Push-Ups: Elbows In vs. Out

Proper push-up form strengthens your muscles without damaging your joints. Incorrect body mechanics when doing a push-up, such as flaring your elbow out, can lead to pain and injury in the shoulder, elbow and wrist and limit your muscle gains.

Different arm positions in push ups work out different muscles. (Image: Mireya Acierto/DigitalVision/GettyImages)

Push-Ups: Elbows In or Out?

To do a push-up, place your hands flat on the ground slightly wider than shoulder-width apart. Keep your core engaged, your spine in a neutral position and your body in a straight line throughout the movement. When you lower your body, the ideal push-up elbow angle is 45 degrees out from the midline of your body, advises the FBI. In this position, your elbows will be stacked above your palms.

At the bottom of the push-up, aim to have your elbows bent at a 90-degree angle before straightening your arms. Alternatively, if you need to rest briefly, lower all the way to the floor, then push back up, advises Harvard Health Publishing. Be sure you are controlling your movment and not allowing your body to fall to the ground.

Warning

If you have a history of shoulder injuries, doing a full push-up may be painful. If you experience pain, stop and make sure your form is correct. If the pain continues, stop and consult your doctor.

One common mistake while doing push-ups is allowing your back to arch. This throws your body out of alignment and increases your risk of back injury, advises Harvard Health Publishing.

Pain and Injury From Push-Ups

Failure to use proper push-up technique increases your chances of injury from doing push-ups. You may also develop issues over time due to the repetitive motion of push-ups, especially if you do them every day without allowing time for your body to rest and recover.

Warning

If you experience stiffness, pain, reduced range of motion in your joints or feel like your shoulder may pop out of place, you may have an injury that requires medical attention. Stop exercising and consult your doctor.

Shoulder injuries from push-ups are common, but you may also develop overuse injuries or pain in the elbows and wrists. Your doctor will determine the type and severity of the injury by doing a physical exam and imaging tests advises MedlinePlus. Some common injuries include:

  • Muscle strains
  • Tendonitis, or inflammation of the tendons
  • Bursitis
  • Tear in the rotator cuff

In many cases, these injuries can be treated home with rest, ice, compression and elevation, or RICE. Over-the-counter anti-inflammatory medications may help relieve swelling and pain. If you continue to workout with a shoulder injury, your condition will likely worsen and may require surgery.

Increase Core Stability

Push-ups are a challenging exercise and failing to use proper form can create pain and damage your joints. If you can't yet do a proper push-up, start doing some other exercises to build up your strength and stability. To develop the strength to maintain the straight body position necessary to do a proper push-up, the FBI recommends the following core stabilization exercise.

Begin in a plank position with your elbows on the floor directly under your shoulders and your forearms resting on the floor. Keep your core muscles tight and your body in a straight line from your head to your feet. Your spine should be in a neutral position.

Maintaining the plank position without rotating your body, raise one leg off the ground and hold for 10 to 15 seconds. Repeat with the other leg. Then, raise one arm and hold it straight in front of you for 10 to 15 seconds. Repeat with the other arm.

Finally, progress to lifting the left arm and the right leg at the same time. Then repeat with the right arm and left leg. When you are first starting out, this step may be too challenging. Continue to practice with the single leg and arm until you are able to do this final exercise. Complete three to five sets of the stabilization exercises.

Build Muscle Strength

Three of the main muscle groups used when doing the push-up are the pectorals, triceps and deltoids. Use weights to target and strengthen these muscles so that you can bring it together for a proper pull-up. Start with a weight that is challenging, but allows you to complete the recommended sets with correct form. Slowly increase the weight as you progress with your workouts.

Target the triceps by lying on your back on the floor or a bench. Hold a dumbbell in each hand and point your elbows toward the ceiling, holding the weights near your head. Without changing the angle of your upper arm, straighten your elbow to raise the weights to the ceiling.

To develop your pecs, lie on your back on the floor or a bench. Hold the dumbbells slightly above your chest and slightly wider than chest level then extend your arms and press the weights up. For each of these exercises, perform two to three sets of 10 to 12 repetitions.

To target the deltoids, start in a standing position with feet placed shoulder-width apart. Hold dumbbells or a weight plate in front of you at thigh level. Keeping your arms straight, raise the weight until it is at eye level. Then return to the starting position. Perform two sets of eight to 10 repetitions.

Push-Up Variations and Modifications

As you build your strength, you can also try some easier push-up variations as you build up to a regular push-up. The most well-known variation is the modified knee push-up. Keeping your hand and body position the same, simply lower your knees to the ground and perform the push-up. Other alternatives include wall push-ups or doing push-ups with your hands on an elevated bench or bar.

When you master the push-up and are ready to increase the intensity of your push-up workout, try some more challenging variations. Some harder variations suggested by ExRx.net include push-ups with your feet elevated on a bench or platform or adding weight by wearing a weight vest as you do push-ups.

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