Before you start your next push-up workout, take a moment to consider your joint health. Push-ups are one of the most popular and most enduring measures of physical fitness, but the simple exercise may be putting your joint health at risk, especially if you're over 40.
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Rotator cuff surgeries and even shoulder replacements are often required to repair an injury caused during a push-up. Look for alternative exercises to protect your joints.
What's Wrong With a Push-Up?
Push-ups aren't inherently dangerous, but like most exercises, the number of repetitions you perform should be appropriate for your fitness level and age.
John Fenlin, an orthopedic surgeon with the Rothman Institute of Thomas Jefferson University, specializes in shoulder surgery, and recommends against performing push-ups as a primary exercise. He cites the dangers of a push-up to the shoulder joint.
"The shoulder is in an awkward position, and because you're working against your body weight, which is static, you can't control or vary the resistance," says Fenlin in an interview with The Inquirer in 2012.
Protecting Your Rotator Cuff
The complex movement of a push-up can endanger your rotator cuff, a dense collection of tendons and muscles that control the action of your shoulder joint.
Out of 7.5 million hospital visits for shoulder injuries, more than half involve a tear in the rotator cuff, according to the American Academy of Orthopedic Surgeons (AAOS).
The motion of pushing up with your arms or the repetition of a reaching motion, both common to the push-up motion, are known causes of rotator cuff injuries. According to the AAOS, shoulder problems can develop slowly through repetitive and intensive exercises.
Read more: Rotator Cuff Tear Exercises
Healthy Enough for Push-Ups
Knowing whether or not your level of fitness is appropriate for a push-up regimen can help you avoid injury. For young, fit individuals in their 20's, a push-up is unlikely to cause any damage. Middle-aged individuals, or anyone with a lower level of fitness, is most at risk for a shoulder injury.
Fenlin's recommendation is to stop doing push-ups and other bodyweight exercises entirely after age 40, but concedes that a careful routine of 20 perfect-form push-ups is a good maximum. "You can be fit and toned, and chances are, you won't have to see me," says Fenlin.
Melanie Bolen, a certified personal trainer and writer for "Chicago Now" recommends a suite of push-up alternatives if the traditional push-up is placing too much strain on your joints. She recommends starting with a push-up motion in the standing position, with your palms placed flat on a wall.
Once you've begun developing core strength, you can gradually increase the angle of your body by performing push-ups against a countertop. A final alternative to a traditional push-up is the knee push-up, which will develop arm and shoulder strength.
"Put as much of your body weight as possible forward into your arms so that you work on building the strength to progress," says Bolen. Keeping your core tight and your shoulders steady is key to avoiding injury. A routine of push-up alternatives can help you meet your goals without putting your joints at risk.
Read more: Proper Push-Up Technique