The Serratus Anterior Strength Test is commonly used to assess scapular control, serratus anterior function and shoulder movement quality during resisted upper limb tasks. This article explains the protocol, interpretation, limitations and practical recording guidance.
The serratus anterior plays an important role in:
scapular upward rotation
scapular stability
shoulder movement efficiency
force transfer through the upper limb
Reduced serratus anterior function may contribute to:
scapular winging
altered shoulder mechanics
shoulder fatigue
reduced overhead performance
shoulder loading intolerance
The Serratus Anterior Strength Test is one of several assessments used to evaluate scapular control and shoulder movement quality during resisted movement.
The test is commonly used alongside:
scapular observation
shoulder strength testing
push-up assessments
movement analysis
shoulder ROM assessment
overhead movement assessment
Although altered serratus anterior function may be associated with shoulder dysfunction in some populations, the test should not be interpreted as a stand-alone diagnostic assessment.
Primary purpose: Assess serratus anterior strength and scapular control
Body region: Shoulder and scapular region
Commonly associated with: Scapular winging and altered scapular mechanics
Positive finding: Weakness, winging or reduced scapular control
Negative finding: Stable scapular movement with appropriate control
Clinical role: Supports movement assessment and shoulder evaluation
Best interpreted with: Movement assessment and broader shoulder findings
The Serratus Anterior Strength Test is a movement and strength assessment used to evaluate the serratus anterior muscle during resisted shoulder or scapular tasks.
The assessment is intended to:
evaluate scapular stability
assess shoulder girdle control
identify movement compensations
assess tolerance to resisted upper limb loading
The test may involve:
resisted shoulder flexion
scapular protraction
wall-based loading
push-up variations
manual resistance testing
The Serratus Anterior Strength Test may help:
assess scapular control
identify winging patterns
monitor movement quality
assess shoulder stability during loading
guide exercise selection
monitor progress over time
The test may be particularly relevant in:
overhead athletes
throwing sports
swimming
gym-based training
shoulder rehabilitation settings
return-to-sport assessment
The test is intended to assess:
serratus anterior strength
scapular movement quality
scapular stability
shoulder girdle control
resistance tolerance during upper limb loading
A positive finding may suggest altered scapular control or reduced serratus anterior contribution. However, the assessment does not independently diagnose shoulder pathology or nerve involvement.
The Serratus Anterior Strength Test may be useful for:
exercise professionals
strength and conditioning settings
sports performance assessment
allied health assessment environments
overhead athlete monitoring
movement assessment education
Consider using the Serratus Anterior Strength Test when a client reports:
shoulder fatigue
scapular winging
difficulty with overhead tasks
reduced shoulder stability
shoulder discomfort during pressing
altered shoulder mechanics
The assessment may become more meaningful when combined with:
scapular observation
ROM assessment
shoulder strength testing
overhead movement assessment
pushing assessments
Use caution when:
acute shoulder injury is suspected
symptoms are highly irritable
severe pain is present
neurological symptoms are worsening
recent surgery occurred
Stop testing if:
pain becomes excessive
neurological symptoms increase
movement quality deteriorates significantly
the client requests cessation
Open assessment space
Wall or plinth if required
Documentation system
No specialised equipment is required.
The client may stand, sit or assume a push-up position depending on the chosen variation.
Common testing positions include:
standing shoulder flexion
wall push-up position
quadruped position
resisted scapular protraction
Position beside the client to:
apply resistance where required
observe scapular movement
monitor compensations
compare sides
Position the shoulder and scapula appropriately.
Instruct the client to perform the required movement.
Apply resistance gradually if required.
Observe scapular movement and control.
Compare findings between sides.
Ask the client to:
move in a controlled manner
maintain posture
report pain or fatigue
avoid compensatory movement where possible
A positive finding may involve:
scapular winging
reduced movement control
early fatigue
asymmetrical scapular movement
inability to maintain scapular position
pain during loading
A negative finding involves:
stable scapular control
symmetrical movement
appropriate resistance tolerance
absence of winging or major compensation
A positive Serratus Anterior Strength Test may increase suspicion of:
reduced scapular control
serratus anterior weakness
altered shoulder mechanics
reduced overhead loading tolerance
The finding may become more meaningful when combined with:
observable scapular winging
overhead movement dysfunction
asymmetrical movement patterns
fatigue-related compensation
However, the test does not independently confirm:
nerve pathology
structural shoulder pathology
scapular dyskinesis diagnosis
Movement changes may also relate to:
fatigue
pain inhibition
movement apprehension
general shoulder weakness
motor control variability
A negative finding may suggest:
adequate scapular control
appropriate serratus anterior contribution
stable movement during resisted tasks
However:
shoulder symptoms may still exist
movement quality may change under fatigue
additional assessment may still be appropriate
There are currently limited universally accepted normative values for isolated serratus anterior strength testing.
Practical comparison guidance may include:
side-to-side comparison
visible scapular symmetry
fatigue tolerance
movement quality during repeated loading
ability to maintain scapular position during resisted movement
Where available, shoulder endurance and push-up performance measures may provide additional context.
Interpretation is generally strengthened when findings are:
repeatable
consistent across tasks
aligned with symptom behaviour
associated with functional movement limitations
Research investigating scapular assessment suggests:
visual scapular assessment may demonstrate variable reliability
movement interpretation may vary between assessors
standardised positioning improves consistency
Reliability may be influenced by:
assessor experience
fatigue levels
movement speed
resistance consistency
observation angle
At the time of writing:
strong MDC and SEM values specific to isolated serratus anterior testing remain limited
Sensitivity and specificity values are not commonly reported for serratus anterior strength testing because the assessment is not generally used as a stand-alone diagnostic test.
The assessment is more appropriately used to:
evaluate movement quality
monitor shoulder function
assess scapular control
support exercise and loading decisions
Common errors include:
excessive resistance
inconsistent positioning
poor scapular observation
failure to compare sides
overinterpreting isolated weakness
Key limitations include:
limited standardised protocols
variable visual assessment reliability
overlap with broader shoulder dysfunction
influence of fatigue and pain
The Serratus Anterior Strength Test may help:
assess scapular control
guide exercise selection
monitor overhead athletes
assess movement quality
track progress over time
contribute to shoulder screening
The test is often most useful alongside:
scapular observation
push-up assessment
shoulder strength testing
ROM assessment
functional overhead tasks
Record:
Test name: Serratus Anterior Strength Test
Side tested
Testing position used
Presence of winging
Strength findings
Fatigue response
Pain score
Compensations observed
Scapular movement quality
Comparison side findings
Related shoulder findings
Retest date
Related shoulder and scapular assessments may include:
Scapular Retraction Test
Wall Push-Up Test
Shoulder ROM Assessment
Empty Can Test
Push-Up Endurance Assessment
The test assesses serratus anterior function, scapular control and shoulder movement quality during resisted tasks.
Scapular winging refers to excessive prominence or altered movement of the scapula during shoulder movement or loading.
No. The assessment may identify altered scapular control but does not independently diagnose nerve pathology.
Yes. Fatigue may significantly influence scapular control and movement quality during testing.
No. Scapular assessments are generally more useful when interpreted alongside broader shoulder and movement findings.
The Serratus Anterior Strength Test assesses scapular control and shoulder movement quality.
A positive finding may suggest altered scapular mechanics or reduced serratus anterior contribution.
The test does not independently diagnose shoulder or nerve pathology.
Fatigue, pain and movement variability may influence findings.
The assessment is most useful alongside broader movement and shoulder evaluation.
Cook, C., & Hegedus, E. J. (2021). Orthopedic physical examination tests: An evidence-based approach (3rd ed.). Pearson.
Kibler, W. B., Ludewig, P. M., McClure, P. W., et al. (2013). Clinical implications of scapular dyskinesis in shoulder injury: The 2013 consensus statement from the ‘Scapular Summit’. British Journal of Sports Medicine, 47(14), 877–885. https://doi.org/10.1136/bjsports-2013-092425
Morrow, E. K., Morris, J. H., & Struyf, F. (2020). Clinical examination and physical assessment of shoulder pain. British Journal of Sports Medicine, 54(20), 1208–1215. https://doi.org/10.1136/bjsports-2019-101168
Struyf, F., Nijs, J., Mottram, S., et al. (2014). Clinical assessment of scapular positioning in musicians and athletes. Manual Therapy, 19(2), 108–115. https://doi.org/10.1016/j.math.2013.11.002
