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    Brief Medical History Overview

    Question Strengthening the Serratus Anterior/Lower Trapezius

    Physical Agents In Rehabilitation
    Hi Everyone,

    I've been working with a physio over the past 9 months to try and eliminate an arm pain I get when working (think something gets trapped at my shoulder). On the whole the physio is working, but I seem to have hit a brick wall.

    She's given me exercises for my serratus anterior and lower/mid trapezius.

    My main problem at the moment is I am almost certain I can't seem to get my lower trapezius working, at all. I used to have a lot of pain where that muscle lies, but one day it just went away (perhaps replaced by my current problem). Is there anything I can try to get it working again?

    As for my Serratus Anterior, I can't seem to get it tired out. I can do full press up position scapula push-ups with 10s holds easily, without my shoulder blades sticking out. But as soon as I try to depress my shoulder blades (feels like maybe I'm using my lats to do this, or perhaps its the serratus?!) my shoulder blades stick out loads and it just feels like I'm stretching my arms.

    I've tried talking to my physio about this, but she assures me I'm doing everything correct, although she has noticed things I do go wrong occasionally (like my lats overtaking when I try and work the mid/lower traps), but she seems to miss the same problems at other times.

    I'm just wondering if there is likely to be any muscle damage or nerve problems. Right now I have no pain in my back, but I do have a tightness where I had a T5 compression fracture - I have had this tightness release twice before and all my symptoms have been alleviated immediately!

    Anyone have any ideas of what I should do or what it could be?

    Thanks for reading such a long post!!!

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  2. #2
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    Re: Strengthening the Serratus Anterior/Lower Trapezius

    Serratus, Lower fibres or trapezius, lats will all work in synergy. So you needn't worry about that. Dips are an excellent choice to help strengthening this area. Also locking out the elbows at the top of the dip and lowering and rising as if you are shrugging the sholders and then reversing the shrug.

    May some decline bench press might be of use as well?

    For our benefit, why are you strengthening them if they seem to be working OK, are they weak or are other muscle groups just overactive?

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    Re: Strengthening the Serratus Anterior/Lower Trapezius

    My physio told me to try and strengthen them, but I don't think I can get my lower trapezius to work. I'm wondering if its possible I damaged it? If you damage a muscle and it gets left for a while does the pain just go away and it doesn't function properly? - I'll give the dips and reverse shrugs a try when I next go to the gym.

    I can do a 20 x 20kg barbell incline shoulder raise with 10s holds and not get tired. So would this imply that the muscle is strong? Or is it possible I use incorrect technique?

    The first time I fixed my arm problem I felt a releasing feeling in my back and it felt as though I could feel my mid/lower traps come back into action. The next day I visited a chiropractor (I had booked the appointment prior to being fixed so I thought I should honor it), she tried to crack my back and the next day I woke up with a lot of pain in my mid back (around where the lower traps is). Is it possible this could have damaged the muscle? or strained it?


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    Re: Strengthening the Serratus Anterior/Lower Trapezius

    Sorry I forgot to answer the other part of your question. My upper trapezius is a bit tense, but not particularly tight. Not sure whether it is overactive or not.


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    Re: Strengthening the Serratus Anterior/Lower Trapezius

    Hello,

    What's the curvature of your spine from a lateral point of view like? If you have exagerated kyphosis of your thoracic spine your going to get a bad setting position of the scapula no matter how hard you try to correct it. This is going to affect the bio mechanics of the scapula in a big way, meaning you utilise other muscles to perform motions like upwards rotation of your scapula instead due to the line of pull.

    Is it only on one side? If so, you might have to address things like the pelvis as any rotation in the spine will again offset the positioning of the scapula and develop different length tension relationships which will again impede function. If there's any shear force in the joint during loading you might find that your SITS muscles may over compensate to correct this thus making them tight due to overuse and therefore during any flexion of your GH joint it will cause the shoulderblade to lift, i.e. wing.

    You need to have your whole body assessed in order to find out if your shoulder is the root of the problem or just a symptom. If it's just a symptom your just going to get milked by poorly trained health professionals. Spend some money and find a practitioner who is aware of the big picture.


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    Re: Strengthening the Serratus Anterior/Lower Trapezius

    We recommend the Physio Shop - www.physioshop.co.uk
    This may be something you have not taken a good look at, but what about your hips? Do you have exacerbated lordotic or kyphotic posture? The reason I ask is that if the hips are out of alignment, it is very hard for the middle and upper back to be in alignment either. If you do get the hips back in balance, then most likely your other issues will be far less severe and problematic.

    Take a look at yourself in profile view in a mirror with your shirt off and see if your hips tilt too far forward or backward. That will certainly put your back out of whack. I strongly suggest dealing with that issue in conjunction with any trapezius and serratus work.

    I found a book that I like for aligning the hips that can be done at home. It is written by an expert in the field and is pretty simple to follow. It is called the S.M.S. Back Program. I recommend checking it out...



 

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