Pain with Push Ups
Form matters!
Push-ups are a high-level exercise. They work not only on your chest and triceps, but spinal stabilization, i.e. activation of your back and abdominals. In other words, it is a full-body exercise. Being against gravity increases the load on our body. If you think of various positions you can do pushups in: standing, inclined, declined or horizontal, the position influences the challenge on the body. If you are doing 100’s of push-ups consecutively, you are likely doing it incorrectly. If you are not feeling it where you should, you are likely doing it wrong or the load is too high. Sometimes reducing the load actually makes you feel more and you feel you are working out harder, believe it or not!
You should be able to have good scapular control (i.e. shoulder blades), glenohumeral joint positioning (i.e. shoulder) and good spinal alignment. If someone was to place a stick along your back from head to tail, you should have multiple contact points, including the back of your head, mid-back and butt.
The biggest compensations I see:
Sinking belly, collapsing into spine; equals poor core engagement
Dangle head –that is what I call it when your head dangles below the rest of your body in the plank position; indicating poor motor control or cervical spine extension weakness
Sinking chest—weakness in upper back or lack of shoulder strength
Winging scapula, i.e. can place hand underneath inner border of the shoulder blade; indicating poor scapular stabilization; probable serratus anterior weakness
Locking out of elbows in plank position (i.e. hyperextending), possible joint hypermobility, in addition to inadequate strength in shoulders and arms to support the body, where you end up relying on your ligaments and joint locking for stability; which overtime, can wear out your joints.
Push-ups are a great exercise when done correctly. Often breaking up the exercise into multiple components can result in improved success with push-ups, i.e. be able to do a chest press properly, a hand plank, etc. If you are having pain with this exercise, it is best to get evaluated by your physical therapist to help resolve your pain and restore optimal function.
