Why do a push up? Well, it's simple, portable, and stresses multiple body parts. You develop strength in the arms, trunk, neck, and lower back.
But, push ups, like any exercise, can can help you or hurt you depending on how you do them.
To perform a push up properly:
- Assume a hands and knees position on the floor with your hands aligned beneath and just outside your shoulders; fingers pointing straight ahead.
- Get up on your toes with your feet together; knees straight; hips in line with the trunk and knees.
- Look at the floor but keep your head in a straight line with your trunk, hips, and legs.
- Brace the abdomen as if you're about to get punched and hold the brace through the drill.
-
Lower your self to the floor.
- Keep your elbows from moving past a 45 degree angle to your trunk.
- Stop the motion when your upper arm is even with the side of your chest (the drawing shows the elbows past the chest which in my opinion is too far; the head is also sagging too much).
-
Push your self back to the starting position - that is one repetition.
-
Repeat until
- You cannot maintain the form or,
- You cannot complete a repetition.
Form failure is common. If you allow the elbows to flare out form the
side, the push up becomes
easier but the stress on your shoulder joint
goes up. If the exercise is too hard, you'll either allow your trunk
to
sag between
your arms or you'll drop your head toward the floor or your lower back
will sag (picture at the right has all three). Many trainers teach that you should touch your chest to the
floor but, for most people, this places the humerus into extension
under significant load and provides an unnecessary risk of injury to
the shoulder.
Another biomechanical fault, but one you can't see your self, is a winging scapula. You may be able to hold the head, trunk, hips and knees in a straight line but the scapula could still be tilted off the chest wall. When this happens, the scapula also tilts anteriorly and increases the risk of impingement in the subacromial space.
The push up uses about 70% of your body weight as resistance and I think that until you can do at least 30, there's no need to do things like bench presses (and I question the value of it at all). A push up forces you to control more of your body and is plenty of load.
If you can't do a push up or can't do very many, start at an incline (e.g. on stairs). Find the angle where you can perform 15 repetitions. Do three sets of these every other day until you feel that 15 has become only moderately difficult (and you'll know this because you won't scrunch up your face or make noises). Then, lower your self down a step. Repeat this until you get all the way to the floor.
I've also used a Total Gym (the newer models have handles on the side of the sliding board) to reduce the push up load. I like the position - hands are under the shoulders; wrists are neutral; elbows tend to not flare out to the side. I helped a friend go from 0 push ups on the floor to 10 in under six weeks using the Total Gym.
How many should you do? Well, that depends on your age and gender. I'm 52 and to place in the 90th percentile, I should be able to do 30 push ups; women should be able to do 25 modified push ups (on the knees instead of the toes). So, if you're younger, shoot for 40 or 50; older aim for 20 to 25.
And, what about speed? Some people claim you should perform push ups slowly (4 seconds down and eight seconds up for exmple). I don't know of any evidence that says a slow push up is any better than a faster push up. I prefer to use a "fast as you can" approach which means speed without sacrificing form.
CONSIDERATIONS
The wrist:
- I also like to use push up stands to place the wrists in a more neutral position. Most joints don't like to be stressed repeatedly at the end of range which is what push ups ask the wrist to do. Mid-range is less stressful.
The elbow:
- Hand positions that use internal rotation of the shoulder will create much higher forces in the elbow and should be avoided.
The cervical spine:
- Degenerative joint and / or disc disease of the cervical spine can be aggravated by the loads created in the cervical spine during a push up. The force of gravity wants to pull the head into flexion which is actually a rotary force. Your cervical muscles combat this rotation which increases stress on the cervical spine joints. And, the levator scapula muscle, which arises from the cervical spine, assists in abducting the scapula but to do this, it uses the cervical spine as a base from which to pull the scapula. This creates increased pressure in the neck and may create neck pain.
The shoulder:
- For people who have a history of multi-directional instability of the shoulder or posterior impingement, push ups can create too much posteriorly directed force in the glenohumeral joint. Make sure that the scapula is well positioned and that there's no sign of the humerus migrating posteriorly during the push up.
