TYPE OF EXERCISE
Upper-body strength and power.
Pectoralis major (sternoclavicular fibers), pectoralis minor, deltoid (anterior fibers), serratus anterior, and triceps brachii.
BENEFITS OF THE EXERCISE
Many variations of the traditional push-up have been developed to improve the effectiveness of this exercise (5,11–13,18,26). Different techniques such as changing hand placement (13) and integrating labile support surfaces (11,17) alter the muscle activity in the pectoralis major and triceps muscles. Performing push-ups with the hands in a narrow base position is reported to elicit greater electromyography (EMG) activity in the pectoralis major and triceps muscles when compared with wide base and shoulder width hand placements (4). Elevating the feet (above the hands) during the push-up increases muscle activation of the serratus anterior and upper trapezius (16) because of an increase in ground reaction forces up to 74% of one's body mass in comparison with 66% for the regular push-up (7).
Other authors have illustrated a progression of this exercise that includes performing the exercise between 2 benches (3,5). Using integrated EMG, previous texts (3) report that this variation recruits 88% of the pectoralis major muscle when using a load of 80% of the athlete's 1 repetition maximum (1RM) in the push-up exercise between the benches for 5 reps. However, there is a lack of definitive experimental data that support these values. Performing the push-up between 2 benches does allow for a greater range of motion, thus engaging more of the pectoral fibers. Despite the potential for greater joint excursion using this variation, mechanisms to increase the external load during the exercise have not been described. Therefore, the purpose of this column is to describe the methods and benefits of increasing external load during a push-up between the 2 elevated surfaces. This description will improve the exercise portfolio for practitioners targeting improvements in upper-body strength and power. The intensity of this exercise can be increased by attaching a rubber-based resistance band (RBR) to the body (Figures 1 and 2), by wearing a weighted vest (Figures 3 and 4), or by hanging a dumbbell from a dip belt (Figures 3 and 4). The former technique is a form of variable resistance training, which changes the external resistance throughout an exercise's range of motion (19). Current forms of variable resistance training are used to match the strength curve of multi-joint exercises with ascending human strength curves such as bench press and squat where the force production capabilities occur at the apex of the lift (19). In theory, this would maximize force production throughout the range of motion and increases in strength would be achieved (9).
RESISTANCE BAND LOADING
There is a notable change in muscle activation patterns when performing resistance exercises at 30–45% 1RM with the intention of moving the load with maximal contraction velocity (21). Specifically for the push-up, higher maximum force and faster rate of force development are seen when performing the traditional push-up as fast as possible as compared with fall push-ups and clap push-ups (12). It is plausible that performing the push-up in the rapid manner while adding RBR will enhance eccentric loading. Numerous studies support the benefits of RBR coupled with dynamic resistance exercise to effectively increase lower body peak force, peak power (22,24), EMG activity in the agonist muscle (6), and upper-body strength (2). Using RBR provides an increased prestretch intensity, which effectively uses the fascicle-tendinous elastic tissue properties of skeletal muscle (1,15) during stretch-shortening cycle activities. This produces a neural adaptation of simulating afferent fibers to the spinal cord, which results in an efferent impulse sent to the extrafusal fibers, thus increasing motor unit recruitment (1,20). RBR provides a large prestretch that increases the acceleration of the load during the initial phase of movement when compared with a constant externally resisted movement with an equivalent load (19). The greater acceleration during the eccentric phase may result in greater eccentric forces and potentially greater stretch-shortening cycle enhancement. Multiple studies indicate that elastic energy derived from rapid stretch-shortening cycles improves work, power, and efficiency for a variety of activities (23,25). These findings are substantiated by the fact that isokinetic exercises that provide a rapid eccentric phase also increase muscle size (8).
Practitioners have expressed opposing perspectives regarding variable resistance training with elastic bands (9). Advocates state that exercises with ascending strength curves may benefit from band training because this modality promotes peak force production where mechanical advantage is at its greatest (i.e., full extension) and elicits greater accelerations at the initial phase of eccentric contraction. However, caution should be employed when selecting RBR strength. If eccentric loading is too high, then a long amortization phase will occur and elastic energy will be released and lost as heat (25). This will lower force output in the concentric phase. Therefore, if the time between the eccentric and concentric phases is minimized, the stretch-shortening cycle will be optimized and muscular contraction will be more powerful (10,25). Optimal tension for this exercise should be a band level of greater resistance, approximately levels 4–5 out of a maximum level 6. In the figures shown here, this is a level 4 intermediate resistance band from Iron Woody, LLC (Olney, MT).
WEIGHTED VEST LOADING
Bodyweight exercises such as push-ups may be disadvantageous because more advanced lifters consider this an elementary exercise without resistance required to provide any benefit (14). An advanced variation is performing this exercise with a weighted vest. Additional weight can also be added by attaching a dumbbell to a dip belt hook as depicted in Figure 4. This will allow higher trained individuals to use heavier loads, thus providing a more challenging stimulus to increase muscle strength.
- Arrange 3 benches. Align 2 of the benches in parallel approximately shoulder width apart. The other bench is aligned perpendicular to and behind the other 2 benches. For faster or easier setup, this exercise can be performed between 2 step benches or plyo boxes (Figure 4). The elevated surfaces play an important role in permitting full range of motion of the elbow and shoulder during the eccentric phase of the exercise.
- Wrap the RBR around the upper body and loop it through one time. Hook the carabineer through the loop. A large carabineer is likely needed for this exercise.
- Kneel on the floor and hook the carabineer to a heavy barbell or dumbbell on the ground. This serves as the anchor. Depending on the strength of the elastic band, a heavier barbell may be needed. Figure 2 shows a 100-lb barbell with two 40-lb dumbbells on top of it.
- Support yourself in the prone position while placing the right hand on the right bench and the left hand on the left bench and then placing both feet on the rear bench.
- Keep the arms extended and hands shoulder width apart while contracting abdominal area and maintain neutral spine position (Figure 1).
DESCENT (DOWNWARD MOVEMENT)
- Inhale and bend the elbows to bring the center portion of the chest to the top of the 2 bench pads achieving a stretch (midchest area) without arching the back. The elbow angle during the descent should reach slightly more than 90°.
- As one becomes more proficient with the exercise, the speed of the eccentric phase may be increased.
ASCENT (UPWARD MOVEMENT)
- Maintain a rigid and neutral spine without excessive lumbar lordosis or thoracic kyphosis.
- Explosively push off the benches by minimizing the amortization period when transitioning from the eccentric to concentric phase. Push the body upward by extending the elbows until the starting position is reached.
- Exhale as you begin pushing back up to the start position.
- Keep the elbows slightly bent at the top of the movement to avoid hyperextending this joint.
- Perform the desired number of repetitions as quickly as possible in a controlled manner.
Proper form for the elastic band and weighted vest push-up between the benches is depicted in Figures 1–4, as well as in Supplemental Digital Content 1 (see Video, https://links.lww.com/SCJ/A115).
Multiple variations of the push-up have been examined to assess differences in muscle activation and recruitment patterns of the upper body (4,5,11–13,18,26). Practitioners need to possess an adequate knowledge of the different variations to optimize the challenge on the target musculature without compromising proper form and risking injury (5). This exercise can assist those in selecting optimal progressions that involve dynamic approaches to performing the push-up. When the athlete establishes a good baseline technique for this movement, heavier elastic bands can be introduced or more weight can be added to the weight vest for progressive overload.
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