Press-Up

Original Editor - Lilian Ashraf Top Contributors - Lilian Ashraf, Daan Vandebriel, Wanda van Niekerk and Kim Jackson

Description

The press-up or the push-up exercise is a very popular exercise used in upper extremity training. It is a closed kinetic chain exercise that requires no tools and uses the body weight for resistance. It has many variations, so it can be adjusted according to the fitness level. The muscles it primary targets are the pectoralis major, tricpes brachii and scapula stabilizers.[1]

Execution of conventional push-up

From a prone position, the hands are placed under the shoulders with the elbows extended. Keeping the back and legs straight with the toes touching the ground.

The body is lowered until the upper arm is parallel to the ground.

Then reverse the movement and raise the body until arm is extended.[1] 

Classic-push-up push-up-variations.jpg

Muscle Activation

Primary involved muscles:

Pectoralis major, triceps brachii, anterior deltoid and scapular stabilizing muscles.

Other involved muscles:

Core muscles and muscle of the anterior shoulder[1][2]

Significance

Push-up exercise is a close chain kinetic exercise which improves the joint proprioception, joint stability and muscle co-activation around the shoulder joint.[3]

The push-up exercise can be used in shoulder rehabilitation as it strengths the muscles around the shoulder, performing the push-up exercise with a push up bar increases the activation of shoulder stabilization muscles more than doing it on a flat surface.[4]

Push-ups strengthen the core muscles, mainly the rectus abdominus and transversus abdominis.[5]

Push-ups activate a large number of muscles together, increasing the demand on the heart muscle and the respiratory rate. Also, push-ups increase the metabolic rate so they can help with weight loss.[5]

Push-up exercise could be used as a cheap and fast method for the assessment of individual’s functional capacity. A study by Justin Yang et al, concluded that participants who could perform more than 40 push-ups had lower risk of cardiovascular diseases than participants who could do less than 10 push-ups, this study was done on active adult men.[6]

Variations

There are many variations of the push-up exercise, each targeting different muscles groups, including:

The push-up with the torso elevated is good for beginners, which could be progressed by bringing the body closer to the ground . The push-up with the feet elevated uses a greater percentage of the body weight so it is used for more advanced levels in training.[7]

Narrow palmer width increased muscles activity of the pectoralis major and minor, triceps brachii and infraspinatus while wide palmer width increased the muscles activity of the serratus anterior which is an important in scapular stability.[8]

The backward and forward push-ups should be performed with caution as they increase the activity of the back and abdominal muscles, increasing the intervertebral joint compressive forces.[9] 

Push-up exercise on an unstable surface increased the activation of the serratus anteiror muscle but not all unstable devices increase the muscle activity compared to conventional push-up. The use of suspension device increased the muscle activity of serratus anterior, lumbrar multifidus and rectus femoris compared to other unstable devices.[2]

The push-up plus exercise is a modification of the conventional push-up exercise, where maximal scapular protraction is performed at the end of elbow extension. It can correct the scapular kinematics as it produces high muscular activity of the serratus anterior and low muscular activity of the upper trapezius, on the other hand scapular protraction decreases the subacromial space which can increase the risk for impingement of the rotator cuff tendons.[10]

The serratus muscle activity increases in the push up plus exercise as the leg angle increases (by raising the foot platform).[11]

References

  1. 1.0 1.1 1.2 Chulvi‐Medrano I, Martínez‐Ballester E, Masiá‐Tortosa L. COMPARISON OF THE EFFECTS OF AN EIGHT‐WEEK PUSH‐UP PROGRAM USING STABLE VERSUS UNSTABLE SURFACES. International journal of sports physical therapy. 2012 Dec;7(6):586.
  2. 2.0 2.1 Borreani S, Calatayud J, Colado JC, Moya-Nájera D, Triplett NT, Martin F. Muscle activation during push-ups performed under stable and unstable conditions. Journal of Exercise Science & Fitness. 2015 Dec 1;13(2):94-8.
  3. Uhl TL, Carver TJ, Mattacola CG, Mair SD, Nitz AJ. Shoulder musculature activation during upper extremity weight-bearing exercise. Journal of Orthopaedic & Sports Physical Therapy. 2003 Mar;33(3):109-17.
  4. Jung J, Cho W. Effects of push-up exercise on shoulder stabilizer muscle activation according to the grip thickness of the push-up bar. Journal of physical therapy science. 2015;27(9):2995-7.
  5. 5.0 5.1 Azeem K. The Push-Up. International Journal of Fitness, Health, Physical Education & Iron Games,(2). 2015 Jan;1.
  6. Yang J, Christophi CA, Farioli A, Baur DM, Moffatt S, Zollinger TW, Kales SN. Association between push-up exercise capacity and future cardiovascular events among active adult men. JAMA network open. 2019 Feb 1;2(2):e188341-.
  7. Contreras B, Schoenfeld B, Mike J, Tiryaki-Sonmez G, Cronin J, Vaino E. The biomechanics of the push-up: Implications for resistance training programs. Strength & Conditioning Journal. 2012 Oct 1;34(5):41-6.
  8. Kim YS, Kim DY, Ha MS. Effect of the push-up exercise at different palmar width on muscle activities. Journal of physical therapy science. 2016;28(2):446-9.
  9. Marcolin G, Petrone N, Moro T, Battaglia G, Bianco A, Paoli A. Selective activation of shoulder, trunk, and arm muscles: a comparative analysis of different push-up variants. Journal of athletic training. 2015 Nov;50(11):1126-32.
  10. Lunden JB, Braman JP, LaPrade RF, Ludewig PM. Shoulder kinematics during the wall push-up plus exercise. Journal of shoulder and elbow surgery. 2010 Mar 1;19(2):216-23.
  11. Lee S, Kim J. The effect of leg angle during push-up plus exercise on shoulder stabilization muscle activity. Journal of physical therapy science. 2019;31(1):33-5.