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Push ups. Everybody knows what they are. You probably did them in gym class. Soldiers
do them in basic training. Moms do them in exercise classes. Theyre used by exercise
physiologists to gauge muscular endurance, and drill instructors use them for punishment. Think
Richard Gere in An Officer and a Gentleman doing push ups in the rain with Lou Gossett Jr.
glowering over him. Or Demi Moore in GI Jane wowing us with one arm push ups. How about
Ralph Macchio in the Karate Kid building himself up to fight the bully. And, of course,
Sylvester Stallones old school, boxing training in Rocky. My favorite will always be Jack
Palance grinding them out at the Oscars.
More than any other exercise.. even probably more complete ones such as squats,
deadlifts, or chin ups..push ups are the most widely known and performed exercise of all. One
obvious reason for this is the only equipment you need is the ground; you can do them anywhere,
inside or out. Another is that they can be modified to be made easier to perform, so theyre
accessible to beginning exercisers and seniors. An interesting and specific benefit to seniors
citizens is the push ups application in regards to injuries from falling. In a March 11, 2008
article; An Enduring Measure of Fitness: The Simple Push Up, by Tara Parker Pope, Dr. James
Ashton-Miller, director of the biomechanics research laboratory at the University of Michigan,
discusses this connection. What so many people really need to do is develop enough strength so
they can break a fall safely without hitting their head on the ground. If you cant do a single
push-up, its going to be difficult to resist that kind of loading on your wrists in a fall. The
article also states that Researchers who study the biomechanics of aging, for instance, note that
push-ups can provide the strength and muscle memory to reach out and break a fall. When
people fall forward, they typically reach out to catch themselves, ending in a move that mimics
the push-up. The hands hit the ground, the wrists and arms absorb much of the impact, and the
elbows bend slightly to reduce the force. These are really interesting implications connecting
the benefits of push ups to the aging process.
Another definite plus with the push up is you dont need a spotter or have to worry about
getting stuck under a bar. And if you fall, well..youre already on the ground! Possible
drawbacks to the push up? Unlike a deadlift, which works the hips and thighs and muscles in the
back, trunk and forearms, most of the work during push ups is by some upper body muscles and
trunk stabilizers. Lets get a reasonably fit person, theres not much active work for going
on in the leg muscles . Many bikers and runners will supplement their endurance training with
sets of push ups and feel that they dont need to do any other strength training, not realizing that
their leg strength and flexibility is poor.
A potential problem with push ups is that as you become stronger, the number of
repetitions and sets usually go up too, and repetitive/overuse type of injuries can occur. The most
common are wrist pains and shoulder soreness. Unlike a bench press where the forearms are in a
straight line to the bar, during a pushup the hands are flat on the ground which forces the wrists
to bend at a 90 degree angle. Over time, this can compress and irritate tendons and nerves.
Shoulder soreness can occur because the deep, smaller rotator cuff muscles which stabilize the
shoulder capsule during push ups are weak, and they become overloaded and inflamed from too
much work. Both these conditions can be addressed, the wrists by using push up handles which
are gripped like a bar, and allow you to keep your wrists in a straight line. Theyre inexpensive
and can be bought in sporting goods stores. Hexagon, flat-sided dumbells can also be used in the
same way. With the shoulders, whats needed is specific work for the rotator cuff

muscles..particularly the external rotators. But regardless of these issues, the push up is a
valuable and productive exercise for developing upper body and core strength.
In this article Ill briefly describe the muscles involved while doing push ups, followed
by some challenging variations of the standard push up for the intermediate and advanced
trainee. By using equipment such as medicine balls, stability balls, dumbells and lengths of
chain, push ups can be transformed from a high rep, endurance type exercise, to a high intensity
movement that builds muscle and fits into the most advanced weight training program.
The push up variations discussed in this article are stability ball push ups, chain push ups,
asymmetrical medicine ball push ups, alternate twist push ups, and boxers push ups.
There are many types of push ups, each kind emphasizing specific muscular and athletic
demands. But all share similar joint actions and muscles being worked. The largest muscles
involved are the pectorals and deltoids (chest and shoulders), which adduct and flex the upper
arms at the shoulder joint (pull the arms across, and up to the front). The serratus anterior
muscles (deep muscles in the ribcage), abduct the scapulae (pull the shoulder blades towards the
ribcage, as when punching). And the triceps extend the elbows (straighten the arms). These four
muscle groups are illustrated below. Other muscles involved during a push up are the rotator
cuff, mid-back, forearms, with hip and midsection muscles acting as stabilizers.


An interesting way to increase the intensity of push ups is to create added stress for the
stabilizing muscles, along with the prime movers. Stability ball push ups adds the element of instability to a push up, which creates more work for the smaller, deep muscles of the rotator cuff.

And since maintaining balance and correct posture becomes a challenge, the core muscles
of the trunk and hips really work hard. Ive also found that holding onto the sides of an unstable
ball while doing push ups, squeezing the ball to keep it steady, creates added work for the
pectorals. Make sure the stability ball is properly inflated, your hands shouldnt sink into it. Set
up like a regular push up; hands slightly wider than shoulders and under the chest. To decrease
stress on the wrists, externally rotate the hands, turning them so the thumbs point forward. A good
way to get a feel for this exercise is to start with the ball braced against a wall or something
underneath to hold it in place. This will reduce some of wobble, giving you time to adapt to the
movement. Once you can achieve 12-15 slow, solid repetitions, move the ball away from the wall
and try the exercise free standing. As with other kinds of push ups, you can work towards doing
them with your feet elevated on a bench or chair. This tilts more of your body weight forward,
making the exercise harder. Tapping into the muscles that make up your core is especially
important in this push up; be mindful in keeping your abs and butt muscles contracted throughout.


Chain push ups are an interesting and really challenging variation to the standard push
up. First off, they most closely replicate a conventional weight training exercise, the dumbell
bench press. And because youre suspended at the ends of two freely moving lengths of chain,
your hands and arms can move in towards each other as you extend upwards. This also allows
you to find a comfortable working angle for the elbows and shoulders. To do this exercise youll
need two lengths of sturdy chain, each exactly 4 feet long, and access to a Smith machine or squat
rack. You can buy the chain, and have it cut for you, at a local hardware store. Make sure to count
the number of links in each chain to ensure both chains are exactly the same size. Also, pick up 2
carabineers (those teardrop shaped, spring loaded clips). These are used to attach cable/pulley
handles to the ends of the chains. All this will cost you around 15 bucks..and its well worth it.
Set the bar in the Smith machine to about waist height, and loop both chains around the bar, a bit

wider than shoulder width apart. Now both chains are hanging down about 2 feet from the bar.
Attach a pulley handle to the ends of each chain, with both handles hanging down under the bar.
Adjust the height of the bar so the handles are suspended a couple of inches off the ground, and
spaced apart at a width slightly wider than your shoulders. Grasp the handles and walk your feet
back until your legs are straight, and handles are even with your chest. As when doing regular
pushups, make sure to keep your back straight, with the abdominal and hip muscles tightly
contracted. Right away, before you even do the first rep, youll feel the muscles throughout your
torso and shoulders working to stabilize and hold you steady. Slowly lower yourself until your
chest is between the handles, then powerfully press back up until arms are fully extended. Keep
your wrists in a straight line. At the bottom position your hands will be directly under your
elbows, at the top position they will be under your shoulders. Advanced progressions for this
exercise is to do them with one leg extended back and off the ground, or the feet up on a bench or
chair..or a stability ball if youre able to.


Like the previous two variations, AMB push ups add the element of instability to a push
up. Whats different about them is the uneven plane that youre working on by doing a push up
with one hand flat on the floor and the other on top of a weighted medicine ball. Start the exercise
in standard push up position; feet slightly apart, back and head in a straight, neutral position.
Hands are positioned slightly wider than shoulder width apart, one on the floor and the other on
top of the ball. In this top position, be sure to keep your back and torso level to the ground, not
twisted with one shoulder higher than the other. This means that the arm thats on the ball side
will be slightly bent at the elbow. Now lower yourself until your chest reaches the height of the
top of the ball, then slowly press yourself back up until your arm thats over the floor-side of the
push up is straightened completely. The other arm remains slightly bent at the top position. The

added stress in this exercise comes from the muscles on the working, ball-side of the upper
body being overloaded due to the shakiness of the ball combined with the elbow never being fully
extended (locked out); the tension is continually on the chest and shoulder muscles. You can do
each side separately, working to fatigue on one set, then switching the ball to the other hand after
a rest period. Or you can do one whole set without a rest between sides. If you do this, make sure
to stop well short of muscular failure on the first side or the workload will be uneven. The
strength progressions for AMB push ups can start with doing them from the knees, with feet
crossed up and behind. Next would be with legs extended straight, military style. Advanced
versions would be to use one leg, with the other lifted off the this case, remember to
switch legs during or between sets. And, of course, placing the feet up on a bench or chair during
the exercise.


Alternate twist (AT) push ups dont require any equipment, morphing a push up into a
yoga-like, postural exercise. Start by getting into a standard position with the body straight, hands
and feet at about shoulder width. Perform one push up, lowering chest between the hands then
pressing back to the top. As you straighten your elbows, begin to shift weight to your right
shoulder and lift your left hand off the ground while twisting your hips and torso. Keep on the
balls of your feet while rotating at the hips and waist until your left hand is straight above you,
fingertips pointing to the ceiling. Keep your neck in a straight, neutral position, with your head
looking to your left. Be mindful of your midsection being tight throughout, with your ribcage
lifted. Keep your right elbow locked out straight. Pause for a second, then return back to the
upright, top position for the next push up. At the top repeat the movement, this time lifting the
right arm off the ground. In performing the AT push ups, I like to emphasize posture and
breathing. Visualize reaching high at the top, being fully extended throughout the torso and limbs.
Take deep, full inhalations through the nose and exhale out of the mouth. To make this exercise
more difficult, you can hold the top, extended position for a period of time. Another way to
increase the intensity and build strength is to perform AT push ups with a dumbell in each hand.
Again, adding weight to the exercise should not come at the expense of sloppy technique.
Because of the twisting nature of this movement, it might be harmful to someone with a lumbar

disc injury. Be sure, as with all the exercises in this article, that you dont experience any pain
outside of the healthy muscular burning and fatigue thats present during intense exercise.


The last push up variation is the boxer push up. These will start in a standard push up position,
but with one big difference. Instead of the hands being opened flat on the ground, boxer-style
push ups are done with the hands held in a tight fist position with bodyweight evenly distributed
along the knuckles and tops of each hand. The benefit to fighters is obvious; over time the
knuckles and punching surface of the hands become toughened and de-sensitized. Also, because
the wrists are held in a tight, straightened position, the forearm muscles get extra work. For
anyone involved in a combat sport, these are valuable benefits. The technique as you perform a
boxer push up will also be a bit different. Hand position is a bit narrower than with a regular push
up, spaced directly under the shoulders, with the palm-side of the fists facing each other. As you
lower to bottom position, keep your elbows into the sides of your body, close to the ribs. Pause a
couple of inches off the ground and extend up to the top position. By keeping the elbows close to
the body the workload shifts from the pectorals to the shoulder (anterior deltoid) and triceps
muscles. An additional element can be added to provide extra work for the serratus anterior
muscles, which are important in punching and pushing movements. Upon reaching the top of the
push up, extend the shoulder blades up and out, rounding the top of the back while lifting the
shoulders. Visualize pushing the hands down through the floor. Keep your spine straight and
abdominals tightly contracted, only the upper back is pushing out of its standard, straightened
position. This powerful rounding movement against the weight of the body puts added emphasis
on the deep ribcage muscles. A is painful on the knuckles doing boxer push ups on a
hard surface. If you want the muscular benefits from doing this exercise without needing to
toughen the hands, you can use a folded up towel under the fists or wear padded lifting gloves.

As important as all the physical benefits Ive discussed, and often overlooked, is the
psychological boost you get from changing elements of your workout from time to time. Apply
the tenets of good form and common sense, and put safety at a premium, as a chronic injury will
eventually undermine the most determined trainee. Good luck !