weeks.

Thanks,
Eric
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Old 03-12-2008, 07:54 PM   #2
Mike ODonnell
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I'll do some quick digging but look around T-nation as a while back I believe it was Eric Cressney that had some good shoulder articles. Might even find them referenced around here somewhere as well.
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Old 03-12-2008, 10:05 PM   #3
Sam Cannons
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This looks like them
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Old 03-13-2008, 06:48 AM   #4
Allen Yeh
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Check out this link for Diesel Crew Shoulder Rehab program, it has a very comprehensive list of rehab exercises for the serratus anterior, internal/external rotators...etc

http://www.youtube.com/watch?v=A0ONHZmsFec

Another good link with a bit more explanation:

http://www.t-nation.com/readArticle.do?id=1426252

In the long run dropping all pressing movements won't really hurt you, I actually dropped all upper body movements for a month because of some impingement issues from too much overhead pressing. And only did a rehab type program for upper body. It kind of sucked but later on I was glad I did.
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Old 03-13-2008, 10:24 AM   #5
Derek Simonds
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Prior to this last mesocycle I did a whole bunch of prehab. I had some impingement at the AC joint and have worked really hard to clear that up.

I can second both the Cressey articles and the Diesel Crew Prehab. I totally changed the way I bench after reading Cressey's piece. The Diesel stuff I still incorporate into my warmups through out the week.
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Old 03-13-2008, 04:25 PM   #6
Eric Kerr
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Thanks for all the replies, gents. Plenty here for me to look through.

Mike Robertson's Inside Out also looks like it might have some good stuff in it, although a bit pricey at $80ish + shipping. Anyone famililar with it?

Back to the pushp-up plus, most videos show people retracting and protracting the scapulae.

Another source I found said simply hold a push-up position and then protract the scapulae, relax back into the push-up position, rinse+repeat.

Chiro told me to protract and hold the protraction and then bend at the eblows to do the movement. Going down 6-8" until I can work my way up to a full push-up plus while remaning protcated. My poor brain/body wants to bobble this badly.

Is one method more correct/effective than the others?

Thanks,
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Old 03-13-2008, 05:32 PM   #7
Garrett Smith
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Eric,
Honestly, I'd like to see the person who can do a push-up in full protraction! As far as I know, that's just not in the mechanics of the shoulder complex during a pressing movement. I just tried doing what your DC described and it felt totally unnatural and weak. I do a lot of serratus prehab with my joint mobility training, so I would guess this movement should come easily to someone like myself.

Strengthening the serratus, IMO, is most easily accomplished with locked arms. Heck, I just tried a bottom-of-a-pushup position with my arms while protracted here in my chair, it feels completely wrong to me in every way.
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Old 03-13-2008, 05:34 PM   #8
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Quote:
Originally Posted by Eric Kerr View Post
Thanks for all the replies, gents. Plenty here for me to look through.

Mike Robertson's Inside Out also looks like it might have some good stuff in it, although a bit pricey at $80ish + shipping. Anyone famililar with it?

Back to the pushp-up plus, most videos show people retracting and protracting the scapulae.

Another source I found said simply hold a push-up position and then protract the scapulae, relax back into the push-up position, rinse+repeat.

Chiro told me to protract and hold the protraction and then bend at the eblows to do the movement. Going down 6-8" until I can work my way up to a full push-up plus while remaning protcated. My poor brain/body wants to bobble this badly.

Is one method more correct/effective than the others?

Thanks,
I've heard it's good but pricey, on your push-up plus question, I have also seen it done different ways so I'm not sure what the "best" solution would be, perhaps do as he tells you for the next 2 weeks or so and try other things later on.
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Old 03-13-2008, 06:20 PM   #9
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Check this out:

Serratus anterior muscle activity during selected rehabilitation exercises.
Quote:
The purpose of this study was to document the electromyographic activity and applied resistance associated with eight scapulohumeral exercises performed below shoulder height. We used this information to design a continuum of serratus anterior muscle exercises for progressive rehabilitation or training. Five muscles in 20 healthy subjects were studied with surface electrodes for the following exercises: shoulder extension, forward punch, serratus anterior punch, dynamic hug, scaption (with external rotation), press-up, push-up plus, and knee push-up plus. Electromyographic data were collected from the middle serratus anterior, upper and middle trapezius, and anterior and posterior deltoid muscles. Each exercise was partitioned into phases of increasing and decreasing force and analyzed for average and peak electromyographic amplitude. Resistance was provided by body weight, an elastic cord, or dumbbells. The serratus anterior punch, scaption, dynamic hug, knee push-up plus, and push-up plus exercises consistently elicited serratus anterior muscle activity greater than 20% maximal voluntary contraction. The exercises that maintained an upwardly rotated scapula while accentuating scapular protraction, such as the push-up plus and the newly designed dynamic hug, elicited the greatest electromyographic activity from the serratus anterior muscle.
I found a description of the "dynamic hug" in this link:
Thera-Band Resistance Band & Tubing, Instruction Manual, Volume 4 , it's a PDF file.

OK, I thought about it a little more.

The serratus anterior originates on the ribs and inserts on the scapula. Note that the humerus plays no role in its attachments. So, assuming the ribs are fixed, movement of the scapula is how this muscle will be activated and strengthened.

Protracting the scapula absolutely changes the orientation of the glenohumeral joint, making it face more anteriorly. While this may be a good thing at the top of a push-up plus, it is definitely NOT a good thing at the bottom of a push-up. I believe the body would specifically fight this combination of movement in an effort to not impinge the shoulder joint.

I highly suggest you don't try to do a push-up with your scapula protracted. It won't work, and you may be worse for trying it.

Or you could just ask your DC to demo it, make sure you point out to him when his scapula aren't protracted anymore at the bottom of the movement.
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Old 03-14-2008, 11:21 AM   #10
Eric Kerr
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I had found the source you cited, Dr. G, but hadn't had time to look up the Dynamic Hug, yet, so thanks for the link to the .pdf.

I had a little quiet time last night to try a couple of different things and you nailed it, feels unnatural to do the push-up plus with the shoulders protracted the entire time, but having a better understanding of what muscles I was trying to activate, I got it to work.

Chiro can do them protracted, at least the 6-8" elbow bend variety.

As Allen suggested, I'll do them his way for 2 weeks and see how that works.

Many thanks for the additional input
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