Serratus Posterior Superior: Pain & Trigger Points

The serratus posterior superior is almost always involved if you have a painful shoulder.

Learn how to massage it and get relief!

1. Pain Patterns and ymptoms

1.1 Pain patterns

Trigger points are painful when pressed on and can trigger pain in areas of your body that might seem totally unrelated to the muscle that contains these points.

The pain zones of the serratus are spread throughout the upper body.

Pain is mainly felt at the top of the shoulder blade and down the backside of the entire arm.

Additionally, this muscle can refer pain to the chest, inner upper arm, forearm and to the back of the hand.

Not shown but still possible is pain at the wrist and palm.

It mainly causes…

The color in the pictures below displays how common it is to feel pain in the respective areas.

The darker the red, the more common it is to feel an ache at this spot when the serratus posterior superior contains trigger points.


1.2 Symptoms & complaints

When lying on your back, your shoulder blade will be pressing on the muscle.

If tender or trigger points are present, this can be painful.

2. Attachment Points

The serratus posterior superior originates at the cervical and thoracic spine and attaches at the ribs under the shoulder blade.

The X1 displays a common area for tender and trigger points to develop.

3. Function

  • It lifts the ribs and assists the diaphragm in breathing.
  • It is easy as that. Muscles not always do complex things.

4. Trigger Point Activation in the Serratus Posterior Superior

Paradoxical breathing, which means breathing mainly with the chest instead of the diaphragm, will eventually overwork the muscle and activate trigger points.

In general, the muscles that assist breathing, ASSIST.

They are not meant to be the main workhorses. It is just too much load for those small muscles.

Also sitting in front of a high desk with your shoulders elevated will eventually lead to problems.

The fibers of the muscles draw near each other in this position.

Such a position, if it occurs often or chronically, is too much for the muscle.

5. Serratus Posterior Superior: Palpation

As the serratus posterior superior lies under your trapezius and rhomboids you are not able to feel it.

Additionally, the most troubling part that you want to massage, lies under the shoulder blade, so that you cannot access it directly with your hands.

Still, with a little trick you will be able to massage it.

6. Self-massage of the Serratus Posterior Superior Muscle

You have two options. You may use a massage ball or the Trigger Fairy.

6.1 Self-massage with a ball

  • Place the massage ball beside your shoulder blade approximately at the height of your spine of scapula.
  • Now move your arm over to the other side.
  • This will rotate your shoulder blade in a way that you can access the most common tender spots in this muscle.
  • Now search for them.
  • As soon as you encounter one, stop there and work it with slow and precise strokes.

6.1 Self-massage with the Trigger Fairy

When does the Trigger Fairy makes sense? 

  • You have no blank space on the wall.
  • It is too exhausting to massage yourself in a standing position.
  • The massage with the ball is too intense.

How to use the Trigger Fairy?

  • Cross the arm of the affected side in front of your body in order to access the muscle.
  • Hold the Fairy with your other hand.
  • Place it on the muscle and search for tender muscle knots.
  • Massage each of them by pulling the Fairy forward and downward. You can also use circular motions.
  • Stay on the point and take a few deep and slow breaths, concentrating on an elongated exhalation.


  • Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print
  • Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print
  • Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams & Wilkins, 1999. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print