An athlete reports a chronic injury to the long thoracic nerve. To which muscle should the rehab exercises be directed?

An athlete reports a chronic injury to the long thoracic nerve. To which muscle should the rehab exercises be directed?

• A. Levator scapula
• B. Serratus anterior
• C. Rhomboids
• D. Supraspinatus

Answer: (B)

The key idea is that the long thoracic nerve directly innervates the serratus anterior, which plays a crucial role in keeping the scapula stable against the rib cage and in protracting and upwardly rotating the shoulder blade. When the long thoracic nerve is chronically injured, the serratus anterior becomes weak or paralyzed, leading to scapular winging and impaired shoulder mechanics. Therefore rehab should target strengthening the serratus anterior to restore proper scapulothoracic function and prevent winging. Effective exercises focus on pushing the shoulder blade forward and away from the spine, such as wall slides with an emphasis on protraction, push-up plus, dynamic hugs, and serratus-specific punches. Strengthening other muscles like the levator scapula (which elevates the scapula), the rhomboids (which retract and downwardly rotate), or the supraspinatus (which initiates abduction) won’t directly compensate for serratus anterior weakness and won’t address the primary stabilization issue caused by the long thoracic nerve injury.

The key idea is that the long thoracic nerve directly innervates the serratus anterior, which plays a crucial role in keeping the scapula stable against the rib cage and in protracting and upwardly rotating the shoulder blade. When the long thoracic nerve is chronically injured, the serratus anterior becomes weak or paralyzed, leading to scapular winging and impaired shoulder mechanics. Therefore rehab should target strengthening the serratus anterior to restore proper scapulothoracic function and prevent winging. Effective exercises focus on pushing the shoulder blade forward and away from the spine, such as wall slides with an emphasis on protraction, push-up plus, dynamic hugs, and serratus-specific punches. Strengthening other muscles like the levator scapula (which elevates the scapula), the rhomboids (which retract and downwardly rotate), or the supraspinatus (which initiates abduction) won’t directly compensate for serratus anterior weakness and won’t address the primary stabilization issue caused by the long thoracic nerve injury.