Ep 240 – Seeing the Serratus Anterior Through Rose-Colored Glasses: “The Rebel MT” with Allison Denney

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0:01:32.8 Speaker 2: I got into this field because I feel stuff. Not like my hands can feel knots, like I feel life deeply and passionately, which is a good thing, life is full of huge emotions and meaningful connections and incredible creations. I am a little over the top happy every morning when my kids wake up and I get to hug them, they get annoyed by it, but I am not about to rein that in. The flip side to this though, is the part where the not so beautiful things affect me. I crumble inside if someone looks at me funny, I am in awe of those who can read the news and not fall into a pit of despair, and I obsess over whether or not I said the right thing. All of this to say, I think that we massage therapists as a whole get into this field because we feel things, we know people are in pain and we want to help. But a funny thing happens along the way, we finally make the decision to go to massage school, and we have to learn science stuff, we have to learn muscles and tissues and systems and dysfunctions, and for some of us, that's cool and intriguing information, but for others of us, it is a big fat obstacle that pokes at us like a mosquito and makes us itch until we either kill it or ditch where we are sitting, so we don't have to deal with it. The tests and assessments to make sure we are working correctly and within our scope of practice are there for good reasons.

0:03:01.8 Speaker 2: But if you are like me and you got into body work because you know deep down in your heart that there is something else there besides Anatomy and Physiology, the whole process feels like an uphill battle, finding joy in discussing origins and insertions does not come easily. Dissecting how a muscle moves a joint, does not move me to tears, learning about how a nerve fires does not make me ponder why we love. Understanding how to apply a myofascial stretch in the right direction doesn't inspire me to write a poem, or does it? I mean, maybe, it is kind of cool how the body works, it does make me want to understand some heftier questions like, why we feel pain or why is it that some people can run faster than others. So admittedly, I have cracked open the door of allowing myself to be in awe of the human body, it does do some pretty incredible things. Does it stop me in my tracks like a good song might? Mostly no, but I'm beginning to think that our connection to the more artistic side of humanity doesn't only live in the art world. We can easily see the world through rose-colored glasses when they're handed to us, but putting on our own pair when we might not usually wear them is a choice that might just change everything.

0:04:31.8 S2: Take for example, the serratus anterior, it's a pretty cool muscle on paper. It's not one of the more obvious muscles in the body, like the biceps or the quads, it hides tucked away under the scapula and it attaches itself onto the ribcage in such a way that it made those who named it, think of the serrated edge of a knife. Okay, so maybe it didn't make them think of their first love or what happens after we die, but it looked cool enough that they gave it a somewhat cool name. What it does is pretty cool too. It originates on the ribs and then slides underneath the subscapularis and reaches up to grab the underneath part of the medial border of the scapula. Okay, so that's different, and that means it's gonna move the scapula because wouldn't it be odd if the scapula stayed in place and the ribs started twisting around the spine when this muscle contracted. We might all be able to rip open our own torsos like some kind of alien from a sci-fi movie. But that's not what happens. Kind of a bummer, but the scapula moves instead, it gets pulled into protraction or away from the spine, I guess if it had to move bones away from the center, it's better that they are our wing bones and not our chest plates.

0:05:47.2 S2: Okay, so the serratus anterior pulls the scapula into protraction. Have you ever seen those people who have insane control over what their scapula can do, they can kind of pop them out and make them dance like they are little pyramids under the skin with legs running all around the upper back. That's the serratus anterior. When someone can really tap into that muscle, it can do some pretty awesome tricks, granted, most of us can't do that, so we settle into the more mundane movements of protraction and retraction, like we settle into the clear glasses we always wear, and decide we are okay with it. But this is exactly my point. Being okay with who you are is good, it honors acceptance and doesn't get us riled up with jealousy or competition when we aren't as cool as the next guy. That doesn't mean though that we have to wait for someone to come along and hand us a pair of whatever colored glasses to wear that might make the world seem more exciting. We can choose to see the serratus anterior as just another muscle, or we can choose to perceive it as a fascinating piece of our anatomy. It has a cool origin, a cool insertion, and it is definitely capable of doing things that are anything but boring.

0:07:03.4 S2: How the body works, and oftentimes how most of us work, can get sucked into the vortex of boring. We eat the same foods, see the same people, listen to the same music, and even pick out the same outfits to wear even though we've got clothes in the back of our closets that we haven't dawned in years. Maybe if we have the means, we buy new clothes or take a trip or eat at a fancy restaurant to ignite a little spark, but when we don't have that kind of access, it is up to us to find that spark. As Judith Astin puts it... And I'm paraphrasing here, "Most of us pay attention to the gravity that weighs us down, but we don't honor the forces that lift us up." In your office with your clients, how you choose to see the anatomy that your hands have the opportunity to interact with is entirely up to you, and in turn, how they then see their own anatomy, because you have offered them a peak through your custom colored glasses, is the beginning of a ripple effect that could result in some pretty great changes. Try this, have your client lay prone on the table, guide their arm into 90 degrees of abduction such that their upper arm is perpendicular to their spine and their form is dangling down to the floor.

0:08:20.3 S2: Now, situate yourself at the side of the table so that you are facing their rib cage. So, if you're working on their right side, for example, their elbow is near your right hip, except that it's not because you're either going to squat down or pull up a stool so that you have better access to their axillary area mechanically. Once you're here, use the whole of both of your hands to grab the group of muscles and surrounding tissues at the lateral border of the scapula. What you've mostly got a hold of here is the latissimus dorsi, and the teres major and minor, the lats are going to be most superficial in the palm of your hand, and you should be able to palpate the teres major with your fingers towards the more inferior portion of the scapula, and the teres minor, up along the superior portion of the scapula, up near the armpit. These are not the muscles we're focusing on here today, I'll save that for a future episode, but they are a good starting point for where we want to go. From here, take your thumbs and push them up toward the ceiling, and get a good feel for the under side or more anterior aspects of these muscles.

0:09:26.6 S2: You can even start to lift these up away from the rib cage and get a good grasp on how they pull at the arm or the shoulder. But if you slide your hands immediately, still pushing upwards, you now have a firm replacement onto the subscapularis. Take a moment and press in to push up against the interior surface of the scapula. I'm assuming and hoping through all of this that you have a patient friend on the table who is not ticklish. Now, shift your focus from pushing up toward the ceiling and navigate your pressure towards the rib cage, you might slip over a rib here, that's okay. Find some solid ground before moving on. Once you're here, ask your patient, non-ticklish friend to reach under the table and push up with their hand against the bottom of the table, kind of as if they were holding on to something with their arm and pressing their hand into their chest. Under your thumbs, you should begin to feel the first firings of the serratus anterior. To get it to engage even more, and this is also a friendly reminder that you can always ask your clients to do a little more than they might be used to doing...

0:10:36.6 S2: Breathe in a little more deeply, exhale a little more completely, sink into the table with a little more weight, ask your client to pull the table closer to their chest, get them to brace their bodies using this arm against the top of the table, like they are protecting a loved one from an oncoming tornado. This should do the trick, that serratus should be firing at full force, and you can now feel the actuality of this awesome muscle. What do you do from here? You might be asking. Well, first, tell your friend that they can let go and you can ease out of their rib cage, but now that you know where this muscle is and what it does better than you ever have, you can use that information to your advantage. Engage it for an AET, soften it for a positional release, go diving for a trigger point, use the tools you have to best approach your client and how working with their serratus anterior might help them with shoulder issues or back pain or arm discomfort. It is entirely up to you. Just remember this, the more fascinating you find your work to be, the more likely it is that your clients will feel inspired by and engaged with what you're doing.

0:11:50.1 S2: The more that they feel that spark, the more likely they are to carry it into their own daily lives, and do their own self-care, stretching, hydrating, what have you. And then the more likely it is that they will begin to heal, and because you have chosen to wear a new pair of glasses and try on a different perspective, your ability to help your clients figure out their own pain just got a little easier. Well done and nice glasses. And here we are, the end of the episode, thank you to the extraordinary crew over at ABMP for helping me get my words into your ears, and if you wanna get any of your words into my ears or more accurately into my brain via my eye balls from a computer screen, drop me a line at rebelmt@abmp.com, that's R-E-B-E-L-M-T@abmp.com. I always wanna hear your questions, comments, suggestions or salutations. Also, if you're interested in checking out anything else I'm doing, head over to rebelmassage.com where you will find all sorts of fun things to click on, like homemade organic products for your practice, cool links to continuing education classes, thoughts I have typed up and posted here and there, and other rebel massage dabblings.

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