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FUNCTIONAL ANATOMY Client Homework— Chest and Arm Stretch 1. Stand or sit up straight. 2. Grasp your hands behind your back without arching your spine. 3. Lock your fingers or grasp a towel with your hands close together. 4. Gently extend your elbows and shoulders back until you feel a stretch. 5. Focus and increase the stretch by squeezing your shoulder blades back and together. Editor's Note: The Client Homework element in Functional Anatomy is intended as a take-home resource for clients experiencing issues with the profiled muscle. The stretches identified in Functional Anatomy should not be performed within massage sessions or progressed by massage therapists, in order to comply with state laws and maintain scope of practice. use, driving, and gardening. Many occupations require prolonged or repetitive movements that stress the serratus anterior, creating tension, shortness, decreased circulation, decreased tissue mobility, and pain. The serratus anterior may also become dysfunctional in people with respiratory pathologies, such as asthma or chronic obstructive pulmonary disease, as they chronically recruit accessory breathing muscles. Shortness or hypertonicity in the serratus anterior is typically observed as excessively protracted shoulders and is often accompanied by shortness in the pectoralis minor and anterior deltoid, and adhesions between the serratus anterior and subscapularis. The chest may appear concave and the shoulders rounded forward, as the serratus anterior pulls the medial border of the scapula laterally away from the spine. Clients typically complain of tension, fatigue, and pain in the head, neck, and mid-back due to overstretching of muscles like the trapezius, rhomboids, and levator scapulae. PALPATING SERRATUS ANTERIOR Positioning: client side-lying with arm resting forward 1. Stand behind the client and find the lateral border of the scapula. 2. Use your four fingers to palpate anteriorly and inferiorly from the lateral edge toward the lateral ribs. 3. Follow each section of the muscle belly toward the zigzagged origin along the lateral ribs. 4. Resist as the client protracts the scapula to assure proper location (see arrows above). therapist, certified athletic trainer, and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Kinesiology and Palpation for Manual Therapists (Lippincott Williams & Wilkins, 2009). Contact her at functionalbook@hotmail.com. Christy Cael is a licensed massage 88 massage & bodywork january/february 2011