Serratus Anterior Strength Test or ( Punch out test )

Original Editor - Anas Mohamed
Top Contributors - Anas Mohamed, Kim Jackson and Amanda Ager

Purpose

Serratus Anterior Strength Test or Push Out Test is used to examine the serratus anterior muscle weakness and scapula winging.

Technique

Step1. Patient in standing or sitting position.

Step2. Ask the patient forward flexing of arm 90 degree.

Step3. Therapist apply backward pressure to the arm.

Step4. Winging of scapula at medial border shows positive sign. This happens when serratus anterior is weak or paralysed.

Step5. This test also can be done by asking patient to do wall push up and for more harder ask patient to do regular floor push up.

The patient also has difficulty abducting or forward flexing the arm above 90° with a weak serratus anterior, but it still may be possible with lower trapezius compensation.[1]


References

  1. David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
  1. David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
  2. Scapular Winging - Diagnosis. Dan Blewett. Available from: https://youtu.be/VJzK2wXEaQA
  3. The winging scapula and shoulder function explained | Feat. Tim Keeley | No.64 | Physio REHAB. Physio Fitness | Physio REHAB | Tim Keeley. Available from: https://youtu.be/Xp8xx1ruDug
  4. JWall Push-up Test for Serratus Anterior, Middle Trapezius, and Lower Trapezius Weakness. COR. Available from: https://youtu.be/4KcHysNGhSg