Just about everyone has some sort of experience with the standard push-up. Some of us may even have nightmares from high school gym class and not being able to perform enough of these to meet the minimum for an “average fitness” rating. Some of us may even adore this exercise and think we have it mastered. Let’s take a deeper look at the push-up, the muscles involved, and creative ways to progress, regress, and partner up to breathe new life into this move.
Muscles of the Push-up
The standard push-up incorporates the whole body, though motion only occurs at the wrist, elbow, and shoulder joints. The main upper body muscles targeted in the exercise for movement and stabilization include the pectoralis major, anterior deltoid, rhomboids, trapezius, coracobrachialis, serratus anterior, biceps, and triceps (1-3). But the muscle involvement continues through the core as the abdominal and back muscles work together to maintain spinal stiffness, the glutes and quads engage to keep the hips and knees straight, and even the calf muscles are active in this move (2-4).
The push-up encompasses the foundational qualities of the plank and the upper body strength needed for the bench press. Push-ups can be used to measure upper body muscular endurance and a variation, the Davies Test, can be used to measure upper body agility and stabilization (1). But what happens when your client can’t perform even one push-up with proper form? The move can be regressed to an on the knees position, or even the placement of the hands on a higher surface such as a bench, counter, or wall (1). Using these regressed variations can still show how much progress they are making in their training programs, even if they can’t yet do proper push-ups. Keep notes of the variation you made to the initial assessment so that when it is time to reassess you use the same protocol and can share the gains they have made.
Push-ups and OPT™
The push-up is a great exercise to show the versatility of NASM’s Optimum Performance Training™ (OPT™) model. When using the push-up during the stabilization level, you can incorporate an unstable surface into the move (once the client can properly perform the standard push-up on a stable surface). Whether it’s a stability ball (figure 1.1), medicine ball, suspension trainer, BOSU, Core-Tex, or any other stability challenging modality, this new stimulus requires the body to recruit more muscles to stabilize it (1). Changing up the equipment is not the only option; remember that decreasing the contact points (e.g., raising one leg) also adds elements of instability as does working in more than one plane of motion (e.g., pulling a knee up and out toward the same side elbow for frontal plane, or up and in toward the opposite elbow to target the transverse plane) (1).
During the strength level of the OPT model, the unstable push-up variations can be partnered with other strength moves that target the prime movers of the chest such as a barbell or dumbbell chest press in a superset format. Another superset option is to partner the push-up with the antagonist muscle group by alternating with row variations. For example, consider a combined move of performing a push-up with the hands on dumbbells (or kettlebells) followed by single arm rows in a plank position (push-up, right arm row, left arm row, repeat for 12 repetitions, figures 1.2-3). Taking the push-up to the power level, there are plyometric push-ups, or even a burpee with a push-up in the sequence.
What’s so Fun About the Push-up?
Besides the versatility of the exercise, the push-up is perfect for play. Clients can roll medicine balls between their hands each rep or drag a ViPR across the floor under their chest while doing lateral moving push-ups. During group personal training sessions, have participants partner up, nearly head-to-head and high-five after each push-up (have them yell out the rep they're completing for a little friendly group competition and encouragement!). Spread further apart and incorporate rolling a medicine ball back and forth to each other between moves (switch to a side-by-side partner placement and roll the ball to the side). Even the wheelbarrow takes on many of the same movement elements of the push-up. Clients with shoulder, elbow, or wrist issues should be cautious if they choose to do push-ups and seek the advice of a medical professional when appropriate (1,5).
Use your imagination on ways to take the basic push-up to new levels, or to regress to meet the needs of clients developing foundational strength and endurance. Share your creative push-up ideas with us!
- NASM Essentials of Personal Fitness Training, 6th Edition. Burlington, MA: Jones & Bartlett Learning; 2018.
- Topalidou A, Dafopoulou G, Klepkou E, Aggeligakis J, Berkis E, Sotiropoulos, A. Biomechanical evaluation of the push-up exercise of the upper extremities from various starting points. Journal of Physical Education and Sport (JPES) March 2012;12(12):71-80.
- Long R. The Key Poses of Yoga, Volume 2. Bandha Yoga Publications; 2008.
- Howarth SJ, Beach TA, Callaghan JP. Abdominal muscles dominate contributions to vertebral joint stiffness during the push-up. J Appl Biomech May 2008;24(2):130-9.
- Lou S, Lin CJ, Chou PH, Shou YL, Su FC. Elbow load during pushup at various forearm rotations. Clin Biomech June 2001;16(5):408-14.