The Push-Up is one of the most basic and well-known exercises around, and would certainly belong in the ‘Annals of Fitness’ if there was such a thing. It is also, however, the exercise that I see done incorrectly the most often.
It seems so simple- and it is- but it does require a significant amount of upper body strength and core/lumbar strength and stability in order to be executed properly and safely. If one lacks the required strength to perform a traditional push-up, a modification should be used instead, as performing a push-up consistently incorrectly can lead to or exacerbate musculoskeletal injury.
So, let’s break the movement down, step-by-step, determine if modification is needed, and learn how to perform the perfect push-up!
Step 1: Determine if you can properly perform a Prone Elbow Plank for 30 seconds. This exercise is a good measurement and indicator of core musculature and lumbar stability. If you are able to perform this exercise with proper form- neutral head position; elbows directly under shoulders; head, shoulders, hips, and ankles all lined up straight and square to the floor; flat lower back rather than arched- without pain, then you likely have the core strength necessary to perform a traditional push-up- proceed to Step 2. If not, skip to Modification 1 at the bottom of this page.
Step 2: Establish proper hand position. Imagine you have to push something really heavy- like a car. How would you position your arms? Probably not at a right angle relative to your torso; but, rather, at a 45 degree angle with the elbows in closer proximity to your ribcage. Not only will you be able to generate more force in this position, but your shoulders will be in a more stable position as well, which will reduce the risk of injury. So, hands should be placed slightly outside of shoulder width, with fingers pointing straight up towards top of head.
Step 3: Establish proper foot/leg position. We gain lumbar spine stability by, among other things, using the powerful muscles of the hips (which I will refer to as the glutes). During a traditional push-up, we are better able to engage the glutes and maintain core stability when our feet touching versus in a wide foot stance. So, walk the feet back, elevating your hips and knees off the floor. Place feet in contact with one another, then fully extend knees and hips, consciously contracting the glutes, thus producing a stiff cylinder from the shoulders to the ankles. Imagine that a small child could stand on your hips, and the rigidity accomplished by your body position and muscle activation would prevent your hips from dipping downward toward the floor. In this position, your lower back should be flat, rather than arched. You should seek to maintain this ‘rigidity’ for the duration of the set of push-ups.
Step 4: Head position- make a double chin. I know this is not an attractive thing to think about, but tucking the chin back will pull the shoulder back as well and thrust the chest forward. This position should be maintained throughout the set. One of THE biggest errors I see with the performance of push-ups is that people reach toward the floor with their head in order to shorten the distance of the movement. This practice when repeated can lead to neck strain and discomfort. Keep that chin tucked and imagine lowering your sternum to the floor, not your face.
Step 5: Begin the movement! Flex the elbows and shoulders, lowering chest to floor. As referenced in Step 2, while descending the upper arms should maintain a (roughly) 45-degree angle to the torso. Keep the shoulder blades retracted throughout, and imagine driving both shoulder blades down and inward toward your tailbone. In order to be effective as an exercise, the pectoral muscles should be stretched under load- use this as a guide for range of motion. While going all the way to the floor is best, be sure to at least descend low enough so that chest moves below the level of the elbows.
As if all of this in not enough to think about, be sure core/hip stability is maintained throughout the movement. The hips should fall and rise in sequence with the chest. Remember- by engaging your glutes and lumbar spine stabilizers you have created a rigid cylinder, not a wet spaghetti noodle!
Step 6: Return to reset position. At the top of the movement, do not let your shoulder blades protract (move away from the spine); but rather maintain retraction (shoulder blades pulled in close to the spine). Repeat for desired number of reps, always maintaining quality over quantity. Once you are able to perform 20-30 traditional push-ups with good technique, consider progressing to a more difficult push-up variation:
*Modification 1- The problem with the ‘modified push-up’ (formerly known as the girl push-up) is that is does not encourage the learning/training of proper core and hip stabilization. It does ‘unload’ the push-up, as a lower percentage of body weight is being moved. However, an alternative modification both unloads the traditional push-up and utilizes core and hip stability- I call this the ‘upper-body elevated push-up.’ Find a stable bar or a bench on which to place your hands. You will then set up for the push up just as described above starting in Step 2. The exception- rather than lowering your chest to the floor, you will lower your sternum to the bar or bench. Adjust foot position as needed to encourage alignment of sternum to bar at bottom of movement. As a guide, the more elevated the upper body is, the easier the exercise will be; the less elevated, the more difficult. As this modification becomes easier and you become stronger, lower the bar progressively until eventually you are on the floor doing the traditional push-up!