Department of Physical Therapy, Marquette University, Milwaukee, WI, USA.
Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
Braz J Phys Ther. 2019 Nov-Dec;23(6):459-466. doi: 10.1016/j.bjpt.2019.01.008. Epub 2019 Feb 2.
The serratus anterior (SA) is capable of a wide range of actions across the scapulothoracic joint. Furthermore, the lack of control, strength, or activation of this important muscle is believed to be associated with several painful conditions involving the shoulder complex. Studies and clinical intuition have therefore identified several exercises that selectively target the activation of the SA.
This paper reviews the anatomy, innervation, testing, and complex actions of the SA. In addition, this paper describes the classic signs and symptoms of weakness or reduced activation of the SA. Several exercises are described and illustrated that purportedly target the activation of the SA, with the intention of optimizing muscular control and encouraging pain free shoulder motion.
This review provides the theoretical background and literature-based evidence that can help explain the SA's complex pathokinesiology, as well as guide the clinician to further develop exercises that likely challenge the muscle. This paper is written along with a companion paper entitled: Kinesiologic considerations for targeting activation of scapulothoracic muscles: part 2: trapezius. Both papers prepare the reader to expand their pallet of exercises that target and challenge these two dominant muscles, with a goal of improving function of the shoulder for several painful conditions caused by their reduced or altered activation pattern.
前锯肌（SA）能够在肩胛骨胸壁关节上进行大范围的活动。此外，人们认为，缺乏对这一重要肌肉的控制、力量或激活，与涉及肩部复合体的几种疼痛状况有关。因此，研究和临床直觉已经确定了几种专门针对 SA 激活的练习。
本文回顾了 SA 的解剖结构、神经支配、测试和复杂作用。此外，本文还描述了 SA 无力或激活减弱的典型体征和症状。描述并说明了几种据称能激活 SA 的练习，旨在优化肌肉控制并鼓励肩部无痛运动。
这篇综述提供了理论背景和基于文献的证据，可以帮助解释 SA 的复杂病理生理学，并指导临床医生进一步开发可能挑战肌肉的练习。本文与一篇题为“针对肩胛骨胸壁肌肉激活的运动学考虑因素：第 2 部分：斜方肌”的配套论文一起发表。这两篇论文使读者能够扩展他们的练习方案，以针对和挑战这两块主要肌肉，目标是改善由其激活模式减弱或改变引起的几种疼痛状况的肩部功能。
