It’s most likely the first exercise you learned and the one fitness novices do almost instinctively when they try to work out. Yet the push up remains one of the most valuable and effective movements, provided you know how to use it to its fullest potential.
Although the push up is well known and commonly practiced in the world of strength training, it’s still very misunderstood and under utilized among performance and fitness professionals. In this article, you will learn how to use creative push up progressions and variations to:
- Assess and correct muscle imbalances
- Build hypertrophy
- Increase strength
- Develop torso stability
- Increase power
- Improve metabolic endurance (power endurance)
The goal of this article is to give you a new appreciation for the push up and help you to understand that it’s much more than just another “horizontal pushing” variation.
Re-thinking the Kneeling Push Up
Performing push ups on the knees is not for everyone. The issue has nothing to do with mechanics or safety. In that respect, the movement is okay. The issue is one of progression, or in this case, a lack thereof.
In the past, the kneeling push up was used as a regression strategy in the hopes that it would eventually lead into normal push ups. Unfortunately, there has been little to no carry over from the kneeling push up to the regular push up. The reasons for this include lever arm length, angle difference, etc. I personally have seen hundreds of people perform endless reps of kneeling push ups but still couldn’t even come close to performing a single regular push up. For this reason, the kneeling push up is what I call a “dead end” exercise. Keep doing them, and you will go nowhere!
Luckily, there is a much better regression/progression strategy when it comes to push ups.
Incline Push Ups
The concept here is pretty simple. Because you are at an incline, there’s less force on the moving muscles and torso stabilizers, which makes the push up easier to perform.
The best place to do this is on a Smith machine because it’s simple to adjust and easy to keep track of the bar depth from session to session.
Once someone can perform 20 quality reps at one height, simply lower the bar one or two pegs. The lower the bar gets, the harder the push up becomes.
As mentioned earlier, just because your client can easily perform kneeling push ups doesn’t necessarily mean she can do any real push ups. However, if someone can perform 20 reps at a low bar setting, she can definitely bang out a few good reps from the floor.
Simple Solutions to Complex Problems
Over my years as a performance coach, I have performed thousands of postural/movement assessments. In doing so, I have successfully used push ups as both an assessment tool and as a corrective exercise. Here are the two most common movement flaws I’ve seen during the push up and simple ways to correct them.
Common Flaw #1 - Faulty Spinal Alignment
This type of flaw is very common and normally caused by a lack of general body awareness, torso strength and postural stability.
Faulty spinal alignment can appear as:
- Sagging head
- Sagging back (lordosis)
- Hunching back (kyphosis)
- Any combination of the above
In some cases, people will begin with ideal alignment and gradually lose alignment as the exercise progresses and fatigue sets in. In other cases, they will start out right away with poor alignment. Regardless of when the fault happens, this is a muscle imbalance that needs to be corrected!
The imbalance I’m referring to is that the mover muscles (chest, shoulders, triceps, etc.) involved in pushing the body away from the floor are stronger and posses more endurance than the spinal stabilizer muscles that are responsible for maintaining ideal alignment. In other words, you’re unable to control the movement and force that you can create. This can put you on the fast track to injury.
It’s for this reason that I usually do a max rep test on the push up during my performance assessments. This allows me to see if an athlete’s stabilizers give out before his prime movers.
The solution to this alignment problem lies with a very high tech piece of gym equipment: a dowel rod. There is a three step progression we use to correct faulty spinal alignment issues using the dowel rod.
Step 1 - Build Awareness
This quadruped position shortens the lever arm (bent legs) and takes most of the load off the system while still keeping the torso and arms in a very similar position to the push up. The dowel is placed along the spine and is kept in contact with three points: the back of the head (not the top), thoracic region (between shoulder blades) and sacrum (tail bone). This forces you to understand and become aware of proper alignment.
Step 2 - Static Control
The elbow plank takes what was learned in step one and lengthens the lever arm (straight legs). This increases postural stability and endurance in a manner necessary to perform the push up successfully. We try to progress everyone to be able to maintain this position for at least one minute without deviation. The hold time we choose for each individual is usually double the number in seconds of their max push up reps. For example, if your rep max is 30 push ups, then you should be able to hold the elbow plank for 60 seconds. We use this standard because the average push up is performed at a 1-1 tempo, which translates into each rep taking two seconds. At 30 reps, that would take 60 seconds.
Step 3 - Dynamic Control
Once awareness is created and strength/endurance is built, the final step is to integrate both components into the actual movement itself (in this case, the push up).
The dowel push up is much more challenging than it looks because so much effort is dedicated to maintaining alignment. Eventually, as your postural endurance improves, this push up will become easier.
We try to get everyone to achieve the same rep max with the dowel rod as without it. Once you can do this, the dowel is no longer needed.
A few additional notes on the above progression:
- During all three progressions, the dowel should remain in contact with the back of the head, T-spine and sacrum.
- Begin with neutral spinal alignment, and stop the exercises when spinal curvatures change or the dowel falls.
- The worse your alignment is, the harder these exercises will be, and the longer it will take to progress through them.
- Use a mirror at floor level to help with visual feedback, body position and awareness.
- In the case of a hunch back (kyphosis), I recommend you perform some additional anterior abdominal stretches because the rectus abdominals is most likely overactive.
Common Flaw #2 - Scapular Winging
Scapular winging can be much more complicated than the previous flaw and therefore may be beyond the scope of even the most experienced trainer or coach. However, there are some cases in which a few simple, well designed corrective exercises are all you need.
In order for you to understand how to successfully address a winged scapula, you must first understand what it is you’re dealing with. A winged scapula is a shoulder condition in which the scapula (shoulder blade) sticks out at the back, particularly when performing pushing exercises like the push up. Common symptoms of a winged scapula include the following:
- Pain and limited shoulder elevation
- Difficulty in lifting weights
- Pressure on the scapular from a chair when sitting
A winged scapula can be caused by one of two reasons:
- Damage to the long thoracic nerve of the shoulder. If the long thoracic nerve is damaged or bruised, it can cause paralysis of the serratus anterior. Damage to the nerve can be caused by a contusion or blunt trauma of the shoulder, traction of the neck and can also sometimes follow a severe illness. In this case, I would highly recommend consulting a skilled orthopedic professional before engaging in any exercise or sporting activities.
- General weakness in the serratus anterior muscle. In this case, the winging scapula can be improved with some specialized exercises designed to build strength in the weak serratus anterior muscle.
There are a few corrective exercises shown below. Important note: If you’re dealing with a winged scapula and are unsure of its causative source, I recommend playing it safe and getting an evaluation from a skilled professional. As they say, “It’s better to be safe than sorry.”
There are three exercises you can use to help correct and prevent scapular winging through strengthening the serratus anterior muscle. During all three movements, careful attention should be paid to scapulohumeral rhythm and symmetry. Also, effort should be made to maintain a stable pelvis and neck.
Each of these exercises achieves essentially the same thing. However, it’s important to utilize a variety of methods in order to find what is best for the specific situation or individual.
1. Hand Walks
The pattern is one hand up, next hand up, one hand down, other hand down, repeat. Adjust the height of the box for added difficulty.
2. Arm Shuffle
Begin with your hands very wide. Shift your weight back and forth while simultaneously touching one hand on top of the other as shown.
3. Push Up Plus
Once you have completed a standard style push up, add the “plus” motion by protracting your scapula as much as possible without changing your spinal alignment. This can be difficult for some people to dis-associate their scapula from the rest of their body. When performing the push up plus, we like the hands to be no wider than the shoulders. Sometime I will even keep the hands together (thumbs touching). This allows for increased ROM and increased demand on the serratus muscle.
Each of the above exercises is normally performed for a timeframe of 20 seconds to one minute.
Now that we have effectively set the stage for building and rebuilding the push up, the next article in this series will look at how the push up can be incorporated to help build hypertrophy, strength, power, power/endurance and torso stability.