Pete McCall by Pete McCall
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The push-up has long been used to develop strength in the arms, shoulders and chest. However, the push-up is also a great core exercise. During the exercise, the trunk and hips should remain as stable as possible to create a lever for the working muscles. The deep core muscles, such as the transverse abdominus, become actively engaged to stabilize the spine and pelvis so that the force generated by the pectoral, deltoid and triceps muscles can move the body around the axis of rotation at the toes (or knees, for modified push-ups).

This is one reason why the push-up is often done incorrectly; many people simply don’t know how to activate all of the muscles required to successfully complete the exercise. In this article, you’ll learn how to develop a consistent method of progression that can help your clients learn how to successfully perform this beneficial exercise.

Before one can learn the push-up, it’s important to first develop the strength of the deep core muscles to maintain stability around the spine so the arms and shoulders can move the body. This is the role of the first three exercises described below—they create the foundation. Have your clients perform these exercises consistently for at least four to six weeks before progressing to the more challenging exercises described later in this article.

Quadruped
The first step is to develop the proper strength and placement in the wrists and shoulders. This can be done in a quadruped or all-fours position, which reduces the amount of weight directly on the arms. Position the wrists under the shoulders, the knees directly under the hips and keep the spine in a neutral position. Push the hands into the floor while pushing the upper back and shoulders up to the ceiling. The goal is to push the hands down into the floor while pressing the shoulders in the opposite direction to create tension in all of the muscles. The hands have a high number of sensory nerve endings; when they are placed directly on the floor for a plank, the pressure of the hands pushing into the floor helps to engage and activate many of the muscles responsible for shoulder strength and spinal stability. Hold for 20-30 seconds, rest for 30 seconds and repeat for three to four repetitions. This exercise should be performed as part of warm-up when working on improving the push-up.

Modified High-plank
A common way to do the plank exercise is with the elbows on the floor directly under the shoulders. This position does not allow for proper strength to develop between the hands, shoulders and the muscles responsible for stabilizing the spine (see above). Doing a modified plank with the knees on the floor (instead of the feet) and the hands on the floor helps strengthen the connection between the palms, shoulders and spine by using a shorter lever (the distance between the hands and knees versus that between the hands and feet), which results in less resistance. This is helpful for developing the strength to do a push-up. Start by holding for 20 seconds, gradually progress to holding the modified plank for 45 seconds. After each plank, have the client rest for the same amount of time he or she held the plank and perform three to four sets. Once the client can do four sets of 45 seconds, he or she is ready for a greater challenge.

High Plank
The high plank is basically the “up” position of the push-up; practicing high planks helps develop the wrist, shoulder, upper-back and core strength to maintain a stable body throughout the entire range-of-motion of the exercise. Place the hands a little wider than shoulder-width apart so that the thumbs are pointing toward the midline of the body and the fingers are pointed the same direction as the head. To increase stability while pushing the hands into the floor, rotate the elbows to point back toward the feet to increase the strength and stability in the shoulder joints. Instruct the client to squeeze the thigh and glute muscles to increase stability around the pelvis (this is a more effective cue than “contracting the core,” which doesn’t address any specific muscle). Start by having the client hold the high plank for 20 seconds and rest for the same amount of time as the plank; perform three to four sets. Gradually increase the time up to 45 seconds. Once the client can hold a high plank for four sets of 45 seconds, it is time to work harder.

During the lengthening phase of muscle action, there is more tension within the muscle fibers so the muscle is capable of generating higher levels of force. Placing the emphasis on the lengthening phase of muscle action by practicing the lowering phase of the push-up can help develop the strength to control movement of the body through the entire range of motion. Have your clients perform the following exercises for three to five weeks before progressing to the full range of motion of the push-up.

Modified Negative Push-ups
The word “negative” is used here because the weight is going down (as opposed to up), which causes the muscles to lengthen and increases the tension in the fibers. This is an effective strategy for initiating strength gains. Start in a modified high-plank position with the knees on the floor and the hands slightly wider than the shoulders. Slowly lower the body to the floor for a count of five or six seconds. At the bottom of the movement, encourage your client to return to the starting position in a way that feels comfortable to him or her. Working on the lengthening phase of muscle action can help develop the strength that will be used later for the complete range of motion of the push-up. Begin with two sets of six to eight repetitions, rest for 45-60 seconds after each set. Gradually add one or two repetitions each workout until the client can perform 10-12 reps with control. Have the client work up to completing four sets, resting 90 seconds between each one.

Negative Push-ups
Once your client can easily perform 10-12 reps of negative modified push-ups, it’s time to progress to the full version. Assume a high plank position with the feet approximately shoulder-width apart. Keep the hands pressed into the floor and the thigh muscles squeezed while slowly lowering the body toward the floor. At the bottom of the movement, place the knees on the floor and return to the starting position. Start with two sets of six to eight repetitions and progress to performing two to three sets of 10-12 reps.

Modified Push-ups
Many people are familiar with modified push-ups, but these are obviously not the best starting point for learning the push-up, especially not for those who first need to develop a foundation of core strength. While the normal push-up has the feet and hands as the points of contact, bending the knees and placing them on the floor shortens the lever of the body significantly thus reducing the amount of resistance. Place the knees together on the floor so that they are bent and the feet are in the air. Keep the hands about shoulder-width apart with the fingers pointed away from the knees. Slowly lower the body to the floor and then push the floor away to return to the original starting position. To increase stability of the core, encourage your clients to grip the floor with the hands and squeeze the thighs to engage the deep spinal stabilizers. Start with two sets of six to eight repetitions and rest one minute between sets. Gradually progress to performing 10-12 repetitions and then start adding sets. Once your client can perform three to four sets of 10-12 reps of modified push-ups, it’s time to progress to full push-ups.

Full Push-ups
To perform a full push-up, start in a high-plank position with the legs hip-width apart. Press the hands into the floor with the fingers pointed away from the feet. Contract the thigh and glute muscles to increase stability and slowly lower the body toward the floor. Press the hands into the floor to return to the up position. Start with two sets of five to six repetitions, resting for one minute between sets. Gradually add repetitions until the client can perform two sets of 10-12 repetitions and then start adding sets.

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