title: Serratus anterior or pectoralis minor: Which muscle has the upper hand during protraction exercises?
abstract: BACKGROUND
  The Serratus Anterior (SA) has a critical role in stabilizing the scapula against the thorax. Research has linked shoulder and neck disorders to impairments in the SA activation. Exercises that target the SA are included in the rehabilitation of shoulder or neck pain and mostly include a protraction component. The Pectoralis Minor (PM) functions as a synergist of the SA. From the literature it is unclear to what extent PM is activated during SA exercises.
  
  
  OBJECTIVE
  To determine the activity of SA and PM during different protraction exercises.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  26 subjects performed 3 exercises: Modified Push-Up Plus (Wall Version), Modified Knee Push-Up Plus (Floor version) and Serratus Punch. Electromyographic (EMG) data was collected from the SA (surface) and PM (fine-wire EMG).
  
  
  RESULTS
  During the Serratus Punch the SA activity was significantly higher than the PM activity. During the Modified Push-Up Plus exercises (both Wall and Floor version), the SA and PM activity were comparable. The PM showed the highest activity during the Serratus Punch and the Modified Push-Up Plus (Floor), which was significantly higher than during the Modified Push-Up Plus (Wall). The SA showed the highest activity during the Serratus Punch, which was significantly higher than during the Modified Push-Up Plus (Floor) which was in turn significantly higher than the activity during the Modified Push-Up Plus (Wall).
  
  
  CONCLUSIONS
  All exercises activated the PM between 15 and 29% Maximum Voluntary Isometric Contraction and the SA between 15 and 43%. The Modified Push-Up Plus exercise against the wall and the floor activated the SA and PM to a similar degree. When maximum activation of the SA with minimal activation of the PM is desired in healthy subjects, the "Serratus punch" seems to be the optimal exercise.
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University Hospital, Ghent, Belgium. Electronic address: Birgit.Castelein@ugent.be.
authors.forename: Birgit
authors.initials: B
authors.lastname: Castelein
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University Hospital, Ghent, Belgium.
authors.forename: Barbara
authors.initials: B
authors.lastname: Cagnie
authors.affiliation: Department of Physical Medicine and Orthopedic Surgery, University Hospital, Ghent, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Parlevliet
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University Hospital, Ghent, Belgium.
authors.forename: Ann
authors.initials: A
authors.lastname: Cools
mesh_terms: D000328:Adult; D004576:Electromyography; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D064169:Intermediate Back Muscles / Q000502:physiology*; D007537:Isometric Contraction / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000502:physiology*
keywords: EMG; Exercises; Pectoralis minor; Scapular muscles; Serratus anterior