The Secret Serratus Society is a cute name for a group of muscles that hide out between the shoulder and the breath. Opening these tissues can either free the breath of extra burden, or ease the shoulders into a more comfy place.
This funny title comes from a 1980-or-so article by Robert K. “Bob” King published long ago. Bob was a stalwart early proponent of massage therapy, as we currently understand it. He initiated the Massage Therapy Foundation, and was a good friend of the founder of this magazine, Robert Calvert. Although he passed from this life in 2013, Bob’s larger-than-life influence is still felt in massage therapy education. As an early supporter of Anatomy Trains and as one of my heroes, he hopefully won’t mind if I repurpose his title.
Our unique human shoulders sit on top of our breath. For horses and dogs, the breath hangs in a sling from their shoulders. Their forelegs run straight like stilts down to the ground. But we humans stick our arms out to the side. Our shoulder half hangs off the neck and half rests on the rib cage. The mobility of the shoulder girdle (coupled with the human tendency to fold in at the chest) means that these inner muscles often get out of balance.
1A) The human shoulder half sits on the rib cage and half hangs off the neck—like a pub sign. 1B) Contrast our arrangement with that of most four-legged mammals where the rib cage hangs in a sling, supported from the shoulder blades. All images courtesy of Anatomy Trains.
Once out of balance, they get fascially fuzzy, usually after months or years of misuse or non-use. By the time that happens, it is more difficult to get lasting change, either in breath or shoulder position. That is when you need to don your robes and meet the secret serratus society.
This particular secret society has only a few members, muscles that run an inside circle under the scapula and collarbone. You can reach all of them from the axilla, the armpit. Serratus anterior and pectoralis minor are the founding members, but we will admit the scalenes into the society for today’s proceedings, with an honorary mention for the subclavius and subscapularis.
We are all familiar with the outer muscles of the shoulder, and these should be addressed first. Ironing out the pectoralis major, lengthening its outer edge, giving much the same freedom to the latissimus dorsi, trapezius and deltoids—all this surface work precedes what we are outlining here.
Assuming you have plenty of techniques for these muscles already, let us look beneath these large, movement-coordinating muscles. Lurking in the darkness of the armpit are the secret serrati, ready to cause trouble if they are not attended to properly.
Muscles are serrated (serratus means saw-toothed) when they attach to ribs, to one rib after another, in fact, giving them the saw-toothed look. Serratus anterior is a huge muscle, attaching to the inside of the entire medial border of the scapula, running deep to the subscapularis with eight slips (strips of muscle) to eight ribs, ribs 2 to 9. (In Anatomy Trains language, the serratus is fascially and functionally linked with the external oblique at the side of the ribs in the Spiral Line.)
The lower part of serratus—ribs 5-9—is easily accessible in side-lying or seated work. Well, the distal part is easily found, but the part that sweeps up from these ribs to the lower border of the scapula is soon covered by the latissimus. Lengthening and freeing this lower bunch of bananas can help reposition a protracted or upwardly rotated scapula.
2A) See how the serratus anterior (pink) interfaces with the rhomboids and rotator cuff muscles to stabilize the shoulder. 2B & 2C) Serratus anterior is an essential part of the Spiral LIne in the Anatomy Trains map. 2D) A seated technique (from above) for freeing the adhesions in the serratus anterior.
The upper part of serratus anterior is harder to reach but definitely worth the effort in terms of deep relaxation and easing of shoulder tension. With your client lying on their side, and their elbow abducted up in the air pointing toward the ceiling, put your flat hand onto the ribs, with your fingertips comfortably up into the armpit. Then have them rest their arm over the back of your hand.
Between your hand and the ribs is the upper part of the serratus anterior—the harder part to release. If you put your other hand on top of the shoulder, you can now slide the shoulder around the rib cage—up, forward, back and down. Using these movements to guide your sensitive hand (which is still in their armpit), see how far up the ribs into the pyramid of the axillary space you can get.
As the shoulder girdle slides up toward their ear, your hand slides up too, and you can gently grip your fingerpads onto the upper slips of serratus anterior. In most folks, they need to be lengthened down and forward to restore their optimal positioning.
Turn your hand to have the fingerpads face posteriorly in the axilla, toward the scapula. Of course the subscapularis attaches all along the anterior under surface of the scapula, so as you ease your fingers between the posterior ribs and the front of the scapula, you are easing the tissue—almost universally adhered—between the serratus and subscapularis, allowing them to work separately as God intended.
“Up the front and down the back” was one of Ida Rolf, PhD’s favorite dicta, and it applies here: As you free the subscapularis from the serratus, you almost always will want to take that tissue down, toward the feet, toward the bottom of the scapula. This usually requires several applications over a few sessions to really free those adhesions.
Now turn your fingers so that the pads face front, and slide into the front of the armpit. Let your fingerpads stay with the ribs, insinuating their way beneath both pectorali. Do not poke into the ribs at all; keep your fingers going along the surface of ribs instead. Gently lift the pectoral tissue—pectoralis minor is close to the ribs—such that you are lifting the muscle off the ribs, and then stretching it up the body toward the coracoid process.
How far can you persuade your client to let your hand in? It will go a lot farther than you might think at first when you encounter that wall of tissue. The pectoralis minor has three slips, to ribs 5 and 4 and 3, and sometimes 2. If you can get that far (and I only get that far with yoga adepts and those with soft, “temple-dance” fascia), you can reach and affect the subclavius muscle, which runs to rib 1 in the same fascial plane as the pectoralis muscle.
And finally, with the client side-lying and elbow up, turn your hand palm-up, lay it in their armpit, and again have them lower their arm over yours. Now your fingerpads, if you curl and uncurl them a bit, can feel the ball of the humerus in its ball-and-socket joint.
Your fingertips are deep in the top of the pit; your fingernails are against the serratus anterior and the ribs.
Use this position to create gentle traction of the arm away from the shoulder—which is a nice way to finish up and smooth out all this strong work in their poor pittiums.
Like the groin, the armpit is not our most pleasant place to work, but like the groin, it is vitally important to work there to get at core patterns of the shoulder. Hopefully your client practices good hygiene, but if someone’s a bit smelly, put a tissue or two over your fingers. It will not seriously de-sensitize your hand, but can protect your hands from picking up odor.
Also, the flesh of the armpit is very sensitive, so again, putting a tissue or two over your fingers will keep you from leaving marks.
There are four sides of the armpit:
Medial—serratus anterior over the ribs,
Posterior—subscapularis/serratus anterior interface (scapulothoracic joint).
Anterior—pectoralis minor and subclavius in clavipectoral fascia
Lateral – traction of the arm out of the shoulder
One final technique I use often for the armpit targets the fascia at the bottom of the scalenes. The scalenes qualify for the Secret Serratus Society not because they attach to different ribs but because they attach to one cervical transverse process after another, and so they have that same saw-toothed look.
There are three scalenes, and together they form a skirt—three muscles on each side—of very fibrous guy-wires around the cervical spine. Even though scalenes do not technically attach to the shoulder, you will find that the following technique will nevertheless ease shoulder position, as well as the breath.
Once again, the client is side-lying, and you place your hand palm-down up in their armpit, but comfortably so. Now cup the top of the same shoulder with your other hand. If you lean in a little, you can get your elbows opposite each other, so that their shoulder is free and easily mobilized. Check out their mobility, and then slide the whole shooting match—their shoulder and both your hands—up toward their ear.
Obviously, any strong nerve pain would be an indication to stop. But in most folks, you can slide your hand way up the ribs without anything more than a feeling of skin stretch. Once there, settle your fingerpads into the ribs, and you are on the inferior edge of the scalenes’ fascial skirt.
Prove this to yourself by having them lift their ear (remember, they are on their side). If you are far enough up the ribs with your fingers, you will feel the scalene fascia tighten under your hands when they do the lift, which indicates that you are in the right place. Hook this fascia with your fingertips as you draw the whole assembly—your hands, their shoulder—down away from the ear over the ribs to its lowest comfortable position.
Most people, even those who were a little wary about your going so deep in their armpit, will thank you for doing this move as it frees their neck and their breath.
When the shoulders are pulled up, this set of moves will benefit from being coupled with work on the rhomboid muscles, and the levator scapulae for best results. Any work that involves these deep armpit or neck muscles will also benefit from smoothing the neck out afterward, pulling taffy to elongate the neck muscles in the usual supine position.
Familiarize yourself with the Secret Serratus Society—those muscles under the shoulder. Get easy with your ability to work effectively in the axillary space. Your results with breath and shoulder problems will make this kind of work a go-to option.
About the Author
Thomas Myers is the author of “Anatomy Trains”(Elsevier 2001, 2014. Churchill Livingstone 2020) and co-author of “Fascial Release for Structural Balance” (North Atlantic, 2010. Churchill Livingstone 2020). He has authored over 100 articles and 50 video programs on anatomy, the fascial network and postural manual therapy. Myers and his faculty offer continuing education and professional certification for a variety of manual therapists worldwide.
