Science and Push-ups

[this_dot]

The science of Push-ups​

This is not a comprehensive review of all the scientific literature about push-ups. It’s a compilation of recent articles and some others that I found interesting or that would be good for discussion.

Feel free to ask for more details!

TL;DR (edit 2)​

• close push-ups use more triceps and pecs
• fast push-ups and close push-ups are more stressful for your elbows
• close fists are less stressful for your wrists
• energy drinks pre-workout don't increase push-up max reps
• push-ups activate the same muscles as bench press, but with my core activation, and induce similar hipertrophy (with bench press at 40% of BW 40% of 1 RM)
• it's possible but rare to get injured doing push-ups

Technique​

Kim et al, 2016 assessed the difference of muscle activation using distinct palmar widths and concluded:

Pectoralis minor, triceps brachii, and infraspinatus muscle activities were greater during push-ups performed with the 50% palmar width compared with the other palmar widths. Pectoralis major muscle activity was greater during push-ups performed with the 50% and 100% palmar widths compared with the 150% palmar width. Serratus anterior muscle activity was greater during push-ups performed with the 150% palmar width compared with the other palmar widths.

A great review by Dhahbi et al, 2018 follows. They searched the literature to review all previous research on kinetic analysis of push-ups. They included 26 studies in their analysis. These are the conclusions:

• The force supported by the elbows flexed is significantly greater (8–20% BW) than that with the elbows extended.
• The load supported by one limb ranged from 6% BW for prayer push-ups to 60% BW for one-arm push-ups.
• The clap push-up imposed the highest Peak Force.
• Fast push-ups and push-ups with the shoulder adducted (e.g., diamond push-ups) resulted in the highest peak elbow flexion moments.
• Suspended push-ups resulted in the highest vertebral-joint compressive forces, which can be relevant in people with previous lower back injuries.
• Except for suspended push-up variations, the lateral and medial elbow-joint force, the peak force and rate of impact force are greater on the dominant limb than on the non-dominant limb.
• The push-ups with less wrist and elbow-joint stress are the ones that adopt a neutral hand position (i.e., closed fists).

Hinshaw et al, 2018 designed an interesting study to evaluate the effect of weighted plyometric push-ups on force and power. Their conclusion:

Because peak power is produced by different combination of force and velocity, push-ups without external loading may be more beneficial when a quick movement speed is desirable, and push-ups with external loading may be more beneficial when a greater force production is required.

Comparison with bench-press​

Kikuchi et al, 2017 found that push-up training induced similar increases in muscle thickness of the triceps and pectoralis major to the 40% 1RM bench press. Similar strength gains were also observed in both groups.

Gottschall et al, 2018 compared different muscles activation on bench-press and push-ups and concluded:

the common difference between closed versus open chain exercises for all three hand positions was the 50% greater activity in the anterior core muscles during push-ups. Thus, closed chain exercises may be preferred for functional training.
While a push-up requires more activation of the core, it is not as easy to increase the activation of the primary muscle groups during this body weight exercise. Stated simply, the intensity and muscle activity during a push-up is limited by body weight as well as anthropometry.

They also compared knee with toe push-ups, concluding:

the ratio of activity for each individual muscle as a percentage of total activity for the exercise was not statistically different between the toe and knee push-ups. (…) Thus, knee push-ups are an effective substitute for individuals who cannot successfully or safely complete a toe push-up, and can be incorporated in these scenarios.

Energy drinks?​

Magrini et al, 2016 showed no improvement in number of push-ups with the use of a pre-workout beverage (Redline) when compared with placebo, however both groups successfully increase number of reps.

Safety​

There are some case reports of injuries correlated with push-ups:

Meena et al, 2014 report an ulnar fracture (forearm) in a 24-year-old cricketer that used to do daily push ups for about one hour in the morning and evening.

Hassan et al, 2011 report an intraocular hemorrage (Valsalva retinopathy) in a 18-year-old man after a few rounds of push-ups.

Keah et al, 2009 reported a rhabdomyolisis case on a 33 year old, sedentary woman, that during a company motivation course was instructed by the speaker to do 90 push-ups as a penalty for losing in one of the events.

De la Fuente et al 2008 report a bilateral shoulder dislocation after a session of 100 push-ups.

References​

De la Fuente, F. A., Hoyte, C., & Bryant, S. M. (2008). Push-ups may be hazardous to your health: an atraumatic etiology for bilateral shoulder dislocation. The American Journal of Emergency Medicine, 26(1), 116.e3–116.e4.

Dhahbi, W., Chaabene, H., Chaouachi, A., Padulo, J., G Behm, D., Cochrane, J., … Chamari, K. (2018). Kinetic analysis of push-up exercises: a systematic review with practical recommendations. Sports Biomechanics, 1–40. doi:10.1080/14763141.2018.1512149

Gottschall, J. S., Hastings, B., & Becker, Z. (2018). Muscle Activity Patterns Do Not Differ Between Push-Up and Bench Press Exercises. Journal of Applied Biomechanics, 1–20.doi:10.1123/jab.2017-0063

Hassan M, Tajunisah I. Valsalva haemorrhagic retinopathy after push-ups. Lancet (London, England). 2011;377(9764):504.

Hinshaw, T. J., Stephenson, M. L., Sha, Z., & Dai, B. (2018). Effect of External Loading on Force and Power Production During Plyometric Push-ups. Journal of Strength and Conditioning Research, 32(4), 1099–1108. doi:10.1519/jsc.0000000000001953

Keah S, Chng K. Exercise-Induced Rhabdomyolysis with Acute Renal Failure After Strenuous Push-UPS. Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia. 2009;4(1):37-9.

Kikuchi N, Nakazato K. Low-load bench press and push-up induce similar muscle hypertrophy and strength gain. Journal of exercise science and fitness. 2017;15(1):37-42.

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.

Magrini MA, Colquhoun RJ, Dawes JJ, Smith DB. Effects of a Pre-workout Energy Drink Supplement on Upper Body Muscular Endurance Performance. International journal of exercise science. 2016;9(5):667-76.

Meena S, Rastogi D, Solanki B, Chowdhury B. Stress fracture of ulna due to excessive push-ups. Journal of natural science, biology, and medicine. 2014;5(1):225-7.

edit: formatting

 

[jermyn]

@this_dot

Thus, knee push-ups are an effective substitute for individuals who cannot successfully or safely complete a toe push-up, and can be incorporated in these scenarios.

Good read for all the people freaking out about knee pushups being bad etc

 

[this_dot]

@jermyn Yes! And there's a lot more on knee pushups, and the conclusions are more or less in the same line.

 

[fromgenesistorevelation]

@jermyn They are shit at promoting one to do pushups with proper form compared to incline pushups. Knee pushups don’t engage the core in the same way and force the elbows to go out to the sides because they can’t send the shoulders forward with knee pushups but rather just down because that’s easier so it engrains improper form so I don’t understand why it’s a good read (or funny). Are they better than nothing? Sure. Anything is better than nothing, sometimes.

 

[jermyn]

@fromgenesistorevelation

They are shit at promoting one to do pushups with proper form compared to incline pushups.

What aspects do you find to be shit compared to an incline Pushup?

They don’t engage the core in the same way

That doesn’t mean much. It doesn’t mean you can’t still get stronger with knee pushups.

and force the elbows to go out to the sides because they can’t send the shoulders forward with knee pushups

That’s downright untrue. Your elbows can still go back with knee pushups. I know because I’ve had trainees do it before.

To be even more fair, the incline pushup changes the angle of push from the arms to the torso. So it’s not exact either. And let’s be honest, if someone is so weak they can’t do a pushup, then just about anything will work on them at that level.

so I don’t understand why it’s a good read (or funny.)

Because people major in the minors about knee pushups being somehow so terrible when they’re still effective for progressing to normal pushups.

Are they better than nothing? Sure. Anything is better than nothing, sometimes.

It seems you have some sort of dislike for knee pushups and that’s okay. But you have to keep it objective. For example, the elbows comment is completely disprovable. If you want, I can take a video of it right now and show you. The core comment doesn’t really matter because it’s a progression to normal Pushup which it does quite well.

 

[fromgenesistorevelation]

@jermyn Okay, I'll clarify. I'm not saying you cant send the elbows back. I don't teach people to send the elbows back. I teach them to send the shoulders FORWARD so the elbows stay in the same position the entire time.

I'm not saying YOU OR I can't do knee pushups properly... i'm saying If someone else can't do pushups on the floor, it will be very challenging to be able to send the shoulders forward with their knees on the floor cause it's frankly difficult and awkward to do that. So if you're going to recommend something to the masses, it's easier to engrain the proper form with the hands elevated to make it easier as it mimics the entire movement far more closer to legit pushups.

In regards to the core, I recommend them to master the plank at least, as a pushup is like a moving plank. And yes, I agree anything will help them if they are doing nothing.

 

[mjwise]

@fromgenesistorevelation If you can't do a few proper pushups it matters fuck all what exactly do you do and with what form as long and you get sweaty and do some work.

At the "was on the sofa eating potato chips but want to get fit" level it does not matter in the slightest what do you do as long as you go out and do SOMETHING that makes you sweat for 1 hour.

By the time your body adjusts and gets past the "this madman is trying to exercise!" phase, you'll be able to do 1 pushup.

Stop thinking about form and optimal exercises when it's a couch potato. What matters is that they sweat and get used to exercises. HOW they exercise doesn't matter, what matters is that they do it at least 2 times per week (3 is preferable) for around 1 hour of sweat inducing exercise.

Doing knee pushups is so natural and logical so let them do the pushup ritual on their knees until they can do a proper pushup, it does not matter at all. Complicating things with an incline and so on is just discouraging them at the point where what they're actually doing is trying to build themselves a habit.

 

[jermyn]

@mjwise Exactly. Like there are exercises to be more particular on but a basic Pushup progression likely isn’t it. At that point, you’re so weak that you can probably go do rows and your Pushups will just magically improve

 

[mjwise]

@jermyn You can go for a walk and your pushups will improve because you swing your arms while walking.

 

[jermyn]

@mjwise Or dancing the Macarena since your arms go out in front of you like that haha.

 

[michaelphemo]

@mjwise Good points - so often I'll be training with people who are totally beginners and i will not be a ROM nazi if it is uncomfortable for them or the just can't physically achieve 'correct range of movement' - for many it's the first time they have 'bent their knees ' or lifted their legs ever... like actually ever... gradual progress is the crucial key...

 

[jermyn]

@fromgenesistorevelation

i'm saying If someone else can't do pushups on the floor, it will be very challenging to be able to send the shoulders forward with their knees on the floor cause it's frankly difficult and awkward to do that.

That hasn’t been my experience at all.

So if you're going to recommend something to the masses, it's easier to engrain the proper form with the hands elevated to make it easier as it mimics the entire movement far more closer to legit pushups.

I don’t think that’s a good claim to make because one, that might be different for different people and 2...

So if you're going to recommend something to the masses, it's easier to engrain the proper form with the hands elevated to make it easier as it mimics the entire movement far more closer to legit pushups.

Im not so sure there. Knee pushups seem have a more similar arm/torso angle. Meanwhile, incline ends up having your hands angled more down towards the hips. Plus you’re inclined and you’re not horizontal so I don’t think it’s much more similar than a knee Pushup which is the same except your knees are on the ground and not your feet.

In regards to the core, I recommend them to master the plank at least, as a pushup is like a moving plank

You can but it’s not needed. I’ve taken people from no pushups to pushups without ever needing a single plank. Core strength is great but it’s a bit overemphasized in BW strength, I’d say.

 

[mjwise]

@jermyn People will naturally use pretty much everything except their arms if they're the typical "office worker" type of a person. Everyone walks and uses stairs and gets themselves off the toilet and everyone moves around and reaches for the TV remote and bends over to do stuff and so on.

So the legs and core will be in a much better condition than their upper body which can be a complete zero.

The situation can be opposite for someone who maybe hits the gym and uses the 3 machines to buff up their arms and goes home. Their core and legs are absolutely trash but their arms are more developed.

 

[jermyn]

@mjwise Haha you know that’s funny. Your legs do get at least SOME training. Like unless you just don’t do anything, then they have to take you up the stairs or a hill or help carry something EVENTUALLY.

Meanwhile your arms canindeed get quite frail if you are a normal daily person.

 

[this_dot]

@fromgenesistorevelation These are good points, and I don't know if they could be corrected or diminished with proper coaching.

Unfortunately, there's no research on form... I hope there will be more in the future with all the tracking software out there.

I found one article that compares knee vs incline push-ups (among others). It's not really relevant for what you are saying but I figure it's interesting nonetheless.

They found that the load of normal push-ups was about 64%, knee push-ups about 49% and incline (with hands elevated 60cm) about 41%.

 

[fromgenesistorevelation]

@this_dot

Unfortunately, there's no research on form... I hope there will be more in the future with all the tracking software out there.

Unfortunately the trajectory of the shoulders can make the movement significantly harder or easier if it's being sent forward or just down. If they are going down, the elbows are often being flared out to the sides excessively when people are weak. If someone is being coached specifically to do it the proper way, all is well, but most people don't have coaches by their side.

 

[dawn16]

@fromgenesistorevelation I say it even better for engraining proper form if you do them properly. Core can be engaged the same except the stress on it is less.

 

[michaelphemo]

@fromgenesistorevelation

Are they better than nothing? Sure. Anything is better than nothing, sometimes.

Hhahahahahaha so true!

 

[clamato07]

@jermyn Its actually is. There no progression from doing knee push up to standard push up compare to doing incline push up on stairs or on a sturdy object you can raise and lower.

 

[dawn16]

@jermyn Well, cmon, the angle relative to the ground is the same as during thr normal push up. That is why I like them more than elevated push ups. Plus it can be even more difficult, mut more rewarding, but certainly not any less effective, to activate the core (abs), because, now you are taking knee crossing muscles out of the equation.