Serratus Anterior

Pointer Plus The Pointer Plus is an easy to use trigger point (TP) locator which incorporates a push button stimulation feature to immediately treat Trigger point pain.

The Serratus anterior is a muscle of the thoracic region of the back.

Anatomical Attachments:

• Origin: Attaches to the outer surface of the upper 8 or 9 ribs.
• Insertion: Attaches to the anterior surface of the vertebral margin of the scapula.

Action: It rotates and pulls the scapula forward; and elevates the ribs.

Synergist: Pectoralis major and minor, Subclavius, Trapezius, Latissimus dorsi, Rhomboid major and minor, Levator scapulae.

Antagonist: Deltoid, Supraspinatus, Infraspinatus, Teres major and minor, Subscapularis.

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Nerve Supply: Long thoracic nerve (C5, C6, and C7).

Vascular supply: Lateral thoracic artery.

• Primary: The pain refers anterolaterally at mid-chest level spilling over down the arm, into the palm, ring and little finger, separately to the posterior area medial to the inferior angle of the scapula.

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Trigger Point Signs and Symptoms: Chest pain, sharp shooting pain in the side, arm pain, breathing difficulty.

Trigger Point Activating and Perpetuating Factors: Riding a bicycle for long periods of time, lifting heavy objects overhead, pull ups, coughing.

Differential Diagnosis: Myocardial Infarction, Angina Pectoris, Pleurisy, Lung Cancer, Splenomegaly, Hepatomegaly, Gallbladder Dysfunction, Pancreatitis, Intercostal Nerve Supply entrapment, Thoracic outlet syndrome, (Segmental, Subluxation, Somatic dysfunction) C5 C6 C7 or C8 radiculopathy, T1 T2 T3 or T4 radiculopathy, Herpes zoster, Rib subluxation/dislocation (Slipping rib syndrome), Fractured rib syndrome, Intercostal muscle tear, Osteoporosis, Osteoarthritis, Polyneuropathy, Polymyalgia rheumatica, Fibromyalgia, Polymyositis, Systemic lupus erythematosus, Ankylosing spondylosis, Diabetic neuropathy, Eosinophilic fasciitis, Stinger or Burner, Tetanus, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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