2015 Volume 15 Pages 127-134
The serratus anterior muscle is an important muscle for scapular joint function. It is innervated by the long thoracic nerve, and its function is to stabilize the medial border and inferior angle of the scapula. Generally, exercises that emphasize the protraction and upward rotation of the scapula (wall push-up plus, dynamic hag, push-up plus) have been recommended for strengthening the serratus anterior. However, because greater activation of the pectoral muscles is likely to occur during these exercises, there is a possibility that efficient serratus anterior muscle activity will not be obtained. In this study, a patient was subjected to physical therapy after right long thoracic nerve paralysis resulted in fatigue during shoulder flexion at 120° or higher. General strengthening exercises for the serratus anterior muscle were incorporated, but sufficient effects were not achieved. Therefore, our training focused on improving serratus anterior contraction patterns through facilitation, while reducing the activation of the pectoralis major. These exercises improved shoulder joint motor function and reduced fatigue during flexion better than general strengthening exercises. We consider that it is necessary to focus on facilitation and contraction patterns to improve serratus anterior activation after long thoracic nerve injury.
