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I'm 25 YO female. Turns out, all this time I had been depending more on arm strength than using chest and core strength to do push ups. This, in addition to sloppy form in side planks, has caused some shoulder injury. Different docs say different things. The latest diagnosis is bicep tendinitis.

I place hands at shoulder width distance and don't flare my elbows. I don't feel tension in the right muscles. I know it might sound very silly but I just want to know how I can correct myself in push ups. Any cue to help engage the right muscles?

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First guess would be "I don't flare my elbows" is a lie you're telling yourself. Get into a position where your arm is blocked so that your forearm is forced to stay completely vertical and your elbow is unable to move in space. (e.g., go to the outside corner of a wall and press one forearm back into the wall so that it can't move around.) You should then absolutely feel the chest work (or discover that you don't have enough real shoulder extension to actually get into the bottom position with the chest activated.) –  Affe Oct 24 '13 at 19:02
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3 Answers

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I see a couple things going on here with your question. First to answer the headline question:

The further away from your body you have your hands, the more you involve your chest. The trade-off is more stress on the shoulders and pectoral tendons.

This bit of advice also works for bench press. To further activate your chest, concentrate on tensing the pectoral muscles while you are at the top for a second each rep.

Dealing with Tendinitis

Tendinitis is a warning that either there is something wrong with your form, or that you are not exercising the antagonist muscles enough. For example, if you are doing lots of push ups which train your triceps, but not doing any type of rows/pull ups/flexed arm hangs to strengthen your biceps. If you are sticking with body weight exercises, you can do body weight rows by laying on the ground and pulling yourself up to either a bar or a table. You could even use a broom handle across two chairs.

By your description, you may be dealing with both a form problem and unbalanced training. Balancing your training is easy. Just add the antagonist work to what you are doing. Initially, you will want to do more antagonist work than the push ups, but eventually you'll want to do equal volume on them. The form is more challenging.

  • Perform planks to teach your body to remain rigid. Lay on your stomach and get up on your elbows. Tighten up your entire body, in particular your abdominal muscles. You should be able to hold that position for at least 30 seconds at a time. If not, work on these until you can.
  • Find a comfortable hand position that is slightly away from your body, but not so far as to cause discomfort in your shoulders. The position should help you engage your pectorals and your arm muscles while keeping the body plank rigid. Slight elbow flare is acceptable. Just make sure you are well supported.
  • Only perform good reps. If you feel your body starting to fatigue and your form start falling apart, stop the set. You can work on adding more good push ups over time.
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Yes, besides form, I can also see myself doing very little back/pull exercises when I look back. Can you tell me one more thing Berin? I find myself keeping my shoulders sloppy and sagging down when doing front/side plank or rising from a push up. Only recently I discovered this one and now I think I can consciously push my body away from floor to keep shoulders tight (although I haven't tried doing this because I still have pain to work with). Could this (sagging shoulders) also be a reason for my chest not getting engaged in push ups? Any thoughts? –  Swati Priyadarsini Oct 26 '13 at 3:59
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That is definitely a contributing factor. When exercising it is best to keep your body tight and not allow any sagging. Aside from inviting injury it actually undermines the exercise as well. Perhaps scapular push ups might be a good idea to train your shoulders how to get involved as well. –  Berin Loritsch Oct 27 '13 at 22:30
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You've missed some important things here:

Try to bring your shoulders back and down and keep that tension over the full range of motion. Imagine that you have a chestnut between your shoulderblades and you'll have to keep it over the complete exercise. If you doing it right, your elbow-pits are facing away from you and your hands will come close to your rip cage and NOT in the height of your shoulders when letting yourself down on the floor. After you've pushed up, try to squeeze/contract your chest muscles and hold that position for about a second.

As you said correctly, try not to flare out your elbows while letting your torso move towards the ground. Position your hands shoulderwidth apart. The closer your hands are moving toward the more you'll work your triceps.

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Keeping the shoulder back would most likely result in collapsing in the upper back and contribute to another shoulder injury, especially for females. In my opinion it is much more useful for most people to work with the shoulders down and forward (relative to the anatomical position) as it activates the front of the body, and will prevent the body from collapsing. There is not much point in tensioning the back in the push-up, because it is impossible to 'collapse up'. Pushing the shoulders down and forward is unnatural for most women, this is why they should work on in consciously. –  BKE Oct 23 '13 at 10:02
    
Absolutely wrong. Why should a woman train different like a man? Generally with your method you will leave the (natural) thoracic extension when bringing the shoulders forward. This leads to shoulder dislocations and imbalances. Check this video and you will see the difference: youtube.com/watch?v=uxTChOEdHoA –  mchlfchr Oct 24 '13 at 7:32
    
Good advice for bench press, not so good for push-ups and other bodyweight arm balancing exercises, imo. They are different in the sense that in the push up the spine stabilization element is much more prominent. Hence the difference in technique. The OP asked how to 'engage the chest'. Thoracic extension releases the chest in the high position of the push-up, and the arm movement won't help this much (flexion happens with the help of gravity, and there's not much adduction involved). It's no different for men, except they have naturally stronger shoulders, while women often hyperextend. –  BKE Oct 24 '13 at 9:07
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It is quite difficult to learn correct technique when you're already injured. So have a few weeks of rest first. Then start with some simple exercises. I give you some ideas grouped by joint complexes (shoulder, spine, hips, wrists etc.) but these all assume you're not injured so really wait until the pain is fully gone.

  1. Shoulders: take the kneeling push-up position. With the arms fully straight, push the floor away from you. Lift between the shoulder blades. Pull your shoulders down in the direction of your hips. Relax the neck and the face. All this should make your upper back a little round and lengthened, the chest muscles engaged. The same instructions apply for the plank.

  2. Hips: in the kneeling push up, make as if you want to pull your knees towards your shoulders (forward and up). Don't really move your knees, just make the effort. Breathe into your abdomen. This should lengthen the lower back and engage the core. The same instructions apply for the plank.

  3. Wrists and hand: spread the fingers and push them into the ground, as if you are trying to make a fist.

If you progress to lifting the knee or bending the hand, you have to maintain the same activations. If you cannot, then you must make the push-up easier by using incline (eg. a chair). When you bend the elbow, it must move backwards along your body, not to the side. Going down, the shoulder blades will move closer together, going up, move them away from each other. Keep the movement slow and controlled, only go as deep as you can control the movement. A good exercise is the scap push-up, it teaches how to work with the shoulders while the arms are passive.

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