Serratus Posterior Inferior

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The Serratus Posterior Inferior is a muscle of the thoracic region of the back.

Anatomical Attachments:

• Origin: Attaches to the spinous processes of T11 and T12, L1, L2 and L3 and the supraspinal ligament.
• Insertion: Attaches to the secondary margin of the lower 4 ribs just medial to their angles.

Action: Stabilizes the lower ribs and pulls them inferior and posterior, acting in expiration.

Synergist: Iliocostalis and Longissimus thoracis, Quadratus lumborum.

Nerve Supply: Anterior primary rami of T10, T11, and T12.

Vascular supply: Posterior intercostal arteries.

• Primary: The pain referral stretches across the back and over the inferior ribs, with a spillover referring over and around the muscle.
• Satellite or associated triggers: Iliocostalis, Longissimus thoracis.

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Trigger Point Signs and Symptoms: Persistent deep aching in inferior thoracic region of the back.

Trigger Point Activating and Perpetuating Factors: Hyperextension of the spine with persistent abduction of the arms, leg length inequality, Scoliosis.

Differential Diagnosis: (Segmental, Subluxation, Somatic dysfunction) T10 T11 or T12 radiculopathy, Thoracic spine Hyperkyphosis, Scoliosis, Rib Subluxation/Dislocation, Slipping rib syndrome, Costochondritis, Sprain/Strain syndrome of the mid-back, Caliectasis, Pyelonephritis, Ureteral reflux, Renal calculi (Kidney stones), Kidney infection, Renal cancer, Polymyalgia rheumatica, Fibromyalgia, Polymyositis, Systemic lupus erythematosus, Ankylosing spondylitis, Osteoarthritis, Osteoporosis, Herpes Zoster (Shingles), Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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