Serratus Posterior Superior

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 Posterior Superior is a muscle of the thoracic region of the back.

Anatomical Attachments:

• Origin: Attaches to the aponeurosis of the lower part of the ligamentum nuchae and spinous processes of the C7, T1, T2 or possibly T3 vertebrae.
• Insertion: Attaches to the upper margin of the 2nd, 3rd, 4th and 5th ribs just below their angles.

Action: Elevates the ribs and assists in inhalation.

Synergist: Intercostal, Scalenes.

Nerve Supply: Anterior primary rami of thoracic nerve (T1, T2, T3, T4).

Vascular supply: Highest and Posterior Intercostal arteries.

• Primary: Occasionally the pain referral is experienced in the pectoral region. It often affects the long head of the triceps and the posterior division of the deltoid, with the referral going down the arm along the ulna surface and into the little finger. Its most distinguishing feature is deep aching or boring pain experienced under the superior aspect of the scapula and shoulder.
• Satellite or associated triggers: Scalenes, Rhomboid, Iliocostalis, Longissimus thoracis, and Multifidus.

Click on a small image to view an enlarged image

Trigger Point Signs and Symptoms: Deep aching shoulder and arm pain at rest, numbness and tingling in the hand.

Trigger Point Activating and Perpetuating Factors: Coughing, paradoxical breathing, and sitting for long periods of time with shoulders elevated and rotated, lifting objects with outstretched hands, lying on the effected side, driving in a car for long periods of time.

Differential Diagnosis: (Segmental, Subluxation, Somatic dysfunction) C7 C8 T1 T2 or T3 Radiculopathy, Thoracic outlet syndrome, Scoliosis, Pulmonary cancer, Chronic Obstructive Pulmonary Disease (COPD, Emphysema), Osteocarcinoma of the shoulder (Bone Cancer), Ulna neuropathy, Glenohumeral dislocation (Shoulder separation), Scapulocostal syndrome, Myocardial infarction, Angina pectoris, Pleurisy, Visceral Reflex pain, Deltoid tendonitis, Post injection soreness of the deltoid, Polymyositis, Polymyalgia rheumatica, Fibromyalgia, Systemic lupus erythematosus, Ankylosing spondylitis, Charcot’s arthropathy, Rheumatoid arthritis, Osteoarthritis, Osteoporosis, Shoulder pointer, Carpal tunnel syndrome, Epicondylitis, Herpes Zoster (Shingles), Eosinophilic fasciitis, Tetanus, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

Back to Top