Trigger Point Series: Serratus Anterior – Could Side-Rib or Shoulder Blade Pain Be Coming From This Muscle?

Do You Feel Pain Along the Side of Your Ribs or Under Your Shoulder Blade?

Do you sometimes feel an unusual ache along the side of your rib cage, underneath the shoulder blade, or around the side of your chest?

One muscle that may be involved is the serratus anterior.

The serratus anterior is an important shoulder-stabilizing muscle that wraps around the side of the rib cage and connects to the inner border of the shoulder blade.

When this muscle becomes overworked or develops sensitive trigger points, discomfort may sometimes be felt around the side of the ribs, underneath the shoulder blade, or along the side of the upper body.

Where Is the Serratus Anterior?

The serratus anterior is located along the side of the rib cage underneath the arm.

It attaches to several upper ribs and runs underneath the shoulder blade to connect along its inner border.

Its distinctive finger-like attachments along the ribs give the muscle its name.

The serratus anterior helps:

• Move the shoulder blade forward

• Rotate the shoulder blade upward

• Keep the shoulder blade stable against the rib cage

• Support reaching and pushing movements

• Assist with raising the arm overhead

It is especially active during movements such as pushing, punching, reaching, and lifting overhead.

Common Symptoms of Serratus Anterior Trigger Points

Sensitive trigger points in the serratus anterior may contribute to:

✅ Aching along the side of the rib cage

✅ Discomfort underneath or around the shoulder blade

✅ Tenderness along the side of the chest

✅ Pain around the back or side of the shoulder

✅ Discomfort during pushing or reaching movements

Some people may also notice discomfort extending toward:

• The side of the upper arm

• The inside border of the shoulder blade

• The side of the chest or ribs

Because pain around the chest and ribs can have many different causes, it should never automatically be assumed to come from a muscle.

What Causes Serratus Anterior Tension?

The serratus anterior can become overloaded by activities such as:

• Push-ups

• Planks

• Repetitive pushing

• Overhead lifting

• Weight training

• Swimming

• Boxing or punching movements

• Prolonged running with repetitive arm movement

• Repetitive reaching

• Heavy upper-body exercise

Sudden increases in exercise volume may also irritate muscles that are not accustomed to the workload.

Serratus Anterior and the Shoulder Blade

One of the serratus anterior’s most important jobs is helping keep the shoulder blade stable against the rib cage.

When you reach forward or raise your arm overhead, the shoulder blade needs to rotate and glide smoothly.

The serratus anterior works together with muscles such as the trapezius to help control this movement.

If these muscles become fatigued or poorly coordinated, the shoulder blade may not move as efficiently.

This is why your RMT may assess the entire shoulder and upper-back region rather than focusing only on the painful spot.

Simple Serratus Anterior Stretch

One gentle option is a seated rotation stretch.

Step 1

Sit comfortably on a chair.

Step 2

Place the arm on the affected side behind you or along the back of the chair.

Step 3

Keeping the shoulder relaxed, gently rotate your upper body away from that side.

Step 4

Hold for approximately 20–30 seconds while breathing normally.

You may feel a gentle stretch along the side of your rib cage and underneath the shoulder blade.

Do not force the movement or stretch into pain.

Another Option: Wall or Doorway Stretch

Place your hands or forearms against a wall or doorway around shoulder height.

Gently allow your chest and upper body to move forward while keeping the shoulders relaxed.

This can create a comfortable stretch through the chest, shoulders, and side of the rib cage.

Move slowly and stop if you experience sharp pain.

How Massage Therapy Can Help

Registered Massage Therapists may work with the serratus anterior when clients experience muscular tension around the ribs, shoulder blade, and upper body.

Treatment may include:

• Trigger Point Therapy

• Therapeutic Massage

• Gentle compression

• Myofascial techniques

• Shoulder-blade mobility work

• Stretching

• Treatment of surrounding muscles

Your RMT may also assess nearby muscles including the:

• Latissimus dorsi

• Trapezius

• Rhomboids

• Pectoral muscles

• Rotator cuff muscles

• Scalenes

Because these muscles all contribute to shoulder and upper-body movement, treating the surrounding areas may be more helpful than focusing on one muscle alone.

What About Pain With Deep Breathing?

Muscles around the rib cage move and stretch as the chest expands during breathing.

If the serratus anterior or surrounding muscles are irritated, some people may notice discomfort during a deep breath.

However, pain with breathing can also be associated with conditions involving the lungs, heart, ribs, or other structures.

It should not automatically be assumed to be muscular.

When Should You Seek Professional Advice?

Seek appropriate medical care if you experience:

• New or unexplained chest pain

• Shortness of breath

• Difficulty breathing

• Sudden severe rib or chest pain

• Dizziness or fainting

• Pain after significant trauma

• Fever or unexplained illness

• Arm weakness or numbness

• Symptoms that persist or continue to worsen

Chest pain or difficulty breathing requires appropriate medical assessment rather than massage treatment alone.

Visit Tsingtao Wellness Spa

At Tsingtao Wellness Spa, our Registered Massage Therapists provide personalized treatments for shoulder, upper-back, rib-area, and muscular tension.

Whether your serratus anterior feels overworked from exercise, repetitive pushing, overhead activity, or everyday muscle strain, your RMT can assess your needs and customize your treatment to your comfort level.

Visit us at our Markham or Vaughan location and let us help you Relax. Recover. Renew.