In most gyms and training circles, people are performing bench press or push-up exercises.  There is no doubt in my mind that repetitive heavy full range bench press causes many of the labral and cuff injuries among males I have seen over the years These injuries are often the attritional type – developing over many months and years.

What about push-ups?  Is the force development pattern the same?  Are they safer?  Honestly, I believe in keeping the elbow at a point at which it does not drop below the plane of the body (bench press) or move above the body (push-up).  Essentially that means keeping to a 90 degree angle or less.  Why?  Well, regardless of load, I feel the real risk is not so much in the motion itself but the very repetitive manner in which it occurs with external loads, often lending itself to acquired anterior shoulder laxity, strain on the proximal biceps anchor (think SLAP lesions) and secondary shoulder impingement.  The picture below hurts my shoulders just looking at it, and over time this technique will hurt your shoulders too.


But, I say all that to set up today’s post.  In a recent article in the February edition of the Journal of Strength & Conditioning Research, David Suprak et al. looked at the effect of position on the % of body mass supported during traditional and modified push-ups.

The study looked at 4 static positions in 28 males (about 34 years old) who were highly trained and members of the special forces or SWAT team (the up and down position for regular and modified push-ups) to determine the change in body mass (BM) supported by the upper body in different ranges of motion.  The down positions studied were at approximately 90 degrees (the lowest depth I safely recommend) and all holds were performed for 6 seconds.

modified-push-up push-ups1

The results showed:

  • Traditional group supported 69.16% of BM in the up position and 75.04% in the down position
  • Modified group supported 53.56% of BM in the up position and 61.8% in the down position
  • Percentage of change of BM supported significantly greater in the modified group b/w up and down position

With respect to muscle activation, previous studies have indicated that modified push-ups and traditional push-ups with a plus preferentially activate the serratus anterior relative to the upper trapezius – important for properly positioning the scapula for arm movement.  The push-up with a plus also brings in more activation of the subscapularis and infraspinatus (key cuff muscles for proper stabilization).

In contrast, wall push-ups tend to have a higher activation of the upper trap and serratus anterior, which may suggest that more arm elevation and less weight bearing lends itself to this pattern (serratus balances the upper trap), whereas increasing weight bearing produces a higher level of cuff activation based on more force and a greater need for glenohumeral stabilization.


Keep in mind during a traditional bench press the lowest force output is at the bottom (sticking point) and the highest output is near full elbow extension.  The results of this study indicate that with push-ups and modified push-ups the force curve is opposite that of the bench press.  The take home message here is that one must understand the load and change in BM across different ranges of motion as this will greatly factor in with rehab and training.

Specific variances may need to be made in accordance with training experience, past medical history, current shoulder pain or impingement scenarios and desired muscle activation.  In designing training programs, clinicians and trainers alike may want to employ the modified version early on to promote scapulo-thoracic stability and move to the traditional version later in the rehab/training continuum to enhance the strength of the cuff and prime movers.

There is so much to know and learn about how our body moves.  I am doing extensive study on screening, movement and body weight work right now as I am both fascinated by it and speaking at several conferences on it.  The better we know the body, the more effectively and safely we can train and rehabilitate it.  I look forward to sharing more with you and hearing from you as well.