Serratus anterior strengthening

After suffering pain in which I thought it was my lat, I decided to take some rest and hope it would be better after 2 weeks to carry on working out, tried working out, still pain during bench/shoulder presses.
 
Decided to go to see a physio, he took a look at my shoulder and said my right scapula is out of place, "winged scapula" they call it online, after researching online I've found out this happens as a result of having a weak serratus anterior.
 
He told me I was ok to carry on working out, just avoid any exercises which caused me any pain. I've incorporated more v bar row's into my back routine and also push up plus exercises, also out of the gym I've been working on my posture, shoulders back chest out etc.
 
I dont want to make it any worse and end up having surgery on my shoulder, I'd prefer to do the right exercises with strict form and hope it goes back into place naturally!
 
Has anyone ever suffered from this, did you manage to fix naturally?
 
Exercises you'd recommend doing or exercises you'd avoid?
 
 

Evening matey! Read Drew's article here. Top stuff.

Cool thanks mate and thanks Drew great article!

I've not really changed my routine as such, I still stick to training mon/weds/fri. (2 upper body, 1 legs)

After every upper body workouts I've been adding a few sets of serratus push ups, I find these good, the dumbell version I'll have to try again find it slightly awkward but I have started doing neutral dumbell presses, simular but pressing rather than just shrugging.

For back I always include v-bar rows, I still do deadlifts.

I hope I can sort this out, its doing my head in now! :(

Remember you're fighting the natural tightness in musculature on the chest and the more active muscles on the back. Setting the shoulder 'pulling the shoulders back' is one thing' but doing it properly is another.

You need to check there is minimal lat involvement but rather that your flattening that scap (bringing it in and back around the rib cage will flatten it) using lower traps not lats

I have gone and found a long ramble that I wrote, it applies here:

http://www.muscletalk.c...igh=setting+the+shoulder

Also a little Q&A here:

http://www.muscletalk.c...igh=setting+the+shoulder

Remember
Your fighting tightness and more active muscles: Do a LOT more pull than push and emphasis should be on vertical push if serratus are OK BUT realise that it is a problem over the whole day which isn;t fisxed in a few reps.

Foam roll, massage etc the chest BIG TIME. Stretching is OK but you need to break down  those trigger points

Activate those lower traps etc. Work on activity and control especially when lifting. You'll still get injured if your fine when not lifting but the minute you pick up a weight all the control goes to ****.

Learn to bench powerlifter style if you develop any subacromial issues.

I will try the foam roller massage daily on my chest, my physio pointed out I had quite a developed chest compared to my back, I've always found my chest grows easy. I am often feeling tightness in my right trap, that must be something to do with the winged scap.

Still a bit confused though training wise, do I need to alter my workouts or just concentrate on my form more, using my lower traps etc when training back rather than lat movement?

Am I ok still training my chest if I get no pain, I have now started doing the powerlifter style bench instead of the bodybuilder flared out style and that seems to help. Shall I train chest every other week maybe?

Also when is best to do these serratus strengthening exerices, pre or post workout or non-training days maybe?

Sorry about all the questions, you've probs answered these 10 million times now and sick of them now!

Just tried posting some pics but had trouble uploading them

No worries,

But some questions are answered above:
YES you need to change a lot more pull than push. Sorry!
I would actually not train chest at all for a while if it were me but this depends upon how quickly you can get some real change in the winging.
Serratus (and lower trap) work could be before and after but do low volume as per the article, it's as much to activate the muscle as to strengthen it.

I noted somewhere that you use pre exhaust type training. I would stop doing this for a while, control is lost when this is done.

Great, thanks mate, I'll leave chest out now, would it benefit me more leaving shoulders out too and just stick to legs, back and arms?

I'd rather sort out the winging asap so if that means leave out chest for a while I dont mind too much!

I dont do high volume workouts anyway, the longest Im in the gym is 50 mins. Around 9 working sets I do when training back and around 6 sets when training chest. I'll also leave out the pre-exhaust training for a while and concentrate on better form!

Thanks again for the advice. :)

I think I will try out something like this, leave chest and shoulders out for a while...

Mon - Back/rear delts (inc serratus setting exercises)
Weds - legs
Fri - Biceps/Triceps (inc serratus setting exercises)

Daily- good stretch of pecs/traps, will use a tennis ball on my pecs to try loosen it.

Im hoping by not training chest and stetching daily will loosen my chest and not pull my shoulders forward as it would having tight pecs, also building a good strong back and activate my serratus will pull my shoulders back and re-set scapula, thats the plan anyway.

Does this sound ok to you drew or would you alter this routine?

Give it a go.

Activation exercises can be done ever day, it is only a few reps. Mobility can be done ever day as can rolling the pec minor with a tennis ball. Just work up duration or reps

Great thanks for all the help, I'll give it a go anyway.

Do you know anyone who's suffered with this and corrected it through training?

I know without seeing it would be hard to tell timescale on recovery, but do you think if I do it correctly I could be back to normal in months or is it going to be years before its back to normal or is it impossible to say?

I dont think I have it really bad, I have full range motion without pain, I can now lift a lot more without any pain ie bench/shoulder presses.

A few good articles I've posted below, well worth a read if you care about your shoulders, just wish I done more to prevent this shoulder injury rather than trying to cure it now! :(

http://articles.muscletalk.co.uk/article-smart-shoulders.aspx

http://www.exrx.net/ExInfo/Posture.html

http://www.sportsrehabexpert.com/public/96.cfm?sd=2

Not sure if these pics are going to work, never uploaded pics before, but if it does work could you see any improvement in my winged scap between the two pics?

^^ Ah never mind, do they have a simple pic uploader on here which I dont know about, seems hard work uploading a pic or maybe its just me?

Hi guys, I know Im opening an old thread about my winged scapula.

Basically I stop training chest and shoulders around 9 months ago as advised on here by Drew, it made a big difference and almost made a full recovery now.

What would be the best way to start introducing chest and shoulders back into my workouts, I dont want to risk having the scapula winging again. I was thinking alternating chest and shoulder workouts each week, one week chest and the following shoulders.

If I slowly get back into full training and continue to do my stretches and serratus strengthening exercises do you think I will be fine to resume chest and shoulders?

Like I said its still winging slightly but hardly noticable compared to what it was, dont want to risk making it bad again thats all but at the same time eager to start back training chest and shoulders! :-/

Glad to hear things are going a little better.

It's a process mate, if you're training more chest then you need to keep and eye on stuff you;re doing to balance it.

Also getting the best bang for buck and using a healthier choice of movement means that you'll hopefully keep volume in check and keep the shoulders healthy. Cable chest press is often a good choice http://www.youtube.com/watch?v=YJWForaoV2c ...If they're good enough for Dave Tate...

Also pressing overhead to a point where you train the serratus is a good thing to look at when pressing overhead. Most BB'ers spend loads of time training serratus the wrong way. Have a google around for info here.

It's one more piece of the 'scapular control' puzzle.

Great, thanks once again, I will start to do some cable work for chest and shoulders, I'll avoid the bench press for a while and just work out with cables and do dips and lateral raises etc.

I found bench shrugs on a smith machine a good exercise, found it better than the push up plus anyway.

Have you done DB Protractions. Always found them good for serratus anterior (staple in my routine).

Along similar lines to what Drew has said, (when I recovered from shoulder issues) I started back doing push-ups, then Neutral Grip DB Floor press, then into Flat and Incline DB Press (Neutral grips). After a while started doing Neutral grip DB OHP.
As you might be able to tell, the two similar things are DB's and a Neutral Grip - both easier on the shoulders. Still get just as good, if not better in some cases, muscle stimulation.

I always keep a balance of about 1:2 Push:Pull. For example in my U/L routine, I do about 85 reps of pushing (Chest and OH), and about 175 reps of pulling total. Its not obviously all heavy, but the volume wont overtrain you. Continue to do scapular and rotator cuff work of course.

To be honest if there's any question mark with shoulder health and you're not a competitive powerlifter I would avoid barbell bench press altogether. There's simply nothing to gain everything to loose.

I know 'barbell' is not mentioned specifically but it's worth mentioning.