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Push-Up Plus

Draftmotor-control95%intermediate⬤ strong evidence

View FHIR resourceFHIR R4 ActivityDefinition — the interoperable form of this exercise

Positions & Range of Motion

Start: Prone plank/push-up start, hands under shoulders, body straight from crown to heel
End: At the top of the push-up, scapulae fully protracted (upper back rounds, serratus wraps the ribs), chest pushed maximally away from the floor
Range of Motion: Full push-up elbow flexion/extension plus additional end-range scapular protraction (the 'plus')

How to Perform

Standard push-up with an additional scapular protraction at the top (the 'plus'). Activates serratus anterior at high amplitude and lower trapezius over upper trapezius. Ideal for scapular stabilization. Addresses scapular winging and promotes upward rotation essential for overhead activities.

Watch on YouTube↗

Opens a YouTube search for “Push-Up Plus”

Starting position: prone

Coaching Cues

1
Wide shoulder blades at the top — serratus wraps the ribs
(verbal)
2
Push the floor away until the upper back rounds
(verbal)
3
Drive the chest as far from the floor as possible
(verbal)
4
Body stays straight as a plank from crown to heel
(visual)

Evidence-Based Dosing & EMG Data

Recommended Dosing

3×8 at 8-RM, 3 days/week

EMG Activation Data

High serratus anterior activation with favorable LT/UT ratio [Andersen 2012, Kibler 2008]

Muscles Involved (10)

Primary Movers

Serratus Anterior— High amplitude activation — the 'plus' targets SA specifically

Lower Trapezius— Activated over upper trapezius

Secondary Movers

Pectoralis Major— Push-up component

Triceps Brachii— Elbow extension in push-up

Lengthened / Stretched

Rhomboid Major— AUDIT: The end-range protraction 'plus' maximally lengthens the retractor rhomboid major.

Middle Trapezius— AUDIT: Scapular protraction lengthens the retractor middle trapezius.

Biceps Brachii— AUDIT: Elbow extension in the push-up lengthens the elbow flexor biceps brachii.

Brachialis— AUDIT: Elbow extension lengthens the elbow flexor brachialis.

Brachioradialis— AUDIT: Elbow extension lengthens the elbow flexor brachioradialis.

Synergists & Assistors

Anterior DeltoidSynergist

Easier Variations ↓

Wall Push-Up Plus

Perform against a wall. At the end of the push, push further to protract the scapulae. Much lower load.

Kneeling Push-Up Plus

Perform on knees to reduce body weight percentage. Focus on the plus motion at the top.

Regress to wall-push-up

AUDIT: Regress to the wall push-up (retaining the plus) to reduce body-weight load while preserving scapular protraction (listed as push-up-plus regression).

Harder Variations ↑

Push-Up Plus on Unstable Surface

Perform with hands on a BOSU or stability ball. Increases serratus anterior and stabilizer demand.

Single-Arm Push-Up Plus

Elevated surface, single-arm push-up with plus. Advanced scapular stability challenge.

Target Movements (4)

Scapular ProtractionScapulothoracic Articulation

Elbow ExtensionHumeroulnar Joint

Shoulder FlexionGlenohumeral Joint

Scapular Upward RotationScapulothoracic Articulation

Why This Exercise Matters

Everyday activities this exercise helps you do — essential means it directly trains the capacity the task needs:

Reaching Overhead Pushing Up from Chair Sustained Overhead Work

Goals This Helps With

Rehab, performance, prevention, and mobility goals this exercise supports — essential means it's a cornerstone:

Subacromial Shoulder Painrehab Rotator Cuff Tendinopathyrehab Shoulder Injury Preventionprevention Improve Overhead Pressingperformance

Research Notes

EMG: high serratus anterior activation, favorable LT/UT ratio [Andersen 2012, Kibler 2008]. Addresses scapular winging and promotes upward rotation [Kibler 2008]. Dosing: 3×8 at 8-RM, 3 days/week [Mulroy 2020]. Closed-chain exercises like planks appropriate after 12+ weeks post-surgery [Kennedy 2020].

Evidence Sources (8)

📄
Therapeutic Exercise: Foundations and Techniques— Kisner C, Colby LA, Borstad J
Therapeutic exercise foundations for Push-Up Plus
📄
ACSM's Guidelines for Exercise Testing and Prescription— American College of Sports Medicine
ACSM exercise prescription guidelines for Push-Up Plus
📄
Scapular Muscle Activity From Selected Strengthening Exercises Performed at Low and High Intensities— Andersen CH, Zebis MK, Saervoll C, et al.
Scapular Muscle Activity From Selected Strengthening Exercises Performed at Low and High Intensities — evidence for Push-Up Plus
📄
Electromyographic Analysis of Specific Exercises for Scapular Control in Early Phases of Shoulder Rehabilitation— Kibler WB, Sciascia AD, Uhl TL, Tambay N, Cunningham T
Electromyographic Analysis of Specific Exercises for Scapular Control in Early Phases of Shoulder Rehabilitation — evidence for Push-Up Plus
📄
Shoulder Muscle Activity and Function in Common Shoulder Rehabilitation Exercises— Escamilla RF, Yamashiro K, Paulos L, Andrews JR
Shoulder Muscle Activity and Function in Common Shoulder Rehabilitation Exercises — evidence for Push-Up Plus
📄
Comparison of Pectoralis Major and Serratus Anterior Muscle Activities During Different Push-Up Plus Exercises— Park KM, Cynn HS, Kwon OY, et al.
Comparison of Pectoralis Major and Serratus Anterior Muscle Activities During Different Push-Up Plus Exercises — evidence for Push-Up Plus
📄
Serratus Anterior and Upper Trapezius EMG Analysis of the Push-Up Plus Exercise: A Systematic Review and Meta-Analysis— Kang FJ, Ou HL, Lin KY, Lin JJ
Serratus Anterior and Upper Trapezius EMG Analysis of the Push-Up Plus Exercise: A Systematic Review and Meta-Analysis — evidence for Push-Up Plus
📄
EMG Analysis of Shoulder Muscles During Press-Up Variations and Progressions— Herrington L, Waterman R, Smith L
EMG Analysis of Shoulder Muscles During Press-Up Variations and Progressions — evidence for Push-Up Plus