As a Physiotherapist people often tell me that they cannot do something. Sometimes these things are general health related goals (Weight related issues, pain issues etc) but more often than not they are a specific physical task.
The reason’s why people say they cannot do things are infinitely varied. Sometimes it is weak muscles, bad genes, the simple fact that “Ive never been able to do it”, or even because of cosmic disturbances in the solar plexus leading to a misalignment in the universe (This is an accurate statement from a young service person I was working with in the UK- he later went on to pass his Black Serpent course to become a Special Forces Combat Medic). The particular exercise that this person and many many others have trouble with is the Push Up.
The Push Up Problem (In UK this is called a Press Up)
This is the first problem! Unfortunately my colleagues have convinced me (only because it is Australia Day this week) to use the Australian name for the rest of the article…but if you ask me, its still a Press Up!
So, the “push up” at first glance is a basic exercise which every human should be able to do. In face down (or prone position) you use your arms to push yourself off the ground keeping your back relatively straight. You then return yourself to the ground; Congratulations 1 rep is now complete!
Press ups are a great exercise for a few things, namely
• Arm strength
• Lower back and abdominal strength
• Shoulder and chest strength
Some of the muscles that get worked (the prime movers in this instance) with a push up are as follows
• Pectoral muscles
• Scapula protractors and retractors
• Lumbar spine extensors
• Abdominals (obliques, rectus abdominus and some transverse abdominus).
• Gluteal muscles (Glut max and some glut minimus and medius).
This exercise is not just a strength challenge though. At the same time you are moving some body parts, others need to stay stiff and still (static or what we call isometric contraction of the gluteals and abdominals is key). This is often where people have difficulty! There is no point having strong arms pushing a floppy body! To perform the exercise you need to have both good control and strength.
So a simple exercise? Yes.
An easy exercise? No.
Why can't I do a push up?
Bar massive trauma and some neurological problems that some people suffer from, I have yet to see your standard human being who doesn't hold the capacity to master the push up.
The main problems I tend to see around performing the push up are
• Poor thoracic range of movement (stiff or hunched upper back)
• Poor arm strength
• Inability to create tension through the spine and maintain a straight spine
• Gluteal weakness
All of these problems are easily corrected first through recognition of the issues and then by implementing some targeted strategies to combat the problems.
The normal first step to doing a full push up is the do knee push ups! Please don’t! Doing push ups on your knees is easily one of the worst ways to correct or improve your strength into a push up!
I have often seen people who have spent years doing knee push ups with little to no improvement. The person mentioned earlier, with the cosmic disturbance issue, had spent nearly 3 years practicing knee push ups.
So whats the problem with doing knee push ups?
In my experience there are 3 common problems:
1. More often that not the spine is held in a sagged position and due to the extra pelvic tilt you cannot use your gluteals and abs to create tension.
2. You are not loading your arms enough. By putting your knees down you are taking anywhere between 20-40% of your body weight off your arms.
3. You are not practicing the movement pattern that is needed to do a full push up- the elbows finish in a different position and you are contracting the upper leg muscles in a different sequence to a full press up.
So what can I do to improve my push ups if I can’t just put my knees down?
As mentioned earlier, you need to know why you cant do the push up in the first place. Always start by asking someone who specialises in movement analysis (and it also helps to find someone who has already got results in the issue/problem/goal you have).
You then need to implement a training program to correct the issue. At the Movement Team we don't over complicate. Some simple work over a decent period of time is often all that's needed!
There are some simple things that can be done to address the common limiting factors:
Make sure you practice the base level movement- a good start point is an inclined press up position.
Here you simply using an included object grading from
A wall- forming a wall push up
A bench- using a 45-60 degree angle to perform a push up.
Weak Ab’s or gluts
Practicing Isometric holds of the basic muscle groups that support the movement
A great exercise for this is a prone hold.
First lie on the ground face down and arms resting at 90 degrees or by your side.
With your heels together squeeze your gluts as hard as you can and also tuck your pelvis under you until your abs are tight. Hold for a minimum of 20 secs and build to 1 minute.
Poor shoulder/scapula control
4 Point Kneeling protraction and retraction.
Start on all 4’s with shoulders over wrists and knees under hips.
Lower yourself to the ground bringing your shoulder blades together. Then push up to the top pulling the shoulder blades apart. Hold the top position for 3 seconds. Again start at 30 seconds and build up to 1 minute where possible.
Push ups are a great exercise which everyone should be able to progress to doing regardless of sex and prior training levels. In learning to do them (like any other movement skill) the key point is to identify your individual weak areas and work on them until they can be used as part of the full movement.
Learning new “tricks” instead of working on your weaknesses is the sure fire path to injury.
As I often say to our strength and conditioning clients; trust the process and you will get the result. All it takes is some simple hard work and period of time.
Yanek is Physiotherapist with has 11 years of experience, across 2 countries, including invaluable experience working in the English Premier League (EPL), military rehab centres and private clinics.