Serratus Anterior Exercises for Winging of the Scapula

Complete Physiotherapy Guide

The serratus anterior is one of the most important muscles for controlling shoulder movement. When this muscle becomes weak or dysfunctional, the inner border of the shoulder blade lifts away from the ribcage—a condition known as scapular winging. This creates a visible “wing-like” appearance and significantly affects shoulder strength, stability, and overall arm function.

Often called the “boxer’s muscle,” the serratus anterior helps keep the scapula firmly anchored to the ribcage while allowing smooth upward rotation during overhead activities. When the muscle becomes weak due to nerve injury, muscle imbalance, poor posture, or repetitive strain, scapular winging can develop.

Why Scapular Winging Matters

Scapular winging can interfere with everyday tasks such as:

Reaching overhead
Carrying or lifting objects
Pushing or pulling
Combing hair or dressing
Performing sports or gym activities

If untreated, winging may lead to shoulder impingement, pain, poor posture, and reduced arm function. Fortunately, targeted physiotherapy and exercise that strengthen the serratus anterior can dramatically improve scapular control.

Physiotherapy Management for Serratus Anterior Weakness

A structured rehabilitation program is the most effective way to correct scapular winging. Physiotherapy focuses on reactivating and strengthening the serratus anterior while improving posture and shoulder mechanics.

Below are the most commonly used therapeutic approaches:

1. Scapular Stabilisation Training

These exercises target serratus anterior activation:

Scapular punches (protraction movements)
Wall slides with upward reach
Dynamic bear-crawl variations
Push-ups with plus (scapular push-ups)

These movements help retrain proper scapular positioning during functional tasks.

2. Stretching & Mobility Exercises

Tight chest and shoulder muscles can worsen winging. Therapists often include:

Pectoralis major/minor stretches
Thoracic extension mobility drills
Shoulder range-of-motion exercises

Improving mobility helps the serratus anterior work more efficiently.

3. Isometric Strengthening

Isometrics are ideal in early rehab when movement is painful or difficult:

Scapular protraction holds
Isometric shoulder flexion
Isometric wall pushes

These exercises build endurance and retrain muscle engagement without placing excessive load.

4. Kinesio Taping for Scapular Control

Taping can:

Provide sensory feedback
Encourage proper scapular alignment
Assist muscle activation

It is beneficial in cases involving nerve irritation or severe winging.

5. Scapular Retraining Techniques

Therapists may use:

Biofeedback
Mirror feedback
Manual cueing

These tools teach patients how to correctly activate the serratus anterior during everyday movements.

6. Progressive Resistance Training

Once foundational stability is achieved, resistance bands, dumbbells, and closed-chain exercises are incorporated. Examples include:

Band punches
Serratus wall slides with resistance
Protraction-loaded carries

Progressive overload ensures long-term improvement.

7. Postural Correction

Poor posture, particularly rounded shoulders, can reduce the function of the serratus anterior. Physiotherapists teach:

Scapular setting
Thoracic alignment techniques
Ergonomic adjustments for work or study

Correct posture is essential for preventing the recurrence of winging.

8. Patient Education

Education includes:

Activity modification
Safe lifting techniques
Shoulder mechanics during daily tasks
Preventive home exercises

Understanding the condition helps patients maintain results long-term.

Best Exercises to Improve Scapular Winging

Here are widely recommended exercises to strengthen the serratus anterior:

1. Scapular Protraction (“Serratus Punch”)

Lie on your back or stand with a resistance band.
Punch upward or forward, letting the shoulder blade slide forward.
Avoid shrugging.

2. Wall Slides

Stand with your forearms on the wall.
Slide arms upward while keeping the shoulder blades flat against the ribcage.
Focus on controlled protraction.

3. Push-Up Plus

Perform a push-up, then add a final protraction at the top by spreading your shoulder blades apart.
Excellent for direct serratus activation.

4. Scapular Retraction

Sit or stand tall.
Gently squeeze the shoulder blades together without lifting them upward.
Helps balance anterior and posterior muscle activation.

5. Resistance Band Rows & Pulls

Strengthen the upper back and stabilisers of the scapula.
Encourages proper movement patterns during shoulder function.

6. Wall Angels

Stand against a wall, keeping elbows and wrists in contact as you slide upward.
Improves posture and mobility, reducing winging.

7. Postural Awareness Training

Maintain a neutral spine
Keep your shoulders down and back
Avoid excessive forward shoulder positioning

This helps the serratus anterior stay engaged throughout the day.

Serratus Anterior Exercises for Winging of Scapula

Serratus Anterior Exercises for Winging of the Scapula

Why Scapular Winging Matters